[Question #972] Scared at 14 weeks post exposure, help!

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94 months ago
Hi, 14 weeks ago i received a 30 seconds - 1 minute of blowjob from a massage parlour. And 11 months ago received a protected vaginal and unprotected oral too. Because of much controversy in risk (majority said NO RISK to little risk) in receiving a bj, i went testing and here are the results : 

(1) Rapid 3rd Gen Antibody Test : 2 weeks, 4 weeks, 6 weeks, 9 weeks post exposure NEGATIVE/NON REACTIVE - Oraquick Swab 11,12 weeks : NEGATIVE 
(2) PCR <40 copies : Not detected after 5 weeks 
(3) Planned Parenthood Unigold Recombigen antibody test : 81 days (12 weeks minus 3 days) NEGATIVE 
(4) Planned Parenthood Unigold Recombigen antibody test : 91 days (FULL 3 MONTHS) NEGATIVE. 

Many guidelines said that HIV Antibody testing after 3 months is considered conclusive and dont need further testing. And also i have done the PCR which search for the actual virus itself. The question is : 
1. I have no antibodies for hiv until 13 weeks or 3 months and at 5 weeks no detectable levels of the virus itself. I read in the studies, that when there is no antibody, there should be high levels of viremia and the reason the viremia might be undetectable is because the antibody attacks the virus. So, because my tests came back NO ANTIBODY AND NO VIRUS, it should be considered 100% conclusive right? 
2. Can a person have hiv and not have antibodies and not have detectable viral load? Even at aids stage? Is it possible that im at aids stage that none o the test results positive?
3. In the last 4-6 months i have health anxiety issues which at one point i believe i got cancer,diabetes and now i scared of death for hiv. And in the last 4-6 months every 2 weeks i got low grade fever and stomach problems and i got this as well this week but only last 3 days or so, do this have any correlation for HIV?

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H. Hunter Handsfield, MD
94 months ago
Welcome to the forum Thans for your question.

There is no controversy about the low (essentially zero) risk of HIV from oral sex, unless "controversy" incluedes non-scientific opinion by uninformed sources. There have no proved cases of HIV transmission oral to penis; and an estimate by the US Centers for Disease Control and Prevention (CDC) is that if the oral partner has HIV, the risk might be around 1 in 20,000. That's eqiuivalent to receiving BJs by infected partners once daily for 55 years before transmission might be likely.

Second, the current HIV antibody tests are conclusive within ~6 weeks, even though official advice remains 3 months. Equally impaortant, the combination of PCR plus antibody is conclusive much earlier, for sure by 4 weeks and probably by ~15 days. Accordingly, you have been seriously overtested. You could have stopped, with 100% certainty you weren't infected, with your first couple of tests.

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

1) Yes, your restuls are 100% conclusive.

2) Once infected and the various tests are positive, they are never negative again, even in advanced AIDS. And anyway, this is irrelevant, since there is no way to have advanced AIDS so quickly.

3) Test results, especially the combination of tests you had, always overrule symptoms. And your symptoms aren't suggestive of HIV anyway.

So no worries. Stop testing and stop worrying. If you have a regular sexual partnership, you can continue unprotected sex without putting that person at risk.

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