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I Met A Sudanease Man Who Never Tested At All
Question: i met a sudanease man who never tested at all in his life. according to him he only fuck his wife with without condoms but he fuck other guys. i mean a lot of guys without condoms. he never complained of any illnesses at all. nothing on his penis , no rash or ulcers. on last Wednesday night, he licked my ass with his tounge and then i swipe his saliva by my hand. then he fucked me with condom. condom did not break or slipped. but he came inside the condom. he did not come inside but he pulled out before cumming. although condom was still on, so he came inside the condom and outside my ass. i am worried because he fucked me rough and hard, i bleed scanty. after sex i put water inside the condom after sex and squeeze it. it appear to me that there is no break or leakage. even i kept the condom few hours after sex to make sure that no leakage. i was worried and crying, i brough a home hiv test by blood that could test hiv within 20 min. i test him and it appear 2 lines ( one on T and C ). THE TEST CONCLUDE HE IS HIV POSITIVE. he did not know that he had hiv. then went to doctors and gave me PEP, I started PEP after 35 hours from the incident.
my second question. i have done the home test many times and it always come 1 line at C, never had 2 lines. but this was first time i use a test and i see that it become positive for someone. another thing ( i did combo hiv test antigen and antibody after that night and it shows non reactive ) so i am sure i am negative before he fucked me. but now i am so scared. please i need ur opinion
my second question. i have done the home test many times and it always come 1 line at C, never had 2 lines. but this was first time i use a test and i see that it become positive for someone. another thing ( i did combo hiv test antigen and antibody after that night and it shows non reactive ) so i am sure i am negative before he fucked me. but now i am so scared. please i need ur opinion
Brief Answer:
Your HIV risk is almost 'NIL'
Detailed Answer:
Hi,
Welcome to ASK A DOCTOR through HCM.
Thanks for posting your query.
Fortunately you had taken post exposure prophylaxis. PEP has to be started before 72 hours. You started PEP 35 hours after the exposure. So if the organism (HIV virus) entered into your body, the infection would have been aborted and you are free from HIV infection.
You had not mentioned:
1. When was your encounter with that Sudanese?
2. Had you completed the course of PEP? If so how many days? Combination of drugs?
3. The HIV tests done during the window period can not be reliable? How many days gone after your exposure and how many days after the exposure, you had your test?
Anyhow as you had PEP your HIV risk is almost "NIL"
Dr S. Murugan
Your HIV risk is almost 'NIL'
Detailed Answer:
Hi,
Welcome to ASK A DOCTOR through HCM.
Thanks for posting your query.
Fortunately you had taken post exposure prophylaxis. PEP has to be started before 72 hours. You started PEP 35 hours after the exposure. So if the organism (HIV virus) entered into your body, the infection would have been aborted and you are free from HIV infection.
You had not mentioned:
1. When was your encounter with that Sudanese?
2. Had you completed the course of PEP? If so how many days? Combination of drugs?
3. The HIV tests done during the window period can not be reliable? How many days gone after your exposure and how many days after the exposure, you had your test?
Anyhow as you had PEP your HIV risk is almost "NIL"
Dr S. Murugan
Above answer was peer-reviewed by :
Dr. Saisudha Kotla
The sex encounter was on Wednesday on 13 of april 2022 at and I started PEP at friday 15 april 2022 at 5:30 am
The medication are 2 drugs ( truvada once day and isentress twice a day evey 12 hours ) for 28 day and I take it exactly at regular times ( i take truvada and isentress together at 5:30 am and sexond dose of isentress at 3:40 pm )
Now i am using PEP for 5 days and I will continue till day 28 after exposure
Today is day 5 after exposure.
I had a combo test ( antigen and anybody 24 hours after the sexual encounter and before i started PEP and it was Non reactive ( i provide a picture for the test from a certified lab )
My question is can i do an HIv test now ? What is the soonest time ? I am scared to get an HIV .. can I do PCR now ? I want to relax. I dont want to wait for a month to do the test. Any reliable test to be done.
Another issue regarding the home HIV kit.
