Question: 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?

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?

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?

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 ?

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.

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.

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.

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?

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