« Go Back

12 Week Negative After PEP Conclusive?

Question: 

Hi,

On January 23, 2018, midnight and in morning, I had unprotected sex with a woman of unknown status, five times at midnight and one time in the morning. Ours is a subcontinent country and she became a citizen of a large first world country in the East and had lived there ever since. While talking, I learned she had known nothing about safe sex and she refused to test vehemently and stated that she hadn't had sex for over five years with anyone else (and she probably meant outside her marriage). The previous boyfriend married and had a healthy girl child, she said.

She was stupid despite her ideas on progressive thoughts and a loud mouth. This got to my mind and my OCD got triggered. She had also invited our other friends before me and I knew they were negative too but doubt had its own ways.

I started PEP about 67.5 hours later and completed it without missing a single dose. I tested immediately after PEP on day 29, 30, 41, 49, 58, 70, 72, 85 and 114 (12 weeks after PEP) with fourth generation Ab/Ag tests. All of them are negative.

Some confusing guidelines say 6 months post exposure on PEP. I don't like it. And I haven't had any symptom at all I guess. I think since it got warmer due to Summer, which is extremely hot here, I have been sweating profusely and I used to since childhood. I sweat even when I eat and even if I do not allow air, while sleeping.

Can I consider my 12 week post PEP results conclusive? Doctors Sera (says test after completing PEP is conclusive), Dr Sean, Dr David Wohl and Dr. Jose say testing 4-6 weeks after PEP is conclusive. Dr Tan and Dr. Benjamin Young say 8 weeks after PEP is conclusive. Dr Tan even goes on to say testing with antibody alone is enough after week eight and that Dr Tan says he has never seen a test immediately after PEP change later on.

On Day 72, I had also cut my little finger with a knife while cutting tape. I had sutures done immediately and feared that the needle used to give me the anesthetic was reused. Anyhow, the test 42 days after that incident has come negative. I had also believed that the phlebotomist who drew blood used a used syringe on day 30. I now believe these were unwarranted irrational fears.

Now, my concerns are:

1) Can I move on with my 114 day (12 week post PEP) results?
2) I should probably enter long term relationships and even get married. So, discussing and testing before we have sex increases my fears. So, does testing at the six month mark, which I don't want to, as I have had enough of fears before testing and waiting for the results.
3) I would still believe I would have to test 6 months after PEP and 7 months after exposure, as we go on.
4) I also want to believe that this result will stay the same and the 114 day result (12 weeks after PEP) is conclusive.
5) Long term consequences and complications that we read of the disease scare me, which is, as you might have seen, a "what if" question.

I hope I can mentally free myself from all these and remain negative to move on with other things in my life. I hope you can answer me soon. Thank you for all the great work you do :)

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the integrity of your negative test results at 114 days (approximately 16 weeks) post exposure.

Most people are known to develop detectable antibodies within 21-25 days post exposure. With this in mind, your negative test results at 114 days post exposure would be considered conclusive provided the method of testing was accurate. Official HIV testing guidelines recommend re-testing at 12 weeks for completely conclusive results. Because you tested at 16 weeks, and results were negative, this would be considered conclusive. Further, gold standard HIV testing methods are known to show up to 99.9% accuracy in results.

Additionally, your responsible use of PEP (Post-Exposure Prophylaxis) within 72 hours post exposure will have significantly lowered your risk of acquiring HIV. PEP is considered one of the most effective methods of defense if used correctly and within the time constraints following exposure, but should only be used in emergency circumstances.

Regards, AIDS Vancouver Helpline/Online, Cody