Dr. Tan and Partners is one of the few approved Anonymous HIV Testing Centres in Singapore. A detailed write up on our service is available here.

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HIV Window Period

Are your HIV tests accurate?

HIV testing may seem very complex.

This is greatly due to the testing ‘Window Period‘. That irksome time from when a person is infected to when tests can actually detect a HIV infection.

Click here to read about the Biology behind the Window Period

HIV Signs and Symptoms

The HIV Window Period and Test Accuracy

HIV PEP Post Exposure Prophylaxis

This has caused a lot of doubt and worry with regards to the accuracy of tests done.

You might even be wondering right now how accurate your tests are.

There is a lot of confusing information out there. Some people claiming a window period of 2 weeks some people even saying 10 years!

This is because HIV testing technology has developed significantly since HIV was discovered in the 1980’s.

So a lot of information out there is out-dated.

Also, not the same standard of tests are available everywhere. This has caused different governments and different health authorities to develop different testing guidelines. So the reason why the Window Period is different in Massachusetts is different from Singapore is not because humans in the US react differently to HIV compared to humans in Singapore. It is because of local guidelines.

So what exactly if the HIV Window Period?

It depends a lot on WHICH TEST was done.

The following graph was prepared based on the latest information on Testing for the Diagnosis of HIV Infection.

HIV Testing Window Period for various Tests

HIV Testing Window Period for various Tests

 

 

 

 

 

 

 

Some points to note:

1. If you are within the first 10 days of possible HIV infection (aka the Eclipse Period), don’t bother doing any tests. There are NO tests that are accurate.

NB: If you are within the first 3 days of possible HIV infection please see us about PEP.

HIV Prevention within 72 hours of exposure (PEP) – Click Here

2. At day 10, the HIV-1 RNA PCR can detect HIV Viruses in the blood.

Remember that the RNA PCR test has a high chance of giving a false positive result.

If the RNA PCR test gives a report of less than 5000 viral copies per ml, it is likely a false positive.

Click here for information on HIV RNA testing at our Clinics

Also, the viral load may drop to an undetectable level upon full sero-conversion.

This is because the body’s immune system may have suppressed the infection to a point where there is not enough HIV virus in the blood for the RNA PCR test to detect.

3. Between day 14 to day 20, the HIV P24 Antigen will start appearing in the blood. This can be detected with 4th Generation tests (aka Combo tests).

This is why, although the official recommended Window Period for the Combo Test is 28 days, we are very confident when a patient tests negative at 2 weeks.

Remember that the P24 Antigen level will peak at about day 28 and becomes undetectable at about 6 weeks from infection.

This does NOT mean the 4th Generation (Combo) test is inaccurate after 6 weeks because the Combo test also detects IgM and IgG Antibodies (See below).

Click here to learn more about the Combo Test at our Clinics

4. Between day 20 and day 23, the IgM Antibody starts to become detectable in the blood.

This is only detectable by 3rd and 4th Generation HIV tests.

This is the other reason why even though the 4th Generation (aka Combo) test is supposed to be conclusive at 28 days, at 3 weeks when a patient is negative, we tell him/her it is as good as conclusive.

5. Between day 28 and 48, the IgG Antibody starts to become detectable in the blood.

This is detectable by 1st, 2nd, 3rd and 4th Generation HIV tests.

This will remain detectable in the blood for as long as a person lives. Therefore, doing a Combo test not only detects HIV infections that occurred recently, it also detects infections from years ago.

Click here for HIV Testing FAQ

More things to note:

The recommended 1st line screening for HIV infection is the Combo test NOT the antibody test.

So when you go for a HIV screening test, you should be asking for a Combo test. Take note that in Singapore the Combo test costs more than an antibody test.

The essential thing to remember about HIV testing is to get the RIGHT test done at the RIGHT time.

Come see us for professional advice on which test you need to do.

Click here to see the full range of our HIV/STD Services

All Our Doctors are Fully Certified and Trained to conduct specialised STD and HIV Testing.

