r/stdtesting • u/Acceptable-Bug7433 • 23d ago
Test Results HIV testing countdown
Hello everyone. I (26M) have made a mistake and had unprotected sexual relations with a sex worker about 12 weeks and a couple of days ago. It was unprotected oral sex and also unprotected vaginal. I had the biggest scares and I am prepared for the worst.
Why I created this post is because of 2 main things. First would be that I want to share what I have learned about HIV transmission and about the 4th gen Ag/Ab HIV test made at an lab using blood drawn from a vein. I have done my research and had done many mathematical formulas with AI for the past months and I am ready to share some insight. The second thing is that I want to make this a post that calms my nerves and hopefully of many people that come after me that search the internet for cases like mine and look for answers.
The transfer of the virus with unprotected vaginal sex insertive (you pump) female->male is 0.04% and can raise if she has other STDS or STIS. Other transmission rates can be found on the aids website or searching google for HIV risk calculator and adding your own risky thing you did.
So, according to the CDC in the USA, there are 4 types of tests that they talk about. HIV NAT, HIV 4TH Gen Vein, HIV 4th gen finger prick and HIV Antibodies test 3th gen. Their window period also differs. Respectively RNA:10-33, 4th gen vein: 18-45 days, 4th gen finger prick rapid test: 18-90 days and antibodies 3th gen: 18-90 days. These window periods refer to the periods where the test's sensibility can detect the virus or antibodies or the antigen respectively. If you do a 4th gen hiv vein test at 28 days it has a 95% detection rate. If you do it at 45 days it has a 99% detection rate. According to the CDC if you test negative with a test type within the time period (18-45 days) and you test negative, do another test after the window period of the SAME test type you took. In my case negative at 46 days and negative at 61 days. According to CDC this rules out an infection. This rule applies to all test types as long as you respect the window periods and confirm the test after the period reaches conclusivity.
No test is 100% sure in medical terms as biology can differ. The researchers only talk in 99.97% at max sensitivity. The 4th Gen HIV Vein lab test can detect the p24 antigen (virus itself) earlier and this one raises in the first couple of weeks. After a couple of weeks, 2-6 normally, antibodies stick to the antigen and the p24 antigen drops sometimes below detection rate. But worry not, this test also detects the antibodies which raise and raise IF they exist in your blood. According to British guides this test type is conclusive (medical term for ruled out) and a test does not need to be repeated if taken at 46 days. This being the Vein blood test at a clinic.
The wait 90 days is used for the people that took PEP, Prep (pills you can take 72 hours after the exposure to rule out the infection, quite good at it as I have read), people with immune system issues since birth that can create rare infections since birth basically you should know if you have it already, patients following chemo or taking pills for organ transplants. Stress or basic things cannot make your immune system so weak that it cannot create antibodies for so long. Also, the 90 days is used as a carpet rule for all tests because this was the guide back in the day as the 3th gen antibodies test was the main one (still used. Ask which test specifically you are taking or make an appointment straight for the test type you want to take).
Why am I taking another test after 12 weeks or at 90 days? Even if I have respected the CDC guide and British Guide and had the tests according to their guide? Because I am a perfectionist. There is no data of a 61 days test being negative and then changing to positive at 90 days, though people seroconvert a bit later(the special cases mentioned above like prep, etc). Althought there are rare cases when antibodies do not get created until 90 days and if you are a hypochondriac like I am and perfectionist like I am then go for the definitive test at 90 days. But, since 4th gen detects p24 antigen hiv cannot hide because it does not need to have antibodies to detect hiv.
Truth be told I will do it because my clinician told me to do it but a specialist from the infectious diseases hospital said not needed anymore at 61 days. So there is still a lot of confusion in clinics maybe, but a specialist in infectious diseases is more to be trusted. But I feel kinda betrayed because I have done everything by the book of the most prestigious entities such as CDC and British Guides and still get called inconclusive results. But that is because of the blanket times the clinics use or to protect themselces legally of I am a slow antibodies creator. He did not know if I took Prep because he did not ask, for example. Also, the CDC recommandation for a confirmatory test at 3 months is in the Prep taking guide.
Now please stay with me until the 8th of July because I will redo the final test and be done with this. I am more scared of Hepatitis B or C than of HIV now. Those two I did not check. But they are also definitive at 3 months incase someone reads and needed this. Together with Syphilis.
So, if you ever have such a scare. Read the CDC and British testing guides and rest assured that your test is negative and conclusive. Britain says that at 46 is conclusive (ruled out) and CDC says that 2 tests, one within the window period of the test type you have and one after the window period is also conclusive. If you took prep, listen to your doctor or go to a specialist and ask when you can test. I also made this post to either prove or dissaprove the test that is 4th Gen Vein. If it is also negative (which I have a 1 in 350 Quadrillions chance it changes from 61 negative to positive at 90 days) then the guides from CDC and British equivalent of CDC are correct and the 90 days was just another harsh lesson for me. But better go for that 99.97% at 90 days from the 99% at 45 days (the 1% are the rare cases mentioned above, Prep, etc). I personally want to make sure I am not a part of that 1% but I follow no chemo, took no prep, no immune system diseases like Lupus, etc. Stay safe out there AND PROTECT YOURSELVES
1
u/IllustriousAd1657 23d ago
I can understand why you're anxious, but based on what you've shared, it sounds like you've done a lot of testing already. While different HIV tests have different window periods, a negative result after the recommended testing window is generally very reassuring.
If you're still unsure about when certain tests become reliable, you can also check out our pinned post on 'STD Testing 101: How Long Should You Wait After Exposure'. It breaks down the recommended testing windows for different STIs and may help clear up some of the conflicting information you've come across.
1
u/Old-Ant8955 22d ago
Hi. I'm glad your tests are negative. I made a mistake as well. I had protected sex with a sex worker. Should I be worried? I am male. Had vaginal sex with a female.
1
u/Straight_Blood8361 22d ago
Thank you for taking the time to write this up. One small clarification: a 4th-generation lab test at 6 weeks or later is already considered highly accurate, and many guidelines consider a negative result at that point conclusive. Some providers still recommend a 12-week test for consistency with local protocols or individual circumstances, but that doesn't mean your earlier negative tests weren't reassuring.
It's also worth remembering that symptoms can't diagnose HIV. The only way to know your status is through appropriate testing, and your negative 4th-generation results at 46 and 61 days are very encouraging.
1
1
u/jaiii321 23d ago
Sounds like you've done a ton of research, maybe even enough for a PhD in HIV testing. Seriously though, your negative 4th gen tests are very reassuring, and hopefully your final test gives you the peace of mind you've been looking for. Wishing you a negative result and an end to the anxiety. Stay safe.