[Question #8197] Follow-up of [Question #8140]

47 months ago

Dear Doctors,

I have a follow-up question based on my previous question. Let me briefly explain my most recent exposure again: I received unprotected oral sex and had protected vaginal sex with a sex worker on 10/07, and I had a duo test on 21/08 which is negative. I become anxious again(unfortunately) because I have some confusion about calculating window periods.

My exposure happened at 5-6 pm on 10/07 and my test was taken at 4 pm on 21/08. So that is 41 days and 22-23 hours. I know you said that 6 weeks is conclusive but in my case, is there a difference between 42 full days and 41 days 22 hours? I really don't want to take any further tests, so my question is:

So are you 100 % sure that my test result is absolutely conclusive and no further testing is needed ever? In other words, can you say 100% sure that I am not infected by HIV?

Sorry for (maybe stupid) questions but I really need some reassurance from you. Thanks so much for your help and your service on this website.

Edward W. Hook M.D.

47 months ago

Welcome back to the forum. I’m sorry my previous responses which stated that your test results were conclusive were not sufficient to address your anxieties. My assessment and responses are unchanged. There is no need for further testing. The 42 day/6 week benchmark is somewhat arbitrary and a day or two earlier really makes no meaningful difference. Further, as you have already mentioned, your exposures were condom protected Vaginal sex and receipt of oral sex. Condom protected sex is safe sex and no one has ever been proven to acquire HIV from receipt of oral sex. You are not going to be the first.

You can be confident you did not require HIV from the exposures you have described. There is no need for further testing. You have proven that you were not infected. Believe your test results. Your results are entirely conclusive. I encourage you to move forward without continuing concern. I hope this for the reassurance is helpful. EWH

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47 months ago

Thank you so much for your reassurance. It really makes me feel relieved. I have a question, just for peace of mind:

Do you still consider a 4th generation test taken at 41 days 22hours conclusive even if the exposure was high risk ?(for example unprotected anal sex with HIV positive people)

I just worry that if there were something risky happened for example the CSW had mouth uncler or blood in mouth when performing oral sex on me, or there were some unnoticed skin damages on my penis.

Thanks!

Edward W. Hook M.D.

47 months ago

Repetitive. I said above that a few hours makes NO difference. Your results are conclusive. Believe them! EWH ---

47 months ago

Thank you so much for your reply! I have one last question: I saw claims you made that there is no meaningful difference between 45 days and 6 weeks. And you also claimed that you recommend changing the window period from 28 to 6 weeks because a few cases happened to turn positive between 28 and 45 days. Then reasonably, I think there maybe(but no data available?) some cases only turned positive between 42 and 45 days? Otherwise, why the CDC says 45 days rather than 6 weeks? On the other hand, the guidelines of several European countries also says 6 weeks rather than 45 days as what you do on this forum.

My question is, given the above content, how can you so sure that there is no difference between 45 days and 6 weeks?(and even 40 or 41 days, as you said earlier) I hope you can address this point? Thanks!!!

Edward W. Hook M.D.

47 months ago

Sigh. You need to address your anxiety. CDC is inherently conservative. I am unaware of any proven cases of HIV which became positive in the interval between 42 and 45 days.

End. Of thread. Further anxiety driven questions on this topic may be deleted without a response and without return of your posting fee, EWH

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