Your are welcome to visit Our Doctors at Our Clinics anytime during our opening hours.

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Our Andrology and Infection Centre at Novena Medical Center is open.

Call us at 63972095 now to book your treatment.

Feel free to email your queries, feedback and suggestions on what other topics you want to see in the comments section below.

All prices quoted below excludes prevailing GST

We are Open on Saturdays and Sundays.

Click Here for Contact Details, Address and Opening Times.

 

We have 5 locations conveniently located at Robertson Walk, Bencoolen Street, Novena, Scotts (Pacific Plaza) and Somerset (H&M)

Robertson Walk          6238 7810   map

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Email: [email protected]

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If you have any questions, visit our free online forum on sexual health, HIV and STDs.More on HIV symptoms.If you need a HIV test visit Our Clinics anytime during our opening hours. You do not need an appointment.Find out more about Anonymous HIV testing at our clinics.Can’t wait for 3 months to find out? Find out more about Anonymous Rapid HIV Combo test at our clinics.If you had a high risk exposure to HIV within the past 72 hours, you can take medicines to reduce your risk of actually contracting HIV. Find out more on HIV PEP Treatment.We are now open on weekends.Related Articles:HIV CMIA Test AccuracyHIV ELISA and ECLIA testGetting HIV from Oral SexMore on HIV symptomsHow long can HIV live outside the body?Erectile DysfunctionPremature Ejaculation

About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

Find the profiles of our panel of doctors.

Consultation $20.00-80.00
Rapid test only $20.00
(not inclusive of test)
8am – 5pm $60.00
5pm – 9pm $80.00
STD screening
Standard HIV, Syphilis, Hepatitis B/C, Herpes Simplex Virus Type I and II $ 200.00
Male
Urethritis
Urine – Chlamydia and Gonorrhoea PCR, Monilia, Trichomonas, NSU, Mycoplasma, Ureaplasma, Urine Culture, Candida $ 280.00
Female
Urethritis and Vaginitis
Vaginal Swab – Chlamydia and Gonorrhoea PCR, Monilia, Trichomonas PCR, Gardnerella PCR, Candida PCR, Group B StrepNSU, Mycoplasma, Ureaplasma, Direct Microscopy, Candida, Vaginal swab culture $ 345.00
Comprehensive (Male) Blood – Syphilis, Hepatitis B/C, Herpes Simplex Virus Type I and IIUrine – Chlamydia and Gonorrhoea PCR, Monilia, Trichomonas, NSU, Mycoplasma, Ureaplasma, Urine Culture, Candida $ 390.00
Comprehensive (Female) Blood – Syphilis, Hepatitis B/C, Herpes Simplex Virus Type I and IIVaginal Swab – Chlamydia and Gonorrhoea PCR, Monilia, Trichomonas PCR, Gardnerella PCR, Candida PCR, Group B StrepNSU, Mycoplasma, Ureaplasma, Direct Microscopy, Candida, Vaginal swab culture $ 525.00
Individual STD Tests
Determine Syphilis test Rapid Syphilis Test $ 50.00
Determine Hepatitis B Test Rapid Hepatitis B Test $ 50.00
Herpes Simplex Virus PCR Herpes Simplex Virus Polymerase Chain Reaction (PCR) Test $ 190.00
Chlamydia and Gonoccocal PCR Chlamydia and Gonorrhea
Herpes Simplex Virus Type I IgG Antibody Herpes Type 1 $ 40.00
Herpes Simplex Virus Type II IgG Antibody Herpes Type 2 $ 40.00
Non-Specific Urethritis (NSU) Culture Mycoplasma, Ureaplasma $ 118.00
HIV test
HIV RNA/DNA Polymerase Chain Reaction (PCR) Test $600
Add $100 for expedited results
Rapid Fingerprick Blood HIV-1/2 P24 Antigen/Antibody Combo (HIV Duo Test) (4th generation!) $ 150.00
Rapid Oral Saliva HIV-1/2 Antibody Test (Oraquick) $ 50.00
Rapid Fingerprick Blood HIV-1/2 Antibody Test (Determine) $ 50.00
PEP $2000 – $2200

