Question about additional testing

[DABFEH]

First, I wish to extend my gratitude to the experts and educators on this forum. I have been trolling this site for weeks and have found some solace in your wisdom and support. You all do amazing work.

On July 25, 2012, I met up with a gentleman on one of those phone apps and engaged in receptive anal sex. As I always have, I periodically checked the condom and adjusted the tip to avoid the 'air bubble' problem.

We finish, I look down, and the condom has catastrophically broken. It is unclear whether he has ejaculated or not.

Nine days later, I order a full STD panel and RNA PCR test through Quest Diagnostics. All tests come back negative, including the RNA test at <20 copies/mL. I take the results to the regional HIV medicine center and am assured, on several occasions, that I am not infected, and that my test would be "in the millions" if I were infected.

Ten days later, the gentleman tests negative on a rapid oral test. He assures me that he tested negative two months ago after having abstained from sex for four months, and he has not been sexually active since then.

Twenty-seven days later, I get a fourth generation Ab/Ag test, which comes back negative for both antigen and antibody. I am again assured that I am not infected and am told that I need no additional testing.

Thirty-eight days later, I get a Oraquick rapid blood fingerstick test, which comes back nonreactive. Again, I am told that, if I were indeed infected, I would have tested positive by now.

I will also note that I have not experienced any acute infection symptoms, despite my being paranoid and hyperaware (checking my temperature three times a day, feeling my lymph nodes, obsessively checking Google, everything that I am sure you are all sick of hearing about).

I now realize that the likelihood that I was infected and that three highly accurate tests missed the infection is astronomical. Nevertheless, the likelihood of a condom breaking despite my attempts at prevention is also fairly low, so I am experiencing a fairly high level of what I can only imagine must be 'healthy paranoia.'

My questions are as follows:

1. In regards to my PCR test, both the HIV counselor and the nurse practitioner explained that, if the gentleman was indeed infected and tested negative because he was in the window period for the rapid test, he would likely have a very high and very infectious viral load, which would have infected me and readily shown up on the nine day PCR. Apparently, the duration of the eclipse period does depend on the initial inoculum, which was also shown in this paper (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC112210/). Does this sound reasonable?

2. I have an ELISA scheduled that I can take whenever I wish. I was thinking about getting it done at the eight-week mark, and then getting another one done at the thirteen-week mark. Is this excessive? Since I got my last test done a few days shy of the six-week mark, I was hoping that the eight-week test would provide a little more assurance. Plus, if I am indeed infected, I figure that the sooner I detect it, the sooner I can get treatment.

3. Can I donate to the forums? I figure that it is the least I can do after having combed over the forums continually for the past few weeks.

Thank you!

[Andy Velez]

1. In regards to my PCR test, both the HIV counselor and the nurse practitioner explained that, if the gentleman was indeed infected and tested negative because he was in the window period for the rapid test, he would likely have a very high and very infectious viral load, which would have infected me and readily shown up on the nine day PCR. Apparently, the duration of the eclipse period does depend on the initial inoculum, which was also shown in this paper (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC112210/). Does this sound reasonable?

YES, IT DOES.

2. I have an ELISA scheduled that I can take whenever I wish. I was thinking about getting it done at the eight-week mark, and then getting another one done at the thirteen-week mark. Is this excessive? Since I got my last test done a few days shy of the six-week mark, I was hoping that the eight-week test would provide a little more assurance. Plus, if I am indeed infected, I figure that the sooner I detect it, the sooner I can get treatment.

I WOULD NOT BOTHER WITH AN 8 WEEK TEST. WITH YOUR 6 WEEK NEGATIVE THE PROBABILITY IS VERY HIGH THAT YOU WILL CONTINUE TO TEST NEGATIVE AT 3 MONTHS FOR A CONCLUSIVE RESULT.

3. Can I donate to the forums? I figure that it is the least I can do after having combed over the forums continually for the past few weeks.

DONATIONS CAN BEMADE TO AIDS MEDS.COM,462 7th AVENUE NY NY 10018 17th fl.

I EXPECT YOU TO COME OUT OF THIS SITUATION OK.

[Ann]

DAB,

I agree with Andy. You are highly unlikely to go on to test positive after the negative results you've had thus far. You don't need to test again at eight weeks - a confirmatory test at three months will be sufficient. I fully expect you will continue to test negative.

Please do yourself a favour and stop micro-examining your body all the time. You do realise that stress will cause physical symptoms, don't you? Knock it off and get yourself busy with other things while you wait for the appropriate time to confirm your negative hiv status.

3. Can I donate to the forums? I figure that it is the least I can do after having combed over the forums continually for the past few weeks.

As an alternative to sending a donation**, you can also take out a one week, four week or three month subscription. Instructions on how to do this are detailed in this thread.

**Send a check made out to AIDSmeds.com, and please note in the lower right-hand corner of the check that the money is to be directed to the forums.

AIDSmeds.com,
462 Seventh Avenue, 19th Floor,
New York, NY 10018.

Thank you very much which ever route you take. It's difficult for us to meet our overheads in these perilous economic times and the continuation of this service depends on the generosity of our readers. Thank you!!!

Ann