[Question #897] 4th Gen Hiv Test Window

50 months ago

I am a 43 year old male who had 5 minutes of unprotected intercourse, due to a condom break, with a female CSW  5 weeks ago.  I was assured she was clean, but was very concerned about HIV.  I did a full std screen and was cleared.  I was tested at Labcorp at 25 days after this event with a HIV 1/0/2 Cascade 4th generation antigen/antibody test, and at 32 days with an Alere Determine 4th gen. HIV 1/2 Ag/Ab Combo test.  Both were negative/non-reactive.  I am comforted by these results but still worried.  Do you feel I need further testing?

Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago

Welcome to the Forum.  I'll be pleased to comment.  We appreciate how disconcerting a broken condom can be and I hope to reassure you.  Before I comment on your test results, let me put your risk of infection into perspective.  Most CSWs do not have HIV (far less than 10% in most settings and in North America the figure is typically less than 1%).  Further, IF your partner did happen to have untreated HIV, the average risk for infection from a single unprotected act of intercourse is less than 1 in1000.  Thus, statistically, your risk for infection is no greater than 1 in 10,000 (1/100th of 1%) and probably substantially lower. 

Your test results however provide assurance that you are not infected.  Because the 4th generation tests detect both HIV virus (the antigen) and antibodies formed in response to infection, these tests provide reliable results at all times more than 4 weeks (28 days) following infection.  Thus your test results prove that you were not infected.  There is no need for further concern about HIV and no need for further testing.

I hope these comments are helpful to you.  EWH

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50 months ago
Thank you so much, Doctor.  Your advice and knowledge are extremely helpful to me.  It has been a very long month indeed and I am so grateful that an expert in this field took the time to put this in perspective for me.  I just wanted to do the responsible thing and ensure I was no risk to others.  It is truly appreciated! 
Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago
I'm glad you found our comments helpful.  Take care.  EWH
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