1,187 Comments

  1. Harrygarry

    Hi,

    I had a sexual encounter with a call girl in Taiwan on 2nd Nov. I believe I had the protection but I am not very sure as I was very drunk that day. This is the only sexual encounter I ever have had with anyone other than my wife. On 8th day after exposure, I got the HIV RNA PCR done and the result was negative. So were the results of all other STD tests. On 18th , I underwent Duo test ( HIV. 1 and 2 antibodies and p24 antigen test) and it was also negative. Basis this can I safely assume that I am not infected. Some of the symptoms such as upset stomach etc are making me nervous. Any advice for my peace of mind would be really appreciated. Thanks

    • While I would say your risk of HIV infection is very low, your tests are still not conclusive. Same with the other STD testing. Please visit us for a proper consult and evaluation.

  2. Hi dr, would like some help and advice. I got an expose handjob with condom. I am planning to do 4th gen test on 14 day onwards. But dr cn i knw is it ok for my cases?

  3. I had an unprotected oral sex (cunnilingus and getting sucked) and protected vagina sex on 1 nov.

    I last had an proctected oral and intercourse on 10 nov. If I were to opt for a HIV RNA on 23 nov, will the results be accurate for both 1 nov and 10 nov?

  4. Hello Dr.

    Sir are HIV testing standards the same all over the world? I got HIV 1-2 antibody with p24 antigen test 34, 44 and 55 days later and all of them came non reactive.

    I had my tests done in 2 different medical centers in Milan, Italy. Can I relax and move on with my life?

    Thanks

  5. i had sex with a lady whose hiv status i did not know 52 days, i tested at 12 and 25 day, but all the test were negative am feeling pain on my right arm, headache and night sweet, can i say that my 25 test is conclusive

  6. Hello Doc, is the alere 4th gen rapid test results as good as 4th generation lab test.?

    I have tested on 56th day with alere 4th gen rapid combo test and the results came as non reactive.

    Should I do a 4th gen lab test to get the conclusive result or the 4th gen rapid test can be taken as conclusive.?

    Please help me.

    Thank you.

  7. Dear Doctor,

    First of all, I really appreciate for the help you are providing at this website.

    The most recent possible exposures were on 9/7 and 9/18 (both time with masseuse but different person each time. Protected vaginal sex only). For the past couple weeks, I have had multiple HIV tests and a full panel STD test (HIV 1&2, Herpes 1&2, Hepatitis A, B, & C, Syphilis, Gonorrhea, and Chlamydia) and the results are as follow. Could you please assess if its safe for me to consider tests results as conclusive?

    1. 10/16 (28 days from 9/18 exposure): 3rd gen. HIV rapid test – negative

    2. 10/18 (30 days): 4th gen. Alere Determine HIV rapid test – negative

    3. 10/18 (30 days): 4th gen. HIV test (blood drawn from vein at a lab) – negative

    4. 10/18 (30 days): HIV 1 RNA TMA test – negative

    5. 10/20 (32 days): 4th gen. Alere Determine HIV rapid test – negative

    6. 10/23 (35 days): HIV 2 RNA/DNA PCR test – negative

    7. 11/1 (44 days): 4th gen. HIV test (blood drawn from vein at a lab) – negative

    8. 11/1 (44 days): Herpes 1 – positive

    9. 11/1 (44 days): Herpes 2 – negative

    10. 11/1 (44 days): Hepatitis A, B, & C – negative

    11. 11/1 (44 days): Gonorrhea – negative

    12. 11/1 (44 days): Chlamydia – negative

    13. 11/1 (44 days): Syphilis – negative

    I have heard all these tests are not conclusive until 3 months post exposure. At the same time, I have also read from different forums that most of HIV specialists regard 4th generation HIV tests are conclusive at 6 weeks post exposure and your forum considers 4 weeks as conclusive. Am I safe to be relieved from stress of HIV and STDs? Or should I get retested again at 3 months post exposure. By the way, I am living in the US.

