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Do I continue testing?

Question: 

Hi. About roughly 5 weeks ago I had unprotected oral and protected vaginal sex with a condom on with an HIV+ woman whom I didn't know had it at the time. I might add that I'd shaved my genitals an hour and half before sex and am afraid of abrasions or small cuts posing a significant risk if they came into contact with her saliva or vaginal fluids.

Since then, I've had:
an Orasure Advance rapid oral swab test taken 15 days after exposure which was negative (too early to detect anything, I know),
a 4th generation antigen\antibody lab DUO blood test taken at 20 days which was also negative,
an Orasure Advance rapid oral swab test at 31 days which was also negative,
and I have another lab DUO test scheduled at exactly 6 weeks (42 days).

I have had no acute HIV symptoms so far (today is the 34th day) for the entire duration - no fever or flu or sore throat or rash or swollen lymphs, and I have no other STDs - all the other STD tests turned out negative too. My doctor told me I was already at very low risk. I have been experiencing severe anxiety for the last week, and my doctor says that symptoms I have experienced: increased salivation and wanting to spit whenever I am more stressed, tingling in my throat and feelings of it being scratchy sometimes that pass, sometimes a tightness around the chest, fitful sleep and waking up feeling tired, are all classic anxiety symptoms. I know that isolated symptoms that are temporary don't mean anything and so have been trying very hard to not stress or panic.

I'm hypothesizing that since I had an early DUO test it should have caught antigens, which it didn't, and the rapid antibody at 31 days should have caught antibodies if I had already seroconverted and the DUO didnt catch anything at 20 days, unless my luck is really shitty and I've been getting false negatives all along. My doctor says a DUO at 6 weeks is considered conclusive according to the new CDC guidelines. Should I do an RNA test and be conclusive (I can't really afford it)? Am I still at risk?

Answer: 

Hello and thanks for reaching out to the AIDS Vancouver Helpline.

It seems that you are concerned that although HIV tests have come back negative after a risky exposure you might still be at risk of having acquired HIV. We are glad to provide some information.

It is encouraging that you have already been tested three times since the exposure and the results have come back negative on all the occasions. With regards to additional tests we recommend that you get tested at 6 weeks like your doctor suggested. Some professionals accept that the results at 6 weeks can be considered conclusive. At Aids Vancouver we recommend that people get tested again at 12 weeks or after for conclusive results. We follow the BCCDC guidelines on this. We do not think you are at risk and we do not expect the results to change. Only in isolated cases have results changed after initial tests have indicated a negative HIV test result.

The Aids Vancouver Helpline Online forum has postings that are related to your question that you can read for additional information. If you have any further questions feel free to contact us again.

Thank you for contacting the AIDS Vancouver Helpline.

In health

Lawrence

AIDS Vancouver Helpline/Online
helpline.aidsvancouver.org