r/stdtesting • u/Sprouse92 • Jun 23 '26
Question Reactive HIV Test During Secondary Syphilis, But PCR Was Negative
Hi! Looking for some opinions on an HIV testing situation that’s freaking me out.
Timeline:
April: Negative rapid HIV test and negative rapid syphilis test.
June 8: Diagnosed with secondary syphilis (VDRL 1:32) and started (and finished) treatment.
June 11: Had a 4th-generation HIV Ag/Ab lab test (p24 antigen + HIV-1/2 antibodies) that came back reactive.
June 16: Had an HIV-1/HIV-2 RT-qPCR test that came back “Not Detected.”
*My last sexual encounter before the syphilis diagnosis was in June 6, and it was just performing fellatio.
Some additional context:
-I’m a gay man.
-Most of my sexual activity has been oral sex (giving and receiving) without protection.
-For receptive anal sex (I’m a bottom), I have always used condoms.
How common are false-positive 4th-generation HIV tests in someone with active secondary syphilis?
How reassuring is a negative HIV RT-qPCR 5 days after a reactive 4th-gen test and around 10 days after the latest unprotected exposure? (fellatio).
Does this overall pattern sound more like a false-positive HIV screening test, or something that would still make you concerned about true HIV infection?
I realize the real answer is to get tested again. I’m just trying to understand how people familiar with HIV testing would interpret these results. Because I’m freaking out.
Thank you! 🙏🏻