[Question #852] HIV worries

64 months ago
Hi Drs.
I had a vaginal sex encounter in an Asian massage place and she used a condom.  Afterward, I began to worry if the condom had broken and all sorts of anxiety set in.
At 10 days I had a full panel of tests including PCR RNA and 4th generation screen from labcorp.  All negative.
At 45 days I had same 4th gen  #083935 from labcorp; again negative / non reactive.
I'm at day 80 now.  Do you think I need another antibody test?  We're my results conclusive at 45 days?  If I need another test, is day 80 close enough to 3 months to be conclusive?

Thank you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
64 months ago
Welcome to the forum. Thanks for your question.

First, you would have noticed if the condom had broken. In most cases, it is very obvious. Small tears are rare, and it's hard to miss the remnants of the condom hanging from the penis. Second, the large majority of sex workers, including ethnic Asians, do not have HIV.  Third, even if she did, and if the condom failed, the average HIV transmission risk for vaginal sex is once for ever 2,000 exposures. So the chance you were infected with HIV is zero for all practical purposes.

Finally and most important, your test results prove you were not infected. The negative PCR plus 4th gen test at 10 days was over 90% conclusive; and the 45 day test was 100%. (Contrary to common beliefs and many websites, the 4th gen tests are conclusive any time 4 weeks or more after the last exposure. Three months is old news, which no longer applies when 4th gen tests are empllyed.)

So all is well. There was almost no chance you were infected and in any case your test results definitely are conclusive. You can stop worrying.

I hope this has helped. Best wishes and stay safe--  HHH, MD


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64 months ago
Thank you for the prompt reply , Dr.

Are you familiar with the labcorp test?  It is called 4th Generation and I believe that means "duo".

If I were to test for emotional confidence at this point, is antibody alone enough?  I'm past 80 days, but not 90...is that close enough?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
64 months ago
There is no "Labcorp test". Labcorp does the same 4th generatio (duo) test as all laboratories. It's the same test, no matter what lab does it.

You did not have an "antibody alone" test. The 4th gen test is for both antibody and antigen. As I said above, it is 100% conclusive any time 4 weeks or more after the last exposure. Your 45 day test is conclusive and you do not need another test anytime in your life, unless and until you have another risky exposure.

Move on without worry. Do not have any more tests. If you remain uncertain or don't understand, re-read and concentrate on my replies above. Please do not re-ask the same questions in different words.

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64 months ago
Thank you again Dr.  This site provides a great service.
I guess anxiety and guilt are powerful emotions.
I have just one more question and I'll be done with this.
In your opinion, am I now safe to have unprotected intercourse with my spouse without risk of passing hidden HIV?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
64 months ago
As noted above, you cannot possibly have HIV, assuming no other recent high risk exposures that you forgot to mention. Therefore, you cannot transmit HIV to your wife and can safely have unprotected sex.

That winds up this thread. Best wishes and stay safe.

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