    Thank you.

  8. dear Dr tan & partners

    i have unprotected sex with lady with unknown the HIV status, after 20 days i have my screening HIV test using ELISA methode 4th generation the result is negative and then on 35 days i do test again same methode but using only antibody test ( 3rd generation ) the result is negative.

    base on the result above , are the test conclusive? please advise

    • I would say your results are a very good indication, but for conclusive results you would need either a 4th gen combo test at >28 days or if you are doing 3rd gen antibody only >3 months.

      • thanks dr jonathan for the respon , more question from me is it true regarding window period update above after 48 days with any test can establish the hiv status ? if yes ,so why do antibody test conclusive only > 3 months?

        thanks

  9. alton cc

    Dear doctor
    I say not good english
    Today 50 days. I mean 7 week 1 days.I will re checked my hiv 1/2 ag and ab. I go the lab and i see test machine name abbot machine. result 0.05.. when 35 days my ac and ab 0.07 after 15 days reduse 0.02 i mean 0.05. Pls doctor say i recheck how days . I use condom sex with prostitute. I am very panic for hiv… no sleep no working panic for hiv. Pls give me a next suggestion.
    Thanks doctor

  10. alton cc

    Dear doctor
    I say not good english

    1…I sex a prostitute with condom. But before sex my left hand middle finger touched her clit. 20 second but clit is dry. Than if i touched my panis left hand water wash. pls say me doctor in this situation any change effect hiv..
    2… after intercours i wash water and some precome in my panis head prostitute finger wipe this… i m very panic.because any chanch of transmitted hiv from prostitute finger.
    Than after 35 days i mean five week i test hiv 1/2 ac & ab .result 0.07… pls doctor tell me something … another test for my situation

    • Your test is conclusive. Anyway, there is no risk from the fingering. The risk is only from penetrative intercourse, although using a condom reduces this risk significantly.

    • alton cc

      Dear doctor
      I say not good english

      Today 50 days. I mean 7 week 1 days.I will re checked my hiv 1/2 ag and ab. I go the lab and i see test machine name abbot machine. result 0.05.. when 35 days my ac and ab 0.07 after 15 days reduse 0.02 i mean 0.05. Pls doctor say i recheck how days . I use condom sex with prostitute. I am very panic for hiv… no sleep no working panic for hiv. Pls give me a next suggestion.
      Thanks doctor

  11. alton cc

    Dear doctor
    I use condom sex with prostitute. But when i open condom after sex. I open condom left hand and left hand wash water panis.if some vaginal fluid in my hand than i water wash my panis.any chance effect hiv? But 35 days i checked hiv 1 & 2 ab and ag test. Result 0.07 .pls give me a suggestion….

  12. Hi Dr.,

    Good morning! May I know is ALL types of 4th Generation tests (Ag/Ab) are conclusive at 28 days onwards?

    I had potential exposure (high risk) on 5th Sept and tested with 4th Gen HIV 1&2 Ag/Ab (ELISA) at 41 days, is it conclusive? Do I need further re-test at 3-month mark necessary?

    Thank yo for your time.

  13. Hi Dr,

    is a 3rd gen test taken 89 days post exposure conclusive?

  14. Hi doctor,

    i did a determine hiv antibody test about 5 weeks back. This was after 7 months exposure ( back in feb). the result was non reactive. However I’m am having various severe symptoms all through my body and my anxiety is high. Just to calm my fears would doing a rna hiv test, finally conclude my results?

    For example if for some reason I’m not producing antibodies would a rna test detect the virus that i may have? Is there any other test that i can take? Thank you for your help

    • Your test is conclusive and thus your symptoms are not due to HIV. You may visit us if you still have any concerns and wish to do further testing.

      • Hey Dr. I took hiv rna early detection test 14 days post exposure it was negative and a 4th generation test 33 days pose exposure negative can I consider these conclusive?

