Hello,

Thank you for your inquiry. From what we gather from your question, you are asking about the conclusiveness of the 3rd Generation TRI-DOT, which we have assessed to be a Rapid or "Point-of-Care" test. Using a Rapid test, HIV is detectable between 4 weeks and 3 months, so a test taken at 7 weeks would be in the prime window of accuracy. Rapid tests are highly accurate when taken at the correct time.

The PCR RNA Test can detect HIV within 2 to 3 weeks of exposure, and is also highly accurate.

Since both of these tests came back not detected/non-reactive, we would consider this a conclusive result. If you are still concerned, we recommend speaking to your physician about getting a 4th Generation test.

Regards,

AIDS Vancouver Helpline/Online, Sara

Hello,

Thank you for your inquiry. From what we understand, you are asking about the accuracy of a Rapid Test (also called "Point-of-Care" Test). The accuracy of the Rapid Test is very high, and is considered conclusive within 4 weeks to 3 months of exposure. Most people develop detectable antibodies within 21 to 25 days, and the vast majority of people are detectable within 4-6 weeks. With your test taken at 26 days, this would be considered conclusive for most people.

If you are still having concerns, please talk to your physician about getting a 4th Generation test, which is considered conclusive at 6 weeks post exposure.

Regards,

AIDS Vancouver Helpline/Online, Sara

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the reliability of the results from the test you received both in Sept 2016 and one year post exposure. From our understanding you did receive the P24 Antigen test within the recommended window period following your exposure. The P24 Antigen test is most effective ONLY within the first couple of weeks following exposure (once the body starts producing antibodies, this antigen is no longer detectable). If you received the P24 Antigen test within the recommended window period of testing, official guidelines suggest re-testing at 12 weeks post exposure. Although the P24 Antigen test you received resulted in a non reactive result, you were responsible in your action of taking a follow up test. With this in mind, the P24 Antigen test is again most effective in detecting the P24 protein associated with HIV only within the first few weeks following exposure. Any further testing five to six weeks and above should be directed to either a Western Blot or 4th Generation EIA test (see link below). In this case, we cannot confirm the reliability of the nonreactive results from the P24 test administered one year post exposure due to the nature of this particular test.

Recommendation: Refer to Physician for 4th Generation/Western Blot test for a more conclusive result. If you are continuously engaging in high risk activity there are biomedical approaches such as PrEP and PEP that help lower your risk of acquiring HIV.

Regards, AIDS Vancouver Helpline/Online, Cody

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the reliability of a home testing kit for HIV. From the information given, this scenario is determined to be high risk (Evidence of transmission through these activities and is the majority of cases of transmission). Unprotected vaginal sex is deemed as a high risk activity.

At AIDS Vancouver we do not recommend home testing kits as there is no opportunity for counselling and can yield false results.

Recommendation: For conclusive results, refer to a physician for an HIV test.

Regards, AIDS Vancouver Helpline/Online, Ashley

Hello and thank you for contacting the AIDS Vancouver helpline.

I understand that you are asking about the accuracy of a point of care (rapid) HIV test performed at approximately 3 weeks after having unprotected sex.

Unprotected anal or vaginal sex is considered to be a high risk activity for the transmission of HIV. PrEP is a relatively new method for preventing HIV infection, and is not meant to replace other strategies for preventing HIV transmission, such as condoms.

The window period for a point of care (rapid) test is estimated to be 3 to 4 weeks, meaning that a false negative result is possible before the 3 week mark.

It is recommended that you have a 4th generation EIA test performed by a medical professional. The 4th generation EIA test has an estimated window period of 2 to 3 weeks is considered 99.9% accurate at 6 weeks. Canadian testing guidelines recommend re-testing with any HIV test at 3 months (12 weeks)

Please refer to table 3-1 on page 13 of the link below

Regards, AIDS Vancouver Helpline/Online, Dyson

Thank you for your inquiry. From what we gather from the question, you were asking about the meaning of a reactive result from a point of care (POC) rapid HIV test.

