3 weeks later, I had a flu which went away after a week and half. Tested the girl and myself using rapid test kits at about 28 days post exposure. Also got a 4th gen ELISA at days 33, 42 and 55 post exposure which were non reactive. 

9 weeks post exposure, fell sick again. All typical acute HIV symptoms. Took a 4th gen ELISA at 77 and 98 days post exposure. Both non reactive. Also took an HIV 1 PCR quantitative test at 92 days post exposure and it did not detect any virus.

My worry is that I still have lingering symptoms and I've read online where it says the HIV 1 PCR and 4th gen ELISA may not be accurate with HIV 2. 

I'm also worried about the PEP I took for 2 days of it might have delayed seroconversion. I did not trust the girl's negative rapid test 4 weeks post exposure since she could have been on the window period. 

Do I need more testing? Am I clear of all HIV types?

I've been to 2 GPs and they all say HIV is ruled out but, I wanted to ask the experts if all is okay and if I can move on from this.

You really needn't be worried. You have learned a lot of misinformation or at least misplaced emphasis in what seems to have been a lot of online searching. You had a minimally risky exposure, given the rarity of HIV in women in the US, including the most sexually active women; the low chance of HIV transmission for any single unprotected vaginal sex event (average once for every 2,500 exposures); your sex being protected, reducing the chance you were infected by another hundred-fold; your negative HIV test results; and very important, your sex partner's negative result. People with newly acquire HIV generally are not infective during the window period; thus her negative result makes it even more unlikely you could have been infected.

As for your symptoms, it is impossible to have HIV symptoms and have a negative blood test:  it isn't the virus that causes ARS symptoms, but the immune response to it, as reflected by HIV antibody. And despite statements easily found online, symptoms almost never are helpful anyway in judging presence or absence of HIV or ARS. Even the most typical symptoms are usually caused by other things, and most newly infected people don't develop symptoms at all. Therefore, the blood tests always overrule symptoms in judging presence or absence of HIV; there never are any exceptions. No matter how high the risk of infection at the time of exposure, and no matter how typical the symptoms seem to be, a negative test result proves that something else is the cause of the symptoms. To my knowledge, here has never been a reliably documented exception. Finally, two days of PEP is not nearly enough to have any effect on any of this. (I'm glad you stopped! As you may know, one of the downsides of PEP is that if it doesn't work, it prolongs the window period by at least several weeks, prolonging the time of uncertainty and anxiety. It's good you decided not to put yourself in that position.

As for the tests other than HIV itself, the FBC, D-dimer, and CRP results were irrelevant. Those tests were a waste of money, at least in regard to HIV infection. And by the way, your doctor's diagnosis of a "minor chest infection" further suggests your symptoms were NOT typical of HIV. HIV or ARS do not cause cough, for example. It sounds to me like you had a garden variety cold, or maybe COVID.

Finally, since you mention HIV2, I'll just say it is much too rare in the US to be a serious consideration. There have been only a couple hundred HIV2 cases diagnosed in the US in the nearly 40 years of the HIV/AIDS epidemic, and almost all of those have been in people born in HIV2 endemic areas of Africa, or their regular sex partners. HIV2 has essentially been absent otherwise in the US. And anyway, the standard HIV AgAb tests are conclusive for HIV2 8 weeks or more after exposure, so your negative test results rule it out.

The bottom line:  your two GPs are exactly right. You can move on without further worry about HIV, assuming no more recent high risk exposures.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

1. The girl was a hook-up.

2. She was from South Africa. I assumed she could be hooking up frequently.

Would these change your opinion on the test results? And, to confirm, the 4th gen ELISA at 98 days rules out both HIV 1 and 2 in light of the 2 days PEP?