Anonymous
I'll keep this as brief as possible. I'd love to get an answer because I am feeling pretty anxious. I'd first like to thank you all for the amazing work you do.

Here are my questions. I had unprotected sex with another male (I was the insertive partner) two-and-a-half years ago. I got a rapid blood test performed at 4 weeks. The test was 3rd generation, I believe. The result was negative. I followed up at 74 days (10 weeks and 3 days post-exposure) and received another negative. The results came back within a matter of minutes (is this normal?). Shortly after this, the local testing clinic in my area stopped providing the tests because the nurse who administered them retired. I was supposed to go for my final test at week 12/13 but never did, assuming my negative was a good sign. Was this a mistake?

Since that time, I've had protected sex with three individuals. I understand this is not a risk, but during the last encounter, the condom I was wearing rode up (but did not come completely off or break). Is this a risk? The encounter happened six months ago, and I was never tested. I'll be honest and say that what's prompting my anxiety is a recurring rash on my torso. I know symptom diagnosing is ridiculous, but anxiety isn't logical.

Could you please tell me 1) how reliable my 74-day results were and 2) if I had a risk with this other encounter? Thank you so much! Hope you all have a blessed day.
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Anonymous
Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about having unprotected anal sex. From the information given, this scenario is determined to be a High Risk activity (There is evidence of transmission through these activities and are the majority of cases of transmission).

The scenario mentioned above does meet the three components of the [HIV Transmission Equation](www.aidswindsor.org/healthy-me/hiv-transmission/). This is a High Risk scenario because there is *direct access to the bloodstream* with an *exchange of bodily fluid*.

With regards to your question about HIV testing, although up to 95% of infections are detectable within 4-6 weeks, it is recommended that re-testing is done at 12 weeks for confirmation with the 3rd Generation Test [1]. Most people develop detectable antibodies in 21-25 days. Due to this encounter occurring two years ago, it is unlikely that transmission occurred due to the negative tests and no symptom development.

The second situation you described as having protected sex is a Low Risk activity (Evidence of transmission occurs through these activities when certain conditions are met). It does meet the transmission equation linked above. 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. Refer to your physicians for further information.

Recommendation: Refer to a health care provider for HIV testing. Testing should be conducted after any High or Low Risk activity.

AIDS Vancouver Helpline/Online, Carson
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