A reactive result is considered a preliminary positive, and means that HIV antibodies were found. A second confirmatory test needs to be done using blood drawn once from the arm, to confirm the first test’s result. Taking any antibiotic will not change an HIV test result. Antibiotics treat bacteria but they do not work with viruses. HIV is a viral infection, so antibiotics will not cure them or have an effect on test results.

According to the British Columbia Centre for Disease Control: "POC HIV tests licensed for use in Canada will have similar sensitivity and specificity compared to standard HIV screening tests (Sn, Sp > 99%). False positive POC HIV tests will occur (particularly in settings with low HIV prevalence). While a negative POC HIV test is considered final and no confirmatory testing is required, a positive POC HIV test is a preliminary result and confirmatory testing is required."

Recommendation: We would strongly recommend you have a confirmatory test administered by a health care professional as soon as possible. A 4th generation EIA test is considered to be 99% accurate at 6 weeks post exposure. In the meantime, please consider taking precautions to avoid the possibility of transmitting infection to others while awaiting results of confirmatory testing.

Regards, AIDS Vancouver Helpline/Online, Dyson

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the conclusiveness of your test results and whether the symptoms you are feeling are caused by HIV. Because HIV symptoms mirror other viral infections like the flu, testing is the only way to know whether you have acquired HIV.

At AIDS Vancouver, we do not recommend home testing kits such as Oraquick as there is a higher chance of yielding false results and there is no opportunity for counselling. We recommend having a fourth generation test done. At 6 weeks after exposure, the fourth generation test is considered to be conclusive and 99.9% accurate [1].

Regards, AIDS Vancouver Helpline/Online, Ashley

References:

1. CATIE. HIV Testing Technologies. [Internet] catie.ca [cited on September 19, 2018] Available from: https://www.catie.ca/index.php?q=en/fact-sheets/testing/hiv-testing-technologies

Hello and thank you for contacting the AIDS Vancouver helpline.

I gather that you are asking about the accuracy and window period of a rapid antibody HIV test.

According to the Canadian AIDS Treatment and Information Exchange: "The window period of the INSTI (rapid) test is estimated to be the same as, or up to one week longer than, the window period for third-generation HIV tests. Third-generation tests can detect HIV infection in 50% of people by 22 days after infection; 95% of people by 40 days after infection; and 99% of people by three months after infection." (1)

Fourth-generation HIV tests and the INSTI rapid test have a sensitivity of about 99.9%. Since the vast majority of people who get tested for HIV are actually HIV negative, the chance of a negative result being false is extremely low.

We recommend retesting at 3 months for a more conclusive result.

Regards, AIDS Vancouver Helpline/Online, Dyson

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about whether the symptoms you are experiencing are indicators of being HIV positive. HIV symptoms mirror other viral infections such as the flu, testing is the only way to know whether you are HIV positive.

The average window period of a rapid test (looks for anti-HIV antibodies) is 22 days, and the average window period for 4th generation tests (looks for anti-HIV antibodies and HIV p24 antigen) is 18 days [1]. At 47 days, the results are considered conclusive.

Recommendation: Refer to physician for more personalized answers.

Regards, AIDS Vancouver Helpline/Online, Ashley

Hello and thank you for contacting the AIDS Vancouver Helpline.

We understand that you are asking about the accuracy of an INSTI rapid HIV test performed at 86 days after a potential exposure to HIV

The window period of the INSTI test is estimated to be the same as, or up to one week longer than, the window period for third-generation HIV tests. Third-generation tests can detect HIV infection in 50% of people by 22 days after infection; 95% of people by 40 days after infection; and 99% of people by three months after infection. Fourth-generation HIV tests and the INSTI rapid test have a sensitivity of about 99.9%. In other words, if 1000 HIV-positive people were tested for HIV, 999 would test positive and one would incorrectly test negative. Since the vast majority of people who get tested for HIV are actually HIV negative, the chance of a negative result being false is extremely low. (1)

At 86 days you can consider this to be a final result. No further testing is required.

Regards, AIDS Vancouver Helpline/Online, Dyson

Hi Nathan,

Thank you for your inquiry. From what we gather from the question, you were asking about the conclusiveness of the testing you received after your safe-sex encounter.