I hve bought many HIV test for myself for the last 2 years and i have used more than 20 tests and it never showed positive ( only 1 line after 15 min of the test )
But this was forst time I saw by my naked eye for someone getting test by same kit and it showed 2 lines. Can ig be wrong ? Or it is very accurate ? FYI : the kit is. Ot expired and i did same test and it showed for me that i am negative but him was positive ( it showed 2 lines for his test within 2 min after the test that we did not have to wait 15 min ) could it be weing and we had to wait 15 min? Or as ling as it showed 2 lines in 2 min that mean hw is strongly positive?
Another thinking of me : can the test accidentally be positive if the patient had hepatitis c or b ? I mean cross reactivity ?
Please answer my all questions if you dont mind
The medication are 2 drugs ( truvada once day and isentress twice a day evey 12 hours ) for 28 day and I take it exactly at regular times ( i take truvada and isentress together at 5:30 am and sexond dose of isentress at 3:40 pm )
Now i am using PEP for 5 days and I will continue till day 28 after exposure
Today is day 5 after exposure.
I had a combo test ( antigen and anybody 24 hours after the sexual encounter and before i started PEP and it was Non reactive ( i provide a picture for the test from a certified lab )
My question is can i do an HIv test now ? What is the soonest time ? I am scared to get an HIV .. can I do PCR now ? I want to relax. I dont want to wait for a month to do the test. Any reliable test to be done.
Another issue regarding the home HIV kit.
I hve bought many HIV test for myself for the last 2 years and i have used more than 20 tests and it never showed positive ( only 1 line after 15 min of the test )
But this was forst time I saw by my naked eye for someone getting test by same kit and it showed 2 lines. Can ig be wrong ? Or it is very accurate ? FYI : the kit is. Ot expired and i did same test and it showed for me that i am negative but him was positive ( it showed 2 lines for his test within 2 min after the test that we did not have to wait 15 min ) could it be weing and we had to wait 15 min? Or as ling as it showed 2 lines in 2 min that mean hw is strongly positive?
Another thinking of me : can the test accidentally be positive if the patient had hepatitis c or b ? I mean cross reactivity ?
Please answer my all questions if you dont mind
Brief Answer:
Complete the course of PEP. You are safe.
Detailed Answer:
Hi,
Welcome back.
All the tests available in the market are highly reliable up to the extent of 97-98%. The HIV combo test is reliable up to the extent of 99% and above. But it will be conclusive after 4 weeks, not earlier, whereas PCR may be conclusive by third week for HIV 1 infection. If you want to rule out HIV 2 infection (very rare) you have to wait up to 12 weeks.
Your PEP is apt and complete the course correctly. You have to follow up with the tests 4 weeks, 3 months and up to 6 months.
You are safe as you are already on PEP.
Dr S.Murugan
Complete the course of PEP. You are safe.
Detailed Answer:
Hi,
Welcome back.
All the tests available in the market are highly reliable up to the extent of 97-98%. The HIV combo test is reliable up to the extent of 99% and above. But it will be conclusive after 4 weeks, not earlier, whereas PCR may be conclusive by third week for HIV 1 infection. If you want to rule out HIV 2 infection (very rare) you have to wait up to 12 weeks.
Your PEP is apt and complete the course correctly. You have to follow up with the tests 4 weeks, 3 months and up to 6 months.
You are safe as you are already on PEP.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Saisudha Kotla
Just now doctor i took my 6th day PEP. I started to count the pills and making sure my PEP is complete for 28 days .. truvada was ok 28 pills but the other medication was missing 2 pills for last day ( isentress ) is that ok? Or i should worry about. because i got it from outside my country and it is very difficult for me to go back and have the last pill
Brief Answer:
Not to worry about the missing tablets
Detailed Answer:
Hi,
Welcome back,
Initially the PEP was Tiruvada (Tenofovir + Emtricitabin) alone. Few years back only PEP was modified to three drugs (Tiruvada+ Isentress (INSTI). When it was Tiruvada alone also almost all the individuals were doing well.
So not to worry, Ignore the missing tablets. Medicine is not mathematics to constant answer. 28 days is just an assessment. not a rule.
Another thing is, when you bought a container of these tablets, it will be packed for 30 days (Monthly pack) not for 28 days?
So not to bother.
Dr S. Murugan
Not to worry about the missing tablets
Detailed Answer:
Hi,
Welcome back,
Initially the PEP was Tiruvada (Tenofovir + Emtricitabin) alone. Few years back only PEP was modified to three drugs (Tiruvada+ Isentress (INSTI). When it was Tiruvada alone also almost all the individuals were doing well.
