[Question #9126] False Positive and questions

35 months ago

Hi Doc

I am a 25 year old Chinese male. I am straight. I am not very good at english, please forgive my question being long and complex. Please take time to read it, thank you very much. I am in a very anxious state. Here is the background information.

On June 12th, I went to a massage parlor and kissed the massage girl and had a handjob. That is all I did. No oral sex, no vaginal sex. On June 14th, 2 days after the event, I got a cold. And at that time I saw HIV on the Internet and started to fear it, because in the past few years I also got same service in massage parlor, but never did unprocted sex nor drug.

So, on June 24th, I went to a hospital and had the 4th gen combo test, and the result was negative. The reason I did at this time was to eliminate the possibities of risks from the past few years.

On July 2th and 11th, I went to the same hospital and had the 4th gen combo test, and the result was negative. and it has been 4 weeks after the event on June 12th. By this time, I actually already know that what I did had almost zero risk and did not worry very much, so I thought a 6 week test will be just for the peace of mind.

HERE IS THE IMPORTANT PART

On July 25, exactly 6 weeks from June 12th, I went to the same hospital and did the duo test. The result usually came out in 2 hours, but this time it didnt untll I called them at 4 in the afternoon, they told me the result is reactive and the value is 1.78 S/CO and would do a confirmation test the next day. So on the next day they told me they used another two assays, ELISA and a quick test(I forgot the name), and showed negative, so they gave me a result report saying 0.95 S/CO and told me it was on gray zone and suggested me to retake the test 3 months later. I was so scared and could not imagine this would happen. I did not know what to do, but could only wait.

On August 5th, I went to another hospital, did the 4th gen combo test, it was negative. I thought the time was not enough, so on August 21, I went back to the first hospital and did the test again, it showed negative. This is the 10th week from June 12th when I did the non-risky event, and 27 days from the false-postive result on July 25.

Sorry that my english is not that good and cannot make succint story. I just want to tell you doctors everything I encountered as I am so panicking. My question is the following:

1. To be honest, I do not worry at all about the non-risky thing I did on June 12th. I worry that there is something wrong with the needle during the blood draw on July 25 that causes the false-positive result, and fear so much it would contract HIV. That is why I restarted the window period, making July 25th the day of risk, and waited 27 days to test. I know it might sound silly and ridiculous, but I never thought this would happen, and because I met a event that is very rare, I dont really believe in propobility number. I think anything unfortunate can happen no matter how impossible they are. Can you tell me if I am okay given the August 21st result?

2. I think on July 25th I saw the nurse tear the plastic cover of needle in front of me, I just worry if there are any virus placed in the hollow needle in advance, so it caused the test result reactive, which created the risk for my blood to contract the virus as the needle was put in syringe to draw blood. Can you please tell me some scientific reason that this is not possible?

3. Given my worry, I dont know if 27 days count as 4 weeks, but I know that you said its about 98% conclusive and needed to do another test at 6 weeks to be 100% conclusive. Do I need to do another test? I mean from June 12th it is beyond the window period, but if referring to the date of false-positive, it is only 27 days.

I apologize for making the question so long, I am so anxious, pancking, I don’t know what to do. Please help me doc, thank you very much.

H. Hunter Handsfield, MD

35 months ago

Welcome to the forum. Thanks for your question. Either your English is fine, or the translation program you are using is working well. I understand everything clearly.

You can stop worrying; you do not have HIV. It really would have been impossible for you to be infected; as you apparently already know, your exposure was zero risk. In the 40+ years of the international HIV/AIDS epidemic, there has never been a case known to be transmitted by hand-genital contact. In addition, there has never been a case related to having blood drawn -- not since clinics and doctors stopped drawing blood with re-usable equipment, i.e. more than 30 years or so. Also, acute HIV infection (i.e. acute retroviral syndrome, ARS) does not cause cold symptoms, i.e. no nasal congestion or cough. Further, almost all initially false positive HIV test results, and all "gray zone" results are eventually confirmed as negative, as has occurred in your case. Finally, you need not worry about the exact numerical values of the tests you had.

Those comments pretty well cover your specific questions, but to be explicit:

1. It is true that bad luck can happen, and that truly rare events can occur. People get struck by lightning. Still, for any one person, the statistics are valid. There is no realistic chance you caught HIV from either the hand-genital sexual event or from having blood drawn.

2. It is impossible that the needle had HIV or someone else's blood inside. It just makes no sense and has never been known to happen. And you are correct that your negative AgAb test at 27 days is about 98% reliable.

3. If somehow I were in your situation, personally I would not feel a need for another test. However, in view of your worry about it, you should have another AgAb test 6+ weeks after the second event you are concerned about, i.e. the initial borderline false positive test date. The result will again be negative.

