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Protected Sex Swollen Lymph Node

Question: 

Thank you for answer my question:
I had Protected sex with someone of unknown status, I believed i was very careful due to my fair of HIV. Two weeks after i noticed my lymph node on my neck swollen, mildly swollen confirmed with Ultrasound, CT, Biopsy.
I went to the clinic at received Fingerstick:
Day 17 Alere Determine™ HIV-1/2 Ag/Ab Combo - non-reactive
Day 44 Alere Determine™ HIV-1/2 Ag/Ab Combo - non-reactive
Day 60 Alere Determine™ HIV-1/2 Ag/Ab Combo - non-reactive

I understand window period, but what is the likelyhood that im positive at receiving a 8 week 4 days Negative?

Thank you for you timely response.

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the conclusiveness of the HIV testing you received after engaging in protected sex. From the information given, this scenario is determined to be Low Risk (evidence of transmission occurs through these activities when certain conditions are met).

The scenario mentioned above could meet the three components of the Transmission Equation due to improper use or the potential breakage of the condom. Even though the risk of HIV transmission is significantly reduced when using protection, it is not zero and thus it was very responsible of you to access testing. The HIV-1/2 Ag/Ab Combo test is a 4th generation test that is very good at detecting HIV infections. According to CATIE, "Fourth-generation HIV tests can detect HIV infection in 50% of people by 18 days after infection; 95% of people by 34 days after infection; and 99% of people by one and a half months after infection" (1). Further, after 12 weeks the 4th generation tests can accurately detect HIV infection in 99.9% of people (1). With this in mind, it is extremely unlikely that you will receive a positive result when you re-test at or after the 12 week mark since you received a negative result 8 weeks and 4 days post-exposure.

In regards to your symptoms, a swollen lymph node can be due to a very wide range of factors. Due to the negative results of your previous HIV testing it is extremely unlikely that the symptoms you are experiencing are due to an HIV infection.

Recommendation: Refer to a health care provider for HIV testing 12 weeks post-exposure for completely conclusive results.

Regards,

AIDS Vancouver Helpline/Online, Marie