So not to worry, Ignore the missing tablets. Medicine is not mathematics to constant answer. 28 days is just an assessment. not a rule.
Another thing is, when you bought a container of these tablets, it will be packed for 30 days (Monthly pack) not for 28 days?
So not to bother.
Dr S. Murugan
Above answer was peer-reviewed by :
Dr. Saisudha Kotla
Unfortunately they gave me exactly 28 pills but they missed one day pill. I bought this by 3000 dollar and it is hard for me to travel again and get it.
I was worried if that pill will make a difference
I was worried if that pill will make a difference
So how soon can i do HIV PCR to make me relax ? And should it be quantitative or qualitative?
I mean the soonest that give me a hint.
I mean the soonest that give me a hint.
Brief Answer:
To get confirmative result go ahead with the test 4 weeks after exposure
Detailed Answer:
Hi,
Welcome back.
Not to worry for missing a dose.
To get a reliable and conclusive report better have the DNA HIV PCR ( or RNA qualitative PCR) test after completion of your PEP, that is after 4 weeks.
Dr S. Murugan
To get confirmative result go ahead with the test 4 weeks after exposure
Detailed Answer:
Hi,
Welcome back.
Not to worry for missing a dose.
To get a reliable and conclusive report better have the DNA HIV PCR ( or RNA qualitative PCR) test after completion of your PEP, that is after 4 weeks.
Dr S. Murugan
Above answer was peer-reviewed by :
Dr. Saisudha Kotla
Right away after i complete the PEP?
Brief Answer:
HIV 1 infection can be ruled out by 4 weeks after the exposure.
Detailed Answer:
Hi,
Welcome back.
Yes, you are correct.
You can go with either HIV 4th generation test or HIV PCR test. Both are highly reliable.
But one more thing is, both can rule out HIV 1 infection by 4 weeks (Commonest more than 99%) whereas HIV 2 infection( less than 0.5% in countries other than certain parts of Africa), can be ruled out by 4th generation test more conclusively 12 weeks after the exposure.
DR S. Murugan
HIV 1 infection can be ruled out by 4 weeks after the exposure.
Detailed Answer:
Hi,
Welcome back.
Yes, you are correct.
You can go with either HIV 4th generation test or HIV PCR test. Both are highly reliable.
But one more thing is, both can rule out HIV 1 infection by 4 weeks (Commonest more than 99%) whereas HIV 2 infection( less than 0.5% in countries other than certain parts of Africa), can be ruled out by 4th generation test more conclusively 12 weeks after the exposure.
DR S. Murugan
Above answer was peer-reviewed by :
Dr. Raju A.T
Thanks for ur reply.
So u saud i can do 4th generation test at 4 weeks after the exposure so meaning that right away after i finish the course of PEP. My question is would PEP affect the result and delay the appearance of the test to become positive
In other way because of PEP , the antigen of the virus wont develop after 4 weeks from the exposure. And it takes more time than normal? Is this right or i am wrong?
So u saud i can do 4th generation test at 4 weeks after the exposure so meaning that right away after i finish the course of PEP. My question is would PEP affect the result and delay the appearance of the test to become positive
In other way because of PEP , the antigen of the virus wont develop after 4 weeks from the exposure. And it takes more time than normal? Is this right or i am wrong?
Brief Answer:
A negative 4th generation HIV test is reliable after 4 weeks
Detailed Answer:
Hi,
Welcome back.
The presence of Antigen is reflecting the presence of virus. 4th generation HIV Combo test detects the P24 antigen. If there is infection, it may reflect,whereas the development of antibodies can be delayed because of PEP. As per PEP protocol, the individual has to be followed for 6 months with tests. Only with a negative test, 6 months after the exposure one can be declared that the individual is free from HIV Infection.
Dr S Murugan
A negative 4th generation HIV test is reliable after 4 weeks
Detailed Answer:
Hi,
Welcome back.
The presence of Antigen is reflecting the presence of virus. 4th generation HIV Combo test detects the P24 antigen. If there is infection, it may reflect,whereas the development of antibodies can be delayed because of PEP. As per PEP protocol, the individual has to be followed for 6 months with tests. Only with a negative test, 6 months after the exposure one can be declared that the individual is free from HIV Infection.
