[Question #859] HIV - Early Detection

52 months ago
I am a male and was having vaginal sex with female friend.  If female had HIV she did not know it.  But she is sexually active.   Condom busted and had a good amount of blood on it when i withdrew.  10.5 days after exposure I had two test - HIV RNA and Duo Antigen/Antibody test both booked through an online testing company and testing done at Lab Corp.  Testing company claimed that RNA test is conclusive at 9-11 days.  Both test came back negative.   On day of test I started having some sore throat and feverish feeling but no temperature when tested.   Is my test conclusive at 10.5  days and if not how much confidence should i have in it (%) and when would the RNA test be conclusive?
Edward W. Hook M.D.
Edward W. Hook M.D.
52 months ago
Welcome to our Forum.  I'll be pleased to comment.  The exposure you describe was relatively low risk.  Relatively few women have HIV and it sounds like you asked her and she said she did not have HIV.  Most people tell the truth when asked directly about their HIV status.  Even is she had HIV, the risk of acquiring HIV following a single exposure of the sort you describe is less than 1 in 1000-2000 (and the presence of blood does not change this).  

Your negative tests are further strong evidence that you did not get HIV.  The RNA do become positive within a few weeks after acquisition of infection but precisely how early is hard to say with precision.  Since these tests are not recommended for these purposes, the good scientific evidence is lacking as to precisely when these tests are 100% positive.  Certainly most tests are positive within 14 days.  The DUO tests are well studied and are clearly completely reliable (definitive) at 4 weeks (28) days after infection is acquired.  At 10 days they provide strong but not perfect assurance that you were not infected.

Considering all above, you should be confident that you did not get HIV from the exposure you describe.  I would not worry that your sore throat is a manifestation of recently acquired HIV.  I would not worry further if I were you.  EWH

P.s.  I presume that you were also tested for chlamydia and gonorrhea at the time you were tested for HIV.  Your risk for these infections are much higher than your risk for HIV

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52 months ago
Thanks for your response.  I have read your comments on other sites and really appreciate your feedback. 

  It has been 17 days since exposure.  For the past 4 days I have had some intense headaches and some aches in my jaw. I have not experienced these type of headaches before.  Should I be concerned?  Should I test again based on your earlier comments and my headaches.  Just so you know, I have read many responses on this site and some others and i know people freak out over the smallest of symptoms.   the symptoms/ headaches I have had are not small incidents but very unusual to my experiences.   
Edward W. Hook M.D.
Edward W. Hook M.D.
52 months ago
If your headaches have been more severe than what you are accustomed to and continuous, I would discuss them with your doctor.  Headache, accompanied by numerous other symptoms can be part of recently acquired HIV but I sincerely doubt that this is what is going on, both because of the low statistical risk pointed out above but equally importantly because of the lack of other symptoms.  My recommendation for you to see your doctor is NOT  because I am concerned about HIV but because your headaches may be part of some other process.  Clearly I cannot practice medicine over the internet and am not trying to.  If you are feeling poorly you should discuss it with your own doctor who will have a chance to take a more detailed history and examine you.   EWH
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52 months ago
Thanks for the response. You had mentioned that finding blood on the busted condom did not increase the risk of getting HIV.  Why is that?  I have read some conflicting information on that.   Also, if my partner had recently acquired HIV but didn't know it how much would that  increase the chances I would get HIV as I understand that is when HIV is more easily transmitted. Thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
52 months ago
Among infected persons the amounts of HIV in blood can be similar to the amount of HIV seen in genital secretions.  Studies that have evaluated blood exposure have not shown that blood exposure is associated with increased risk for infection.

It sounds like you are spending time searching the Internet for answers.  This is not a good idea.  Much of what is found on the Internet is misleading or even just plain wrong.  I suggest you stay off the Internet.

Finally, we believe that HIV infectiousness is determined by how much virus a person is exposed to.   In the month after exposure, persons are more infectious than later because they'd have vey high virus levels.  Remember however that recently acquired HIV among heterosexual women is incredibly rare.  Once again, I urge you to stop worrying about HIV.

As per Forum guidelines, this is my third and therefore,final response to your questions.  If you have further comments they will not receive answers unless you start a new question.  I hope you will not feel the need to do that.  EWH
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