  15. Tyrese929

    I had an possible exposure to hiv a few weeks ago and just recently started getting sick. I took a alere determine 4th generation hiv test at 28 days and it came out negative. By me being sick will this make my test come out negative because my body is producing antibodies for a cold and not hiv?

  16. Hi Dr. .. i’m from KSA and
    I have unprotected vaginal sex with sex-worker for 3 times in different days with same lady With the penetration ..
    i did combo (4th generation) in ( 30,37,45 and 60 days ) it was negative but i got rash in my neck and fatigue for one week and after 60 days i have little enlarged lymphnodes in under my jaw .. i’m really worried about that .. I don’t know if the combo machines different from countries or not .. pls dr. I need deep answer.. thank you for your help 🌹

  17. Hello Dr., I tested negative using the 4th gen combo test on the 15th day of possible exposure, on the 24th day, on the 29th day and once again on day 45. I have had a persistent cough that won’t seem to go away, would you say my results are conclusive or should I test again? Thank you.

    • Your tests are conclusive, you do not have HIV and do not need further tests. Get your cough assessed at a doctor – there are a hundred other more likely causes of cough.

  18. Hi
    Had a possible exposure with a homosexual mail…got my PCR RNA done at 7th day which is negative… doctor has advised me to not do any futher check as he claims it to be conclusive…

    What do you suggest…

    • HIV PCR RNA is considered essentially conclusive at 10 days. It is not an official diagnostic test for HIV, so as such we would still recommend a 4th gen HIV combo test at 28 days.

      • I am worried now… I would get a test done… but what are chances that its positive after 28days

  19. Hi Doc
    I had a protected sex with an CSW, however during withdrawal the condom stayed inside her…Not sure what time it came off, she was on top of me rubbing.

    Am i at risk, have gor PCR RNA done at 10th day which is negative…

    • The initial exposure would pose a risk but your HIV RNA test is done and essentially conclusive, so there is nothing to worry about now. Make sure you check for other STDs as well such as chlamydia and gonorrhea, etc.

      • Thanks Doc, are you saying the risk is due to condom coming off.. When I checked with lady she said it only came off during withdrawal… is this much exposure sufficiant for having a risk.. are such encounters risky and what are my chances I have HIV… I head women to men is considored very low risk

  20. Hi Dr.,

    Basically, I had a casual encounter (mutual masturbation), he masturbated me and he masturbated himself and ejaculated on my chest/stomach. As far as I could remember I had no cuts on my body during those times. Three weeks after that encounter I had a sore throat which up until now is still present. I performed the following tests:

    4th gen (15 days after encounter) – Negative
    4th gen (33 days after encounter) – Negative
    3rd gen (57 days after encounter) – Negative
    3rd gen (75 days after encounter) – Negative

    Will this be considered conclusive?

  21. Dear Doctor,

    I did 4th generation HIV combo test on 75th day of possible exposure (protected with condom).

    Is it conclusive or I need further testing?

  22. Perhan Nugraha

    Dear Doctor.. have you ever seen/heard of a 4th generation negative hiv test at one month turning out to be positive after 3 months?

  23. Perhan Nugraha

    Doc, one question
    Have you ever seen/heard a negative hiv test with in 2 months turns out to be possitive later?

  24. kishore kumar

    Hi Doctor, I had exposed to gonorrhoea and chlamydia and got treated. i had tested for HIV and other SITs on 15th & 36 days of exposure. both tests came back all negative. But im suffering from chronic diarrhea, swollen lymphs and severe caugh. Am I still at the risk of HIV?

    • If the HIV test was a 4th generation combo (antigen and antibody) then it was conclusive. If not, you would need to repeat a test at 3 months (if using a 3rd gen test).

  25. HI Doctor,

    i did the hiv1/2 determine rapid test for antibodies last sunday. This was after 7 months exposure ( feb was time of exposure) . My results are non reactive. Are these conclusive or do i have to take the antigen combo test as well?

