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Please, some peace of mind

Question: 

Hello
I am a 22 years-old MSM. Until now, I've had 10 sexual encounters. Only one of them led to anal intercourse, with me being the unprotected receptive man with a guy of unknown status. After that time, I had two more encounters (receptive oral sex without ejaculation). The last one of these encounters took place almost two months after my first anal experience.
Then I lost my mind and the testing frenzy took place for the first time. 16 days after my last exposure, I got a RNA HIV-1 test form LarbCorp: NEGATIVE. That same day, I took an Oraquick which turned out to be negative. A very faint line appeared on the T zone after about one week of taking the test (I kept it as a "souvenir"). 5 weeks after my last exposure (that is, more than 3 months after my high-risk exposure) I took a blood test (it was an immunochromatography for antibodies like OraQuick but with blood). The first test I took that time developed a red linear faint spot perpendicular to the C line, on the T zone. I took another test then since the first one seemed to be defectuous, and the result was negative.
I know that I have got 3 -ve results so far. The RNA test is usually nor recommended for diagnostics although LapCorp claims that its test is FDA-approved. The Oraquick test was taken during the window period, although it had already been about two months after my high-risk exposure. The blood test I took with proper timing was negative, but I still have the image of the defective test on my mind.
I am planning to get psychological support, but I feel that I need to be sure of my status before doing so. What do you think taking into account your experiences? what about the timing and the incidents I had? Should I get re-tested? Which test should I get? Anything that you tell me would be very appreciated...I am seriously losing my mind about this situation. I feel like I haven't found peace of mind after so many attempts...

Answer: 

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

First of all, it's really great to hear that you have taken it upon yourself to get tested for HIV. Also, it sounds like you're aware that unprotected anal intercourse is considered a high risk activity. Remember that you can always use condoms to turn this activity from high risk to low risk. That might be something to consider doing to help reduce your worries.

Now, in terms of testing, what we typically do is focus on the most recent test, which in your case sounds as though it was a Rapid blood test done 5 weeks after your last exposure (receptive oral sex) and more than 3 months after your unprotected anal intercourse exposure. Rapid tests are considered conclusive 12 weeks (3 months) post-exposure, and so this indicates that you did not acquire HIV from the unprotected anal intercourse. Next, we look at the most recent exposure, which was receptive oral sex. Receptive oral sex is considered a low risk activity, meaning that although there have been reports of HIV transmission occurring from this activity, they have usually been under very specific circumstances, such as the person receiving oral sex having large, open sores in the mouth or having recently had major dental work. Regardless, it's still great that you went to get tested after this encounter.

The majority of people develop detectable antibodies (the substances that Rapid tests look for) within 21 to 25 days post-exposure. Since your test was done 5 weeks after your last exposure, the negative result is a really good indicator that you did not acquire HIV; however, results are not considered conclusive until 12 weeks (3 months) post-exposure. For peace of mind, you may want to consider going for another test (any type of HIV test would be fine) at the 3 months post-exposure mark to get a conclusive result.

If you want some more information on the types of tests, window periods, and when to test, some good websites to check out are AVERT and CATIE: HIV Testing Technologies.

Try to focus on the most recent test results, and not so much on the image of the defective test you did earlier. Hopefully this information helps! Thanks again for contacting the AIDS Vancouver Helpline.

All the best,

Erin

AIDS Vancouver Helpline Volunteer

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