Really, do your best to stop worrying. There is no realistic possibility you have HIV. I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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35 months ago

Hi Doc

Thank you very much for the detailed reply. I'm very scared and worried. I think this false positive thing has caused OCD and PTSD to me, and I could not help thinking some bad and radical ideas. I swear I have told everything I did and encountered. Since June 12th I have never done any sexual exposure nor contact, all I did during these days is blood draw in hospitals, which I considered risky given my "gray-zone" event last time. Please allow me to ask few more questions, and please dont feel offended. Sorry I know the questions I ask might seem irrational to you, but due to the rare incident I met, there are just horrible ideas coming across my mind.

1. If the virus is contracted by blood in vein, does the window period get shorter or it still follows the typical one?

2. How possible is the needle contains virus, say someone puts it in advance and seals the plastic bag. In this case, when blood draw takes place, will there be an exchange of blood and virus, and would the amount of virus in the needle be enough for contract HIV? (I ask this because I think I saw the nurse open a new bag of needle, but I fear so much if the needle has virus placed inside in advance)

3. Does 6 week mean the same as 45 days? ( I know I ask this because of my OCD mindset, but I really want to get 100% conclusive because this whole thing is like a nightmare to me)

4. Although I know the CDC says the conclusive time is 45 days, have you or your colleagues seen any cases changing from their 27 days result?

5. When you said "the results will again be negative" in your last 3rd answer, are you 100% percent confident? Have you seen cases like my case in your career? Sorry I really dont mean to offend you nor cast doubt on your statement, I'm just so worried, because a rare event forces me to think of something bad even it has tiny possibilities.

I feel so wronged and unjust because if it ends up turning positive, it will just be so speechlessly unfortunate and ironic to become someone who does not get HIV from the orignal non-risky activity but get from testing HIV in hospital. I dont know, Doc, this idea has been in my mind for weeks. I just want to tell you this is an nightmare for me. I can only sleep 2-3 hours every night. Every day I wake up by this anxious pain in my heart. At daytime I just live like a zombie. I really dont know what to do except thinking of these ideas and panicking. Thank you very much for your understanding.

H. Hunter Handsfield, MD

35 months ago

1. The window period does not change with the amount or source of exposure to HIV.

2. Who knows? Ridiculous assumptions and I won't play that silly game. Zero risk in any case.

3. The data support 45 days. On this forum, we round say 6 weeks for simplicity, because three days almost certainly makes no difference in test reliability.

4. No, I have never known of a patient with negative results at about 4 weeks who later had a positive test result. However, rare things happen, and my experience is irrelevant. I have also never cared for a patient struck by lightning, but that doesn't change your chance of being struck.

5. Yes, I am 100% confident. Perhaps it will also help you to know this: In the 15 years of this and our previous forum, with thousands of questions from people worried about a possible exposure to HIV, nobody has yet reported that they tested positive. You will not be the first. If and when that finally happens, almost certainly it will be a genuinely high risk exposure, like unprotected anal sex with a partner known to have HIV. It will not be a trivial event like the one you are worried about.

It seems clear that my words are not going to settle your irrational fears. Your thinking on this is not normal and indicates a significant psychological problem. Please consider professional counseling. I suggest it from compassion, not criticism!

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35 months ago

hi doc

Thank you very much for the firm reply and confidence you gave. I have waited for 45 days to do the combo test today, which is 45 days. The result is negative. I really appreiciate your information. I just have one more question to ask, it might be a bit silly though, please forgive me.

On the way back home, I was walking, and something fell off the tree or from somewhere, and it landed on my left hand. Its size was about 1/3 of my thumb nail. I flicked it off by my fingers quickly. I didnt know if it was a bug or leaf because it is kind of green and brown mixed. But as soon as it got flicked off, the spot on my hand where it landed started to feel so painful and was like burning. I guess it did not bite me because the pain began right after I flicked it, not before. Few minutes later I saw a red spot and few blood came out. Since it was an empty street, there was no restroom or alchohol wipes available. So I had to walk home and wash hands, which was about 1 hour later. Now the spot was still a bit red and swell. I was really confused because I have not met such thing before. It just came out of nowhere and created this pain, which furthered my anxiety.

I would like to know if there are any risk caused by insect bite, sting, or fluid? (or maybe from some kind of tree leaf?) I know this question sound silly... I admit I have mental issues after my fear of HIV. I will seek psychological counseling very soon. I know your answer will end the thread. I want to say thank you very much for your understanding and wish you the best.

H. Hunter Handsfield, MD

35 months ago

I'm glad to hear of your negative test result, but of course not surprised. Thanks for the thanks about the discussion so far.

This sounds like bird droppings to me. If there really was blood, maybe it was from a self inflicted injury from your reaction (which was only human -- nobody likes being pooped on by birds!). Or maybe the bird had swallowed something sharp (??). But of course there is no HIV risk, either from bird droppings, insects, or plant material. Nobody ever gets HIV without direct sexual contact or overt blood exposure to an HIV infected person.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope these additional comments also are helpful. Best wishes and stay safe.

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