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What are the chances of getting HIV after having negative HIV tests?

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HIV AIDS Specialist
Practicing since : 1974
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Dear Dr, On 31Oct13 I was in Antwerp Belgium and visited the legal red light district there. I ended up with a CSW. She put on a condom on my penis the very first thing and gave me an oral erection with condom. Then with the same condom we had 5-10 min of protected sex. Before vaginal penetration she put on a lubricant on her vagina. After the even the condom was intact and she rolled it off my penis. I did not wash off my genital area immediately and just dressed up and left back for my hotel. Does not washing the genital area immediately put me in any trouble? I am quite depressed at my actions and took a HIV 1 RNA RT-PCR quantitative test at 14 days after exposure which came stating target not detected (negative). On the 28th and 40th day I took the HIV 1/2 & P24 combo test done by CMIA method and the index value was 0.19 and 0.21 non reactive respectively for these tests. My doctor says that these tests are 4th gen and are conclusive and I need no further testing for HIV. I wanted to as your opinion whether these can be considered conclusive (CMIA) method at 28 and 40 days after exposure and do I need further testing? In between I had all urine analysis and culture tests done at 40 days and my sample was sterile. I also did the VDRL(RPR) test for syphillis at 40 days which was negative. To be on the safer side, I repeated the HIV 1/2 and P24 combo test done by CMIA method after 55 days (almost 8 weeks), 65 and 84 days (12 weeks). All were negative, and the index value for the 12 week test was 0.21 (negative). The RPR VDRL was also non reactive. I would like to ask your opinion on my situation and whether you think I need to test again after 6 months?
Posted Sun, 16 Feb 2014 in HIV and AIDS
 
 
Answered by Dr. S. Murugan 1 hour later
Brief Answer: Free from HIV/STD beyond any doubt. Detailed Answer: Hi, Welcome to XXXXXXX Thanks for posting your query. Your fear for HIV is baseless. You had protected oral and vaginal intercourse and the condom was intact. Not washing immediately did not increase your risk in any way with regards to HIV. Moreover as your physician told that the CMIA COMBO HIV test done after 28 days itself proved that you had not infected with HIV. That is a 4th generation HIV test more specific and sensitive. All the test done afterwards were unnecessary and waste of money only. Tests for syphilis and urine culture also were repeatedly negative declared that you free from HIV/STD. No further tests of any sort is necessary. Just forget about that incident and erase it from your life and enjoy you days coming ahead. Dr S.Murugan
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Follow-up: What are the chances of getting HIV after having negative HIV tests? 5 minutes later
Thank you doctor. I had a surgery done on the 19 day after this incident in Belgium to remove piles. I was discharged the next day. I was put on cefixime 200 mg twice a day and paracetamol twice a day for ten days. Will these medications or surgery have any effect in hiv or std testing?
 
 
Answered by Dr. S. Murugan 24 minutes later
Brief Answer: Cefixime has effect on bacterial STDs,can abort. Detailed Answer: Hi, Welcome once again. Tablet Paracetamol has no effect on HIV/STD or on the tests. Tablet Cefixime is an antibiotic and has no effect on HIV or other viral STDs whereas it could able to abort any Bacterial STDs, if at all there was an infection. If you had taken this drug for not less than 5 days you need not worry about the STD tests also as it could abort the disease if there was any. It is confirmed that you are free from HIV/STD and need not worry at all. DR S.Murugan
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Follow-up: What are the chances of getting HIV after having negative HIV tests? 17 hours later
Thank you doctor. Online forums also mention 12 weeks/3 months for completely conclusive HIV testing. Also CDC states that no tests are conclusive before 3 months/12 weeks. How is the CMIA combo test conclusive at 4 weeks? I have a family. Based upon my resukts can i start normal inprotected relations with my wife and plan for our family. Will it be alright now?
 
 
Answered by Dr. S. Murugan 5 hours later
Brief Answer: You can resume unprotected sex with your wife. Detailed Answer: Hi, Welcome once again. Antibody tests are conclusive after 12 weeks, but antigen tests become conclusive after 4 weeks. Antigen test detects viral particles itself or viral proteins. It is more confirmatory and highly reliable. With my experience of 15 years with these tests, antigen tests are highly reliable. You can trust me. You can resume unprotected sex with your wife safely without any doubt. Dr S.Murugan
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Follow-up: What are the chances of getting HIV after having negative HIV tests? 18 minutes later
Thank you doctir sibce i took an antigen+antibody combo at 84 days after exposure. I think the result would be conclusive even on the antibody part. I have a burning, stinging sort if pins abd needles ceeling all over my andoben and back. I see two red slouch lines below my chest area which also burn. I see some red folicilitus type dots all over my abdomen. Can they be related to this incident? Do you recommend going to a dermatologist or is it brcause of dryness of weather and skin ?
 