    Furthermore do these antibodies remain in our body forever? And also will the p24 test pick up infections that the antibody test could not?

    Thank you very much Doctor

  26. I had HIV-1/2 &P24 tests after 18 and 33 days of the exposure. Both are negative. Are these conclusive?

  27. Is hiv dna pcr qualitative test accurate after 57 days after exposure? Plz reply.

  28. Doctor, I had a 4th generation combo test 18 days after exposure, about 3 months back. The test came back negative, and I haven’t shown any symptoms of ARS. Do I need to retest now for a conclusive result?

    • Yes, we would recommend a repeat test for conclusive results. Up to 70% of people infected with HIV will have no ARS symptoms.

      • But based on point 3 as written above, it indicates that with 4th Gen combo test, you guys are very confident that if the patient is tested negative, he or she will be considered HIV negative. However, your reply seems to contradict what was written above

        • As it states, we are confident of the result but it is not officially conclusive until 28 days post exposure.

          • Well, if that’s that case, pertaining to point 4 whereby you guys indicated, quote “at 3 weeks when a patient is negative, we tell him/her it is as good as as conclusive”. This is also not official as it is less than 28 days exposure and doesn’t mean he/she has to take the test again to officially confirm his/her status. Not trying to prove any case here but since you guys allows comments/questions, I sincerely hope your reply can be more specific rather than generic.

            Understand anything written here may have legal obligations if things do not turn out as per said but I think most of the people here are concerned about their health and was hoping to have assurance in any form. Again I know they are responsible for involving in such activities but you guys are doctors and doctors are supposed to help physically and mentally.

            I’m someone who went through this and had several anxiety attacks because of this so I kind of empathise the people who are really worried and concerned

          • I tell my patients exactly what I have written here – if they have taken the test at 3 weeks, I say this is an extremely good indication but officially you would need a repeat at 28 days for 100% conclusive results. This is not being generic, but it is the nature of population-based probabilities. The virus does not choose a day for it to become detectable – the numbers are obtained from population-based studies, knowledge of viral replication, etc. We try to be as forthcoming and accurate as possible with current scientific knowledge.

          • Pertaining to your latest feedback, I’m fully aware and totally agree with you on, quote “if they have taken the test at 3 weeks, I say this is an extremely good indication..” and this is exactly what I’m hoping to hear from a doctor when i posted a question like what Sam did rather than just quote “yes, we would recommend a repeat test for conclusive results”

            In my humble opinion, the first sentence will be extremely helpful and will help to put the patient mind at ease, even only for awhile. Anyway, thank you for your advice and help..especially in this field because contracting HIV is really a big issue and turning point in life which I believe everyone here is hoping to avoid. You guys are heroes in my opinion

          • Dear Sr. Jonathan, good afternoon!

            as per you combo test is 100% conclusive after 28 days which now WHO & British guidelines are saying then why CDC & other major guidelines are not accepting this fact

          • If I worked at the CDC maybe I could tell you. Unfortunately, I do not. You will need to ask them about their guidelines.

  29. Hi,

    Lots of conflicting messages online,

    I am currently on PEP, and am due my 28 day post exposure test in 3 weeks time.

    Would a negative 4th generation test immediatly after PEP be encouraging in your opinion or does PEP delay possible infection as some people say?

    I notice on your site you believe that even on PEP 28 days 4th gen duo test is very encouraging?

    Thanks.

    • Yes it is very indicative. There have been no cases of a negative test post-PEP becoming positive later on if the PEP was taken properly and there were no other high risk exposures in between.

  30. Is Malaysia using gen 4th for hiv test? I did the test about 23 days and negative result, how accurate the test? I online check with the lab already, they mention they using 4th gen. Is the 4th gen Malaysia and Singapore same?

    • I see no reason not to believe what the lab says. In any case, your result is not conclusive until at least 28 days post-exposure.

      • Not I dun wan to believe. Bcz from your website, you can give a conclusive result after 28days, thus, im thinking is it different test I’m taking.

        • Malaysia ask me take another test after 3 months and 6 months to conclude.

