i had sex with a CSW on 9th sep 2018, i used condom but when i removed the condom i saw blood outside the condom that i touched with my finger , i had small cuts on my fingers , the cuts one has bec of skin dryness , i washed my hands with hot water and then with soap , after that i had no symptoms but once or twice mild fever 99.1 and i tested for HIV , on 17th day , 25, 32, 35, these were 3rd generation antibody test ( retro viral ab 1and 2 ) then on 42nd day , 49th and 65th day i had 4th generation CMIA test , and again on 75th , 83rd and 85th i had again 3rd generation antibody test ( retro viral ab 1and 2 ) as i am in a place where 4th generation test is not available , all these tests were non reactive , please explain
1. are these test conclusive
2. do negative test at 85 day turn positive on 90th day
3. how reliable are 3rd generation test as compare to 4th generation test
4. do i need to test again
5. how long antigens are in body to be detected by 4th gen test
please reply i am in depression
Thank you for your inquiry. From what we gather from the question, you were asking about whether you are at a risk of contracting HIV from having protected vaginal sex, having blood coming in contact with the dry skin of your fingers and the validity of 3rd and 4th generation HIV testing. From the information given, having protected vaginal sex is considered Low Risk as there is an exchange of body fluids (Evidence of transmission occurs when certain conditions are met) For e.g. during vaginal sex (improper use and potential breakage of the condom may occur)
Most of the body's surfaces are dry skin (e.g. legs, arms) and they do not allow HIV to enter the body. Wet skin (or mucous membranes) is more vulnerable to HIV. In this scenario however, you had dry skin with small cuts on your fingers that were not actively bleeding therefore the risk of getting infected is reduced.
Regarding the HIV testing, The 3rd generation ELISA Test: Detects the presence of HIV-1 and HIV-2 antibody as early as three weeks after exposure to the virus and has a window period of 4 weeks to 3 months, with up to 95% of infections being detected within 4-6 weeks. 3rd Generation ELISA tests are 99.8% accurate after 3 months. Since you have been tested early and the results were negative and on the 85th day again the results were non-reactive. We believe the test results are conclusive. The 4th Generation EIA/P24 Antigen Test: is detectable immediately after infection, & only for the first few weeks. The antibody (ab) test has a window period of 4-12 weeks. Most HIV specialists consider this "DUO" test conclusive at 6 weeks. Official HIV testing guidelines still recommend re-testing at 12 weeks for completely conclusive results. Accuracy is 99.9% This is the standard testing method in several countries now. Since your tests were negative around the 6 weeks period and you do not have the P24 test facility available to get tested at 12 weeks again, these results are thought to be conclusive by most specialists at 6 weeks.
Recommendation: Refer to a physician for more personalised answers.
Regards, AIDS Vancouver Helpline/Online, (Vardah)