How do I assure that I have escaped HIV infection?
Q: I had sex on six different occasions over the last one year. I always used condoms. When I had the last encounter, the condom broke. I did not notice it until the end. I am worried and I am not sure if the same thing happened on other occasions as well. I do not know the HIV status of the partners. After this, a couple of months back, I had cold and a sore throat but this could be because I had gone to east US and was there for two weeks. It was snowing there and I had to roam around and was exposed to the cold. I am worried whether I may have contracted the HIV infection. I went to private pathology laboratories and got tested for HIV using the rapid test method. I was tested negative by Tridot method twice. I also had ACON rapid test done, which too was negative. I know that these tests look for antibodies. Is there a chance of antibodies not getting produced even if there is HIV infection? I have almost completed 6 months since the last encounter. Can I assume that I have escaped from infection forever or do I have to get tested again? When can I conclude that I am safe? I have been spending sleepless nights and not able to concentrate on anything because of the fear. I am 30 years old.
A:The chances of your being HIV-1 positive are rather slim. The antibody tests should become positive after 12 weeks of last exposure in about 99.99% individuals. In case you are still worried please get your blood tested for the presence of HIV proviral DNA from an accredited laboratory in your town. One word of caution regarding the antibody tests: though these tests claim to detect HIV-2 infections as well, I am not sure it the sensitivity and specificity of these tests to detect HIV-2 infections can be guaranteed. Since in India most infections (>99%) are due to HIV-1, chances of your getting HIV-2 infections are rather slim. A standard ELISA for HIV-1 and 2 antibodies should be able to rule out HIV-2 infection as well. One word of advice: Do not indulge in casual sex. It is dangerous. Not only HIV, you are also taking enormous risk of getting deadlier virus infections like HCV (Hepatitis C virus) and HBV (Hepatitis B virus) which may also be transmitted through saliva (for example, deep kissing).