  31. Dear doctor,

    I had an unprotected anal sex with male (the highest risk category). I did the first test 41 days after the exposure and it came back negative. It was the 4th generation Ag/Ab Hiv test. In the lab where I did the test (I am from Serbia, South East Europe) they said that the window period for test which they use is between 6 and 8 weeks and they confirm that the test is the 4th generation.

    1. Do all test of the 4th generation have the same window period (28 days)?

    2. How conclusive is my result 41 days after the exposure?

    3. Could the fact that I did test one day before the six-week period affect my result?

    I am going to do test after 8 weeks but I feel very anxious about my further results.

    • Current 4th generation tests have a window period of 28 days. However, different countries may follow different guidelines, and it is best you heed the advice of your local healthcare professionals.

  32. sandeep

    Please advice me help me can I come in ur clnic I am really very depressed

  33. sandeep

    Doctor please help me .I take pep 96 hours at 30 day after completed pep I take duo test and pcr rna they both are negative. There are 1 spot below my armpit 2 more also same side . Doctor feel on that side lymph node he advise m ultrasound of this side and advice me to check this spot to dermatologist and say if dermatologist say it’s hiv rash then we start hiv treatment . I am not feel any lymph node no fever .only loose weight after pep .he say no test come positive before 3 months.

    Please help me I am in India what can I do can believe on my test or doctor

    • I would trust in your tests, as I’ve told you about 20 times. There is no way to diagnose HIV just by looking at a rash. Your doctor seems more paranoid than you.

  34. sandeep

    Doctor please help me

  35. dr. can I get a hiv by oral sex ?

  36. hi dr . I have make the 4th generation test after 26 days .
    and it was negative , is it like conclusive ??
    regards

  37. Dear Dr, I had a possible exposure and was prescribed PEP immediately at the Emergency, here at the USA. My first dose of PEP (Truvada/Isentress) was within 4 hours of the possible exposure. I completed the PEP with tight adherence for 28 days and took an ag/ab test 6 weeks post exposure (i.e. 2 weeks after PEP). The results were negative. My Dr says the results are practically conclusive, but I would need an ag/ab negative confirmation at 3 months. Do you envision the results changing? In other words, do you think the results are good?

    • I believe the results are conclusive. There have been no cases of a negative case 2 weeks post-PEP turning positive later. The 3 month test is still recommended by most institutions but it is largely precautionary.

  38. Hello Doctor, I need your advise. I am a male of 27 and was involved in a protected encounter with a masseuse in a spa on 12th of May. It was protected all the time. But after 2 weeks I had severe sore throat which continued up to 10 days. Since then I am feeling swollen lymph nodes in neck which are hurting a little and are still perpetrated. Also, I have minor rash on my right hand.

    Are these symptoms of Acute HIV Infection or Seroconversion?

    Also, I did 4th Generation HIV Combo Test (HIV1/2 +P24 Antigen) on 18th, 24th, 29th and 44th day after the possible exposure and all came out non-reactive with values 0.04, 0.05, 0.07, 0.09 respectively. As you can see the values are increasing every time. Is this a point of concern? Also kindly help me to decide how conclusive are these results??

    Also one last thing, If I am experiencing the Seroconversion symptoms, shouldn’t I be tested positive??

    Need your advise urgently doctor as I am terrified a lot.

    Thank you.

    • The tests are non-reactive and conclusive. If the symptoms are from seroconversion, the tests would be positive. You do not have to worry.

      • Dear Doctor,

        Thanks for your reply. I really appreciate your efforts to calm me down. But even after your reply I was really worried and went for another HIV Combo Test 75 days Post Possible Exposure. The Results were Non Reactive with 0.07 Value.

        I want to ask whether this test or conclusive? or should I go for another test at 90 days as the guidelines?

        Need your advise.