 
Answered by Dr. S. Murugan 7 hours later
Brief Answer: Nothing wrong to have another test to make it sure Detailed Answer: Hi XXXX, Welcome back. You need no more tests. If you want to have one more after 12 weeks there is nothing wrong and you feel happy to see another negative result and your all doubts would be cleared. All your symptoms are not at all related to HIV/STD. As you pointed out they could possibly due to whether changes. But to clear your doubts and for an earlier relief it is better for you to meet a Dermatologist and have a consultation. Get well soon. Dr S.Murugan
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Follow-up: What are the chances of getting HIV after having negative HIV tests? 11 hours later
Dear Dr, I meant as I have already taken the HIV 1/2 and P24 combo (cmia) test at 83 days (12 weeks) after exposure, the antibody part of this test should be conclusive as well. I do not wish to repeat any tests for HIV/STD if not necessary. It has been a very tense period of 12 weeks for me and I am glad that it is over. Today I went to my dermatologist and showed him my folicilitus and red lines on abdomen. He said nothing to worry, it was due to dryness of weather and skin. He prescribed me xceptional moisturizing lotion and acutret 10 for one month and told me no connection with incident in Belgium. I wanted to ask you about Hep C. Do you think I need to test for that.
 
 
Answered by Dr. S. Murugan 4 hours later
Brief Answer: Unlikely, you don't have any risk for Hep.C Detailed Answer: Hi Welcome back. As you had a protected exposure and not washing immediately your own semen after the condom removed, is not a risk for Hepatitis C. So you need not worry about that also. Just forget about the incidence and enjoy your days ahead. Dr S.Murugan
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Follow-up: What are the chances of getting HIV after having negative HIV tests? 13 minutes later
Thank you doctor. You have been most helpful. The only thing that bothers me is that there would have been vaginal fluid on my genital area not covered by condom. I took a full bath after an hour of this incident. I am vaccinated against Hep B . And my HBsAg came negative at 5 weeks.
 
 
Answered by Dr. S. Murugan 7 hours later
Brief Answer: NEGLIGIBLE RISK and nothing to worry. Detailed Answer: Hi XXXX. Welcome once again. With protected coitus and intact condom, there is not much chance to come in contact with vaginal fluid. Even if you had some contact with the vaginal fluid in the condom uncovered area, it carries a very negligible risk and you are HIV free Nothing to worry. If you have more questions feel free to ask Dr S.Murugan
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Follow-up: What are the chances of getting HIV after having negative HIV tests? 3 hours later
Thank you Doctor. So with my 12 week negative HIV 1/2 and P24 combo test result and vdrl rpr negative result i am clear of any problems related to this incident. I promise to never repeat this mistake in my life in future. I would like to thank you for your patience and help with my queries and doubts.
 
 
Answered by Dr. S. Murugan 6 minutes later
Brief Answer: You are welcome Detailed Answer: Hi, You are most welcome. It is certain that you are free from HIV and Syphilis. Carry on your routine in full swing with cheer and spirit. All the best. Dr S XXXXXXX
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Follow-up: What are the chances of getting HIV after having negative HIV tests? 5 days later
Dear sir, today was the 92nd day and I did the following tests 1. HIV 1/2 P24 Combo test - 0.58 non reactive 2. CBC - all OK except low playlets 117 (150-450) 3. Anti HCV - negative 4. HbSAg - hep b surface antigen - negative 5. VDRL - non reactive I am really freaking out as the value of my HIV test has increased from 0.21 to 0.58 in just a week. Does this mean anything doctor? I am very very worried. Do you suggest that I take another test anytime soon? What is the significance of indeed values?
 
 
Answered by Dr. S. Murugan 4 hours later
Brief Answer: Confirmed free from HIV/STD. Detailed Answer: Hi, You are reacting too much. Just ignore the past. No more tests are necessary. Reading of any test must be below the 'cut off' value, that is less than 1. The value has no extra meaning like it has raised from 0.21 to 0.58 etc. Just ignore. The result is non-reactive. That is you are free from any infection including Hepatitis B and C and Syphilis. If you can not come out still from your fear for HIV/STD , it is better for you to meet a psychiatrist once for consultation and follow his advice. Dr S.Murugan
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Follow-up: What are the chances of getting HIV after having negative HIV tests? 2 minutes later
I am sorry doctor, i did not know that below the cutoff value of 1 for these test there is no significance of these numbers. I promise to hold my end from now on. Your repeated reassurances mean so much to me. Thank you so much. s
 
 
Answered by Dr. S. Murugan 6 hours later
Brief Answer: Most welcome. Detailed Answer: Hi, I am very happy that you gain confidence. You are most welcome. If you don't have anything to ask you can close this conversation. Enjoy your days ahead. Dr S.Murugan
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