Dr S Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
If i do PCR after 8 days of stopping PEP, would be tgat conclusive ? If negative do i need to do another test ?
Brief Answer:
Recent guidelines declared that testing HIV, 6 months after not necessary
Detailed Answer:
Hi,
Welcome back.
Yes, it is better to follow the protocol recommended for PEP. Test for HIV at the 0 day, 4 weeks, 12 weeks and feel free afterwards, even though, such chances of becoming are remote.
Sequential HIV testing should be obtained at baseline, week 4 and week 12 post-exposure.
o If at any time the HIV test result is positive, an FDA-approved confirmatory assay must be performed.
o A negative HIV test result at 12 weeks post‐exposure reasonably excludes HIV infection related to the
exposure; testing at six months post‐exposure is no longer recommended.
o If the exposed person presents with signs or symptoms of acute HIV seroconversion, an HIV serologic
screening test should be used in conjunction with a plasma HIV RNA assay to diagnose acute HIV infection. A
4th-generation HIV antigen/antibody combination test is the recommended serologic screening test.
Immediate consultation with a clinician experienced in managing ART should be sought for optimal treatment
options. (https://www.health.ny.gov/diseases/aids/general/pep/docs/followup.pdf)
Dr S. Murugan
Recent guidelines declared that testing HIV, 6 months after not necessary
Detailed Answer:
Hi,
Welcome back.
Yes, it is better to follow the protocol recommended for PEP. Test for HIV at the 0 day, 4 weeks, 12 weeks and feel free afterwards, even though, such chances of becoming are remote.
Sequential HIV testing should be obtained at baseline, week 4 and week 12 post-exposure.
o If at any time the HIV test result is positive, an FDA-approved confirmatory assay must be performed.
o A negative HIV test result at 12 weeks post‐exposure reasonably excludes HIV infection related to the
exposure; testing at six months post‐exposure is no longer recommended.
o If the exposed person presents with signs or symptoms of acute HIV seroconversion, an HIV serologic
screening test should be used in conjunction with a plasma HIV RNA assay to diagnose acute HIV infection. A
4th-generation HIV antigen/antibody combination test is the recommended serologic screening test.
Immediate consultation with a clinician experienced in managing ART should be sought for optimal treatment
options. (https://www.health.ny.gov/diseases/aids/general/pep/docs/followup.pdf)
Dr S. Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am asking if pcr hiv after 1 week of stopping PEP, would that be accurate?
Brief Answer:
Protocols to be followed as per the guidelines to get maximum assurance
Detailed Answer:
Hi,
Welcome back.
HIV PCR tests can detect or rule out HIV 1 only and you need a separate qualitative PCR test to rule out HIV 2 even though it is a very rare possibility.
Moreover guidelines and protocols are designed by experts after great consultations and considerations.
So get assured that you are HIV free after 3 months with 4th generation HIV combo test.
Dr S. Murugan
Protocols to be followed as per the guidelines to get maximum assurance
Detailed Answer:
Hi,
Welcome back.
HIV PCR tests can detect or rule out HIV 1 only and you need a separate qualitative PCR test to rule out HIV 2 even though it is a very rare possibility.
Moreover guidelines and protocols are designed by experts after great consultations and considerations.
So get assured that you are HIV free after 3 months with 4th generation HIV combo test.
Dr S. Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
4th generation test can detect hiv with in 16-22 days .. why do i need to wait for 3 months ? It is antibodies test who i need to wait for 3 months
If i did pcr hiv after 7 days from finishing PEP and it is negative, is not that enough?
If i did pcr hiv after 7 days from finishing PEP and it is negative, is not that enough?
Brief Answer:
Window period for HIV 1&2 can be delayed up to 12 weeks after the exposure
Detailed Answer:
Hi,
welcome back.
PCR can detect HIV as early as a week after exposure, But the result will be more conclusive after 3-4 weeks after exposure as some will have a delay in reactivity. Moreover PCR cannot detect HIV 2 unless you request for another separate HIV 2 PCR which is rare and the test is available with few laboratories only.
Whereas antibody detection HIV tests can detect both HIV 1 and 2. Even though antibodies against HIV in the presence of an infection, can occur between 4- 8 weeks after the exposure, may be delayed with certain individuals up to 12 weeks after the exposure, So it will be more conclusive only after 12 weeks.
