Anonymous
Hi there, I'm a Canadian living in New York City. I had unprotected vaginal sex multiple times with the same girl on the weekend of September 18th 2015. We were seeing each other for a few weeks on and off but it wasn't a committed relationship. This wasn't some random girl I met either, we worked together, and as far as I knew she was clean. We had also been sleeping together unprotected in the months prior to that...

The following friday after that weekend I fell suddenly sick, Immediately I went to the docs and was diagnosed with just a bad cold. After it didn't go away for a few weeks it got worse and turned into a sinus infection. I've been dealing with a laundry list of different symptoms and feeling terrible on and off ever since then. I haven't felt all the way better or at least how I felt before I got sick since then. I was taking loads of over the counter meds plus 3 different antibiotics over the course of the fist few months or so after I initially got sick (I also had a Hepatitis A vaccination prior to a trip to mexico a few months before on June 30th 2015).

I spoke with her shortly after that weekend and she was fine, not feeling sick either in the days before or after that. She tested negative for everything when she went for her yearly gyno appointment a few weeks after that weekend.

I've tested for all other STI's and infections as well as gone through a general physical and general blood test/cell count test. The doc's tell me everything is in the green and fine. However, In the back of my mind I always suspected HIV so I started testing:

October 5th 2015, rapid hiv test: negative
November 27th 2015, HIV 1/2 AG/AB 4th gen w/ reflex, non reactive (negative)
December 16th 2015, HIV 1/2 AG/AB 4th gen w/ reflex, non reactive (negative)

I'm still feeling quite ill and still very paranoid. I haven't had any sex since that weekend to be safe in the meantime also. At my last followup I asked the doctor when can I be finally sure and does he recommend that I test again and he said:

Your HIV is negative and typically waiting 3 months is the standard. I cannot guarantee that you do not have HIV but it is HIGHLY unlikely. The lymph nodes you have are either normal palpable nodes or residual from your prior infection (sinus). However, in answer to your question, Yes repeating your HIV again in one month would be recommended.

So basically, he's asking me to come in and test again at the 4 month mark, which worries me because I thought I was done and past all of this...

I'm reaching out to you in hopes in calm down my anxiety and get some questions answered.

Mainly, after I take this 4th month test and it comes up negative again can I stop worrying? Is there a chance that it would take this long for a positive to show up if I indeed was actually infected? Everything I read online says 3 months is conclusive. Other than being sick right now I'm a perfectly healthy individual. I'm not on any of the things I've read that would affect it (chemotherapy, heavy medications, immune deficiency, etc) Are there any factors that would give a false negative? I just want to be sure after this 4 month test because I keep reading some people take up to 6 months and I really don't want to go through another 2 months of worrying and waiting.

Thank you in advance.
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Anonymous
Hello and thanks for reaching out to the AIDS Vancouver Helpline.

It sounds like you still feeling ill and paranoid in spite of the HIV testing you done.

Let me give you a detail information regarding how HIV is transmitted, and the various testing that are evident (researched-based).
To answer all your questions, For all HIV testing a 12 weeks (after exposure to HIV) negative is considered conclusive.

You are correct that there are specific circumstances which might require you to delay testing until 6 months; perhaps if your doctor is asking you to re-test, then one of those situations might apply to you. Sometimes doctors are conservative when it comes to testing, so perhaps your doctor is asking you to re-test to be sure the three months has definitely passed (in case there is any uncertainty about the date of exposure).
Only your doctor can advise why he wishes you to re-test, and we at AIDS Vancouver recommend that our clients follow the instructions of their doctors, as of course, he has much more of your personal medical information available.

Below is some information about the tests that you have taken:

RAPID

4th Generation EIA
Test Name Method Window Period Conditions
Rapid or “Point-of-Care” Blood or oral swab test that looks for antibodies. Up to 95% of infections are detectable within 4-6 weeks post exposure. Most people develop detectable antibodies in 21-25 days. The rapid test is a type of 3rd Generation test. Two forms available: finger prick blood sample or oral swab. Oral swab test is most common in the U.S. but due to false positives in Canada it is not approved and blood collection is more likely. Many places in the U.S. and abroad may charge a fee for rapid testing. Conclusive at 3 months post exposure.

I hope this information answered your questions, calm you down, lessened your anxiety, and most importantly stop worrying. And hey, Congratulate yourself for being proactive with your physical and sexual health. Your healthcare provider is giving you a good information regarding your health care status. Keep that practice!

Here is a good information that you might be interested to explore[ AIDS Vancouver ](http://www.aidsvancouver.org/)and [CATIE](http://catie.ca/basics)

Thank you for contacting the AIDS Vancouver Helpline.

Best in Health!

Roel

AIDS Vancouver Helpline/Online

Monday-Friday 9am-5pm (PST)

1 844 INFO-HIV (Toll free Canada & U.S.)

helpline@aidsvancouver.org

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Test Name Method Window Period Conditions
4th Generation EIA Blood test that looks for antibodies AND p24 protein antigens. Commonly referred to as the "combination," "combo" or "DUO" test. P24 protein is detectable immediately after infection but only for the first few weeks. The antibody (ab) test has a window period of 4-12 weeks post exposure. This test is widely available in North America. Most HIV specialists consider this test to be conclusive at 6 weeks but official HIV testing guidelines still recommend re-testing at 12 weeks for conclusive results. Conclusive at 3 months post exposure.