Hi .. i had sex with a prostitute 4 and half months ago .. i used condom but it broke during the sex  after 21 , 70 and 89 days from the exposure i did hiv tridot tests all were negetive .. after 90 days from the 1st exposure i did protected sex with an unknown women with unknown hiv status the condom didnt break or slipped i checked it after the sex and i pulled it out at the time of ejaculation i didnt kiss her nd no oral sex .. after 20 days from the 2nd sex and 110 days from the first incident i did hiv Cmia Test Which was non reactive both p24 and antibodies ..after 42 days from the second incident i did hiv rapid tridot test which was negetive and after 137 days from the first incident and 47 days from the second incident i did hiv cmia antibody antigen test which was non reactive .. i just want to ask should i test again or these tests are enough?


Thank you for your inquiry. From what we gather from the question, you were asking about the testing you accessed after engaging in protected insertive 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 if the condom broke during sex or was used incorrectly. It is important to note that even with perfect condom usage, the risk of HIV transmission is not reduced to zero. Helpline Transmission Equation .jpgIt was very responsible of you to access testing after engaging in a High, Low, or Negligible Risk activity. A 3rd generation antibody test, such as the HIV TRI-DOT test, is considered completely conclusive 3 months post-exposure. A 4th generation antibody and antigen test, such as the HIV CMIA test, is considered conclusive by most HIV specialists 6 weeks post-exposure (99% accurate), but some physicians and guidelines do recommend re-testing 3 months post-exposure for completely conclusive results (99.9% accurate) (1). Thus, an HIV test 3 months after your most recent risky exposure is recommended for completely conclusive results.

Engaging in a second risky activity essentially "resets" the clock for testing. Although you will know 3 months after your initial exposure whether transmission occurred during that first activity, you will not know your actual HIV status until 3 months after your most recent exposure. This is why it is very important to refrain from engaging in risky activities when you are uncertain about your HIV status and are in the window period. For the future, if you are continuously engaging in High-Risk activity, there are biomedical approaches such as PrEP and PEP that help lower your risk of acquiring HIV.

Recommendation: Refer to a health care provider for HIV testing at least 3 months after your most recent exposure for completely conclusive results. Refer to your physicians for further information on PrEP and PEP if you plan to continue engaging in risky activity.

AIDS Vancouver Helpline/Online, Marie

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