Hello Dr.

First off - I’m sure you can see my prior questions and I apologize for revisiting the forum again so soon.  However, I was presented with some conflicting information and I would like to get it verified.  As you can see from my prior questions (#7855)(#7886), my exposure was low risk, yet I’ve experienced several unexplained symptoms.  To ease my anxiety, I tested frequently with Oraquick and had 2 4th generation blood drawn tests.  One at 55 days, then 2nd just last week at 84 days (12 weeks).  All tests were negative.  I was also tested for all other STD’s as well - all negative. 

1)    I tested at a health department for the 4th generation tests and the first time it was done the nurse advised me that at 8 weeks the tests are highly accurate.  He said that I could always return at a later date and be tested for peace of mind, which I did last week.  The nurse that did the test then told me that I was only about 80% conclusive at 12 weeks and she even asked the provider on call to verify that.  She mentioned that since I had an exposure with someone that I had no background with that I needed to be tested every 3 months up until a year in order to be clear.  I was floored - what’s the purpose of a 4th generation test, if it’s going to take that long to be conclusive?  Have you ever heard of such advice??

2)    Having heard that from the nurse I started investigating the 4th generation tests the best I could.  The only thing that I could see as to why they would have said to keep coming back for testing is that the tests are helpful in finding the P24 antigen early, but that antigen usually disappears quickly after a few weeks.  It would seem that the test would then be the equivalent of an antibody only test (less effective after the antigen disappears).  Am I way off base with that or is the test as good at week 12 as it would be for early detection in week 3?  

3)    As I’m sure you can see from my last questions - I’ve had white tongue, loss of appetite, nausea and persistent diarrhea for the last 2 months.  I was on Doxycycline for 20 days prior to having those symptoms, but as you know they also mirror some ARS symptoms.  The million-dollar question in mind is that if I did have HIV, would my tests have shown reactive?  Could the tests have missed HIV if the issues I have been experiencing were actually from HIV…I keep reading that test results overrule symptoms, but again with what I was told at the health department certain cast doubt in my mind. 

4)    Have you ever had dealt with patients that have experienced extreme trauma of the fear/anxiety of HIV exposure testing?  I just started working a couple of days ago with a therapist on my fears and subsequently started medication as well.  As mentioned above I have had chronic diarrhea for 2 months and my PCP and I cannot determine the root cause yet.  Stool studies are negative, so it is somewhat looking like anxiety from the HIV fear.  Any experience dealing with patients in those scenarios in the past?

Thank you again and I assure you that I’m only back because of the immensely conflicting information that I received from the health department.