Regarding the Combo test (4th generation) test, the antigen part of the test which can detect the P24 antigen of HIV 1 only not HIV 2 whereas the antibody detection part can detect both HIV 1 and 2. once again the antibody detection will be more confirmative after 12 weeks after the exposure.
I hope you understand the situation. on these basis only the PEP protocol is being designed.
Then it is up to you to decide which test you preferred and how many days after the exposure.
Dr S. Murugan
Window period for HIV 1&2 can be delayed up to 12 weeks after the exposure
Detailed Answer:
Hi,
welcome back.
PCR can detect HIV as early as a week after exposure, But the result will be more conclusive after 3-4 weeks after exposure as some will have a delay in reactivity. Moreover PCR cannot detect HIV 2 unless you request for another separate HIV 2 PCR which is rare and the test is available with few laboratories only.
Whereas antibody detection HIV tests can detect both HIV 1 and 2. Even though antibodies against HIV in the presence of an infection, can occur between 4- 8 weeks after the exposure, may be delayed with certain individuals up to 12 weeks after the exposure, So it will be more conclusive only after 12 weeks.
Regarding the Combo test (4th generation) test, the antigen part of the test which can detect the P24 antigen of HIV 1 only not HIV 2 whereas the antibody detection part can detect both HIV 1 and 2. once again the antibody detection will be more confirmative after 12 weeks after the exposure.
I hope you understand the situation. on these basis only the PEP protocol is being designed.
Then it is up to you to decide which test you preferred and how many days after the exposure.
Dr S. Murugan
Above answer was peer-reviewed by :
Dr. Saisudha Kotla
Thank u. So if i did a PCR HIv at day 30 post exposure and after 2 days of finishing PEP. Would be this conclusive ? For hiv 1 ?
I am asking about the PEP and it is effect on the result. Can i do forth generation p24 test after i finish PEP right a way? Or even PCR? Would that be helpful? Or it is not conclusive ? If it is helpful, how much it would be helpful?
Brief Answer:
As per PEP guidelines HIV status will be definite 3 months after exposure
Detailed Answer:
Hi,
Welcome back.
There is no study that I had come across to say that either PCR or 4th generation HIV test is reliable 2 days after the completion of PEP as far as HIV is concerned. As per the PEP guidelines one can be declared that he/she is free from HIV after 3 months.
Dr S. Murugan
As per PEP guidelines HIV status will be definite 3 months after exposure
Detailed Answer:
Hi,
Welcome back.
There is no study that I had come across to say that either PCR or 4th generation HIV test is reliable 2 days after the completion of PEP as far as HIV is concerned. As per the PEP guidelines one can be declared that he/she is free from HIV after 3 months.
Dr S. Murugan
Above answer was peer-reviewed by :
Dr. Kampana
But i mean how likely i become positive if i test negative by pcr after 7 days from finishing PEP
Brief Answer:
Unlikely to become reactive for HIV after completion of PEP
Detailed Answer:
Hi,
Welcome back.
Very much unlikely after the completion of PEP as you had started PEP well ahead 72 hours after the exposure.
Dr S.Murugan
Unlikely to become reactive for HIV after completion of PEP
Detailed Answer:
Hi,
Welcome back.
Very much unlikely after the completion of PEP as you had started PEP well ahead 72 hours after the exposure.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
But my question is is pcr after 9 days from finishing PEP is conclusive?
Brief Answer:
consult a microbiologist
Detailed Answer:
Hi,
Welcome back.
Guidelines are not saying so.
Moreover separate HIV PCR is needed for HIV 1 and 2. By doing HIV PCR, 9 days after the completion of PEP, you may have ruled out HIV 1 only. That too I can't give any guarantee.
If you want more clarification you can approach a microbiologist.
I can say what the guidelines indicated and what I had come across. Other than this, I cannot give any conclusive remarks.
Dr S. Murugan
consult a microbiologist
Detailed Answer:
Hi,
Welcome back.
Guidelines are not saying so.
Moreover separate HIV PCR is needed for HIV 1 and 2. By doing HIV PCR, 9 days after the completion of PEP, you may have ruled out HIV 1 only. That too I can't give any guarantee.
If you want more clarification you can approach a microbiologist.
I can say what the guidelines indicated and what I had come across. Other than this, I cannot give any conclusive remarks.
Dr S. Murugan
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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