Anonymous
Hi,
Recently I have been extremely concerned about my HIV testing, especially since I have/am experiencing a few symptoms. I am a nineteen year old female and my possible exposure was on November 1st of 2015 with a male through vaginal intercourse. I unfortunately did not know his status. While were were having sex, at some point the condom broke. I do not remember the details, (I was somewhat intoxicated and this was quite a while ago) but I fear that he did not realize the condom had broken until after he had finished. I then performed oral sex on him (I know that is low risk but I am just trying to be as specific as I can be). I then saw him about a week and a half later on Nov. 11 and we had protected sex and I performed oral again (unprotected). After this (2 weeks) I went to the Women's Clinic at my university and tested negative for chlamydia and gonorrhea. At this point I was not experiencing any symptoms of ARS (at least I don't remember any). A little less than two months later I got a deep cough and sore throat after a late night out in the cold. The sore throat went away in a day but the cough has been on and off ever since, sometimes with phlegm, sometimes without. I then started to think about HIV. At 81 days after the unprotected sex and about 10 weeks after the protected, I tested negative with an Oraquick Home Rapid Test. I might add that I was extremely careful with following the instructions. This test provided me with some relief, but a couple of weeks later (13 weeks past possible exposure) I got a cold. The cough was worse and with congestion in my head/nose and a sore throat. The doctor said my lymph nodes in my neck were a bit swollen but not too bad, no fever or anything. She have me some cold medicine and it cleared up in a week, but the cough still lingers on and off today. Because of the cold, I decided to test again with Oraquick (seeing that the first test was not past 12 weeks since exposure). At exactly 14 weeks since the most recent possible exposure (the protected sex and unprotected oral on Nov. 11th) I tested negative with Oraquick. Being me, I was still extremely freaked out as I dwelled on the experiences and scheduled a test at my clinic. On February 23rd (16+ weeks post the high risk unprotected sex and 15 weeks since the lower oral risk) I was tested with a Clearview Complete rapid antibody HIV 1/2 Test, which I think is a 2nd Gen. test. The result came back nonreactive. Despite these few tests I cannot shake the idea that I could be HIV positive, especially since I am still experiencing the cough with a few other symptoms like occasional headaches, congestion and some mild joint pain. I have been to the doctor several times since and she has told me not to worry too much, seeing that it is most likely due to allergies and the weather here, but nothing really seems to work. I have even expressed my fear of HIV to her. My main fear is that I have/am seroconverting late so my tests would not have picked up antibodies. I know that some say the window period is 3 months, but I have also read i that you cannot be sure you are negative until after a 6 month test, especially after you had a high risk event like mine, or if your "medical history is incompatible with the tests". I really do not understand that last statement, does it mean that since I still have symptoms I should test again? I'll add that I have not had any health issues in the past so I really do not know why I would be a late seroconverter, nor am I on any serious meds. Since the experiences I have not engaged in any high risk actives, out of fear that I will infect someone I care about. Also, I really do not know much about the Clearview Complete test, just that it is only a second gen. test. Which makes me worry if it is as updated/popular/recommend as other tests. I am getting a 6 month test (Clearview) on Tuesday, but am terrified! Is there a large likelihood that I will be positive? Are these rapid antibody tests that I have been taking any less reliable then a blood test? Thank you so much for taking the time to listen to my worries, it is extremely appreciated!
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Anonymous
Hello,

Thank you for contacting the AIDS Vancouver Helpline as your source for HIV/AIDS related information. I would be happy to answer your questions and clears some things up for you.

It is wonderful that you used a condom! When used properly, condoms are the best and most effective way to protect yourself from HIV and other STI's. With that said, it is unfortunate that the condom broke. Since the condom broke, your situation is considered a high risk exposure. This means that if your partner was living with HIV, there is a chance for [HIV transmission](http://www.avert.org/hiv-transmission-prevention) during your exposure. On the other hand, you are correct when you say that protected oral sex and the giving of oral sex is low risk. Having said all this, it is wonderful that you have been tested.

With regards to [testing](http://www.avert.org/hiv-testing), AIDS Vancouver does not recommend the use home oral tests like the Oraquick as it is not approved in Canada. The reason for this is because there is a high chance for human error when performing home tests. For more accurate results, AIDS Vancouver recommends testing through a testing site or a laboratory that uses rapid testing kits like the [Clearview Complete Test](http://www.alere.com/en/home/product-details/clearview-complete-hiv-1-2.html). Rapid tests are 3rd generation tests that look for HIV antibodies in your blood. Antibodies are what our bodies produce in response to being infected with viruses such as HIV. If you get a reactive result, know that this is only a preliminary result. Repeat testing using blood sampling (through a blood draw) must be performed for confirmatory results. All HIV tests are considered conclusive at 3 months or 12 weeks after your last high risk exposure. Any test you have done past this time frame is considered conclusive.

With regards to seroconverting late, please know that there are only 4 situations when testing at 6 months is recommended. These 4 situations are:

1. if you are currently receiving antiviral treatment for Hep C
2. if you are currently receiving treatment for cancer
3. if you have received Post Exposure Prophylaxis (PEP) medication
4. if you have an underlying immunodeficiency

If you do not have any of these factors, then you do not need to be tested at 6 months and your non-reactive tests performed after 12 weeks are conclusive.

With regards to symptoms, please know that HIV has no clinically definable symptoms. This means that symptoms vary from person to person with a common symptom of newly infected individuals being flu-like symptoms. However, as I said previously, the only way to know if you have HIV is to get tested, which you have done and have been found to be negative! If your symptoms continue to bother you, please see your local medical professional to determine a cause and if needed, receive treatment.

I hope I have answered your questions. Please feel free to contact us if you have any more questions or refer to the links provided for more information.

Best wishes,

Mary

Helpline Volunteer
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