        Thanks

  39. shobhini

    I am extremely worried 4-5 years ago I had a high risk of vaginal exposure with someone whose HIV status was unknown to me. After 5 years , last month of May, 2017 i decided to take a test in Mumbai, India where I reside. I went to a reputed lab and got myself the latest fourth generation test and also a pcr HIV 1 viral load test. All were negative and pcr viral load test of HIV 1 was undetectable completely. Since then I never indulged in any such activity which could make my window period confusing. The last exposure was 2012 and since then in the year 2017 I tested directly through HIV 4th gen, HIV 1 pcr viral load and western blot for HIV 1 and 2. All came negative but the only thing which I am concerned about is HIV 2. What if I am a negative sero- negative , my antibodies are not coming even after 5 years and the test which I took was of HIV 1 viral load and p24 antigen but not of HIV 2. HIV 2 antibodies I did and it came as negative but what if I have a genetic immunity problem and this is not making my antibodies to appear for HIV 2 as well. I was reassured of my HIV negative status however now I got worried again thinking what if I have HIV 2 and what if my antibodies are not being detected due to some genetic or immunity problem. Is there a possibility doctor? My humble request to you is please read my question and kindly reassure me of my status , can I move on in my life permanently and concentrate on other things such as my career and my family ? Are my tests after 4-5 years of exposure 100% conclusive ? Is there a chance for me to be sero-negative although it is extremely rare of not being able to detect HIV 2 antibodies? I am confident of my HIV 1 negative status but am a bit nervous about HIV 2 status. I don’t feel like taking more tests as I have already given much of my money for different testing s still not able to assure myself of HIV 2. Please please please reply i am begging you.

  40. Alvin Poo

    Dear Doctors,

    I have read about articles claiming that Oraquick has 92% sensitivity, but some sources also said 99%. Why is that so?

    I have also done an Oraquick 3 months after an incident but I gargled with water 15 minutes before. Also, I have done the same Oral swab 6 months later after the incident. Both are negative. Should I move on?

    And is it even a risk, I was afraid that doctors reuse a lancet and have you heard of any transmission cases in the world from this?

    Thank you so much.

    • I suppose it depends on the study. So the sensitivity range may have varied between the different studies. I believe that two tests is more than enough to confirm your negative status. And no, we do not have re-usable lancets nor have there been any case of HIV infection from contaminated lancets.

      • I took a HIV combi PT test more than 40 days post exposure and it came out Negative 0.392COI <1. My risk was from kissing outside her vagina and I gave her a handjob. She also gave me handjob. No Vaginal sex happened. I took another Combi PT test yesterday and doc said the result came out today. So if it comes out NEGATIVE (more than 63 days post exposure), can I really move on with my life or do I need to take a confirmative test at week 12th ? Best regard.

        • The tests are conclusive and do not require further testing. And there is essentially zero risk from your exposure in the first place.

  41. is there any possibility that combo tests are less sensitive to hiv-2 and some subtypes of hiv?

    • No evidence of this being an issue thus far. If you have concerns, please speak to the manufacturers for more details.

  42. hi doctror..i have a question..It seems that test accuracy is almost 99,7%.That means that in 100milion peaople get tested 300thousand will be false negative..can this possible be true?

    • Not necessarily. Most HIV tests will claim extremely high sensitivity, meaning low to nil numbers of false negatives, but may have relatively lower specificity, meaning few cases of false positives. This is why any positive result on a rapid test must be sent for confirmatory testing with Western Blot.

      • yes but this rates are for all who ve done the test and are negative? that means that a lot people have the virus and they don t know it doctor…

  43. Hi doc, I had an exposure 31 days ago with a prostitute when my
    condom had a small hole on the neck of the
    condom…I did the elisa/p24 antigen combo
    test at 24 days and the results were
    negative and the doc told me its conclusive but My throat has been irritating since
    2-3 days after the exposure and its upto a
    whole month now and theres no
    improvement..i’ve had a running nose from the
    28th upto 30th day but its now almost gone. am so
    worried it could be hiv..now that i’m on the
    32nd day, should i be less worried or what hiv
    test do you recommend and at which time so
    that i can be totally sure?

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