This is a follow up question. I was tested negative for HIV after multiple potential exposures. The test was a rapid test , however not sure was it a 2nd or 3rd generation test as BioSure test sold online in Poland by Polish Aids Community is likely 2nd generation test. Testing was done at anonymous HIV testing facility and later I was told over a phone that they use 3rd generation tests. Anyway the test was conducted at 49 days since my last exposure to high risk CSW - condom protected intercourse without breakage, unprotected oral sex on me and deep kissing with my lips being inflammed quite heavily and she bit me on my lip leaving bloody dot under my skin. Above condom on my shaft - probably due to rough oral sex - during two separate intercourses with her, that day - I had an abrasion which likely got in contact with her vaginal fluids and genital warts above my condom, as well. The abrasion was more like a reddening of the skin without bleeding, but was stingy afterwards when I applied some alcohol on it.  I know the test is not conclusive but please assess my risk as she was somewhat high risk and a need for re- test again. Thank you

In our previous discussion, I was mistaken about Biosure -- it's a third generation antibody test, not fourth generation. But still extremely reliable, with probably 95-98% of infections detected at 7 weeks. Even if "only" second generation, 90-95% of infections would be detected. It seems very unlikely that Biosure sold in Poland is a different test than in the UK, where the test was developed and is manufactured.

If we assume the worst case scenario for your sexual exposure(s) -- that your partner has HIV and the condom can be considered to have failed -- then even before testing, the chance you had HIV was somewhere around 1 in 2,500. Let's assume your 7 week test would detect 95% of infections, i.e. would miss 5% of infections. Mathematically, the chance you have HIV would calculate to be 0.0004 x 0.05 = 0.00002. Thats 2 in 100,000, or one chance in 50,000. And that's the maximum chance you have HIV.

If you remain concerned, you can repeat a Biosure test at 3 months. Or have a lab-based AgAb (4th generation) test now. Either way, you can expect a negative result, which would be conclusive. In the meantime, mellow out:  you don't have HIV. (Perhaps you'll be interested to know this:  In the 15+ years of this and our preceding forum, with thousands of questions from people concerned about catching HIV, not one has turned out to be infected. You won't be the first. If and when that happens, almost certainly it will be a legitimate high risk exposure, such as unprotected male-male anal sex, or unprotected sex with a known infected partner.)

HHH, MD

I was mistaken about the BioSure® test:  the manufacturer classifies it as a second generation HIV antibody test, not third generation. But this does not change my evaluation or advice above.

HHH, MD