It was responsible for you to seek testing following your safe-sex encounter in order to ensure both you and your partner's safety. Although you were safe, vaginal sex with a condom is still considered to be a Low Risk (Evidence of transmission occurs through these activities when certain conditions are met), due to potential for improper use and breakage (1).

Official HIV testing guidelines for the 4th Generation EIA recommend re-testing at 12 weeks post exposure for completely conclusive results. Because of your diligence with testing follow ups (as long as your test results returned negative) you can confidently be assured that your 14 week (96 day) post exposure test results are considered extremely accurate and conclusive.

Recommendation: No need for further HIV testing with the scenario provided, refer to a physician for other health related questions.

All the best, AIDS Vancouver Helpline/Online, Cody

Hello there,

Thank you for your inquiry. From what we gather from the question, you were asking about your risk of HIV acquisition through performing oral sex without a barrier.

From the information given, this scenario is determined to be Low Risk: (Evidence of transmission occurs through these activities when certain conditions are met). Although you had received semen to the eye, this poses the same risk as performing oral sex. There is a technical risk of acquiring HIV through receiving ejaculate to the eye, yet exposure to oxygen outside of the body would significantly reduce the concentration of HIV (1). For this reason alone, there is no additional risk involved in receiving semen to the eye than that of performing oral sex without a barrier.

Additionally, please consider that it is nearly impossible to attribute any/all physical symptoms to HIV without adequate HIV testing confirmation.

Most people develop detectable antibodies in 21-25 days post exposure. Yet, you may want to consider biomedical approaches such as PrEP and PEP that help lower your risk of acquiring HIV. If you have had an exposure, and feel as though it is one of high risk, PEP is a viable option for up to 72 hours in protecting yourself from HIV acquisition.

The P24 Antigen test is the most commonly used test within the first few weeks post exposure. It is recommended that you receive testing within this window period, in order to reduce any likelihood of transmission to other partners. For completely conclusive results, most HIV specialists recommend re-testing at 12 weeks post exposure.

Recommendation: Refer to Physician for HIV test.

All the best, AIDS Vancouver Helpline/Online, Cody

Hello and thank you for your inquiry.

We understand that you are concerned with the accuracy of multiple non-reactive HIV test results you have received since having unprotected anal sex, with the most recent test being done at 20 weeks after your exposure.

At AIDS Vancouver, we do not recommend the use of home testing kits, as they can yield false results and there is no opportunity for counselling the individual. For this reason, we will address the rapid antibody test you received at 15 weeks, as well as the 4th Generation EIA (combo) test you received at 20 weeks.

The rapid test looks for HIV antibodies and the average window period for this test is 22 days (3 weeks), but it can be up to 3 months (12-13 weeks).

4th Generation EIA tests detect HIV antibodies, as well as the HIV P24 antigen. The average window period for this test is 18 days (2.5 weeks), but can be up to 1.5 months (6-7 weeks)

When performed outside the window period, Fourth-generation HIV tests and the INSTI rapid test have a sensitivity of about 99.9%, meaning that they are accurate 999 out of 1000 times. (1)

Based on the timeline you have provided, both your rapid test and your 4th generation test were performed well beyond their respective window periods. Given the superb sensitivity of these tests, and the fact that you have had multiple non-reactive results, you can most certainly consider yourself to be HIV negative.

In the future, please consider using protection when having anal sex, no matter how brief the encounter. This will not only reduce your risk of acquiring HIV, but is also likely to reduce the anxiety you experience afterwards.

If you think that having unprotected anal sex is something you might find yourself doing again in the future, there are biomedical approaches such as PrEP and PEP that help lower your risk of acquiring HIV. Refer to your physician for further information

Regards, AIDS Vancouver Helpline Volunteer, Dyson

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the conclusiveness of an instant HIV test. From the information given, this scenario is determined to be High risk (Evidence of transmission through these activities and is the majority of cases of transmission). Unprotected vaginal sex is considered to be a high risk activity because they involve an exchange of body fluids. In addition, a significant number of scientific studies have repeatedly associated these activities with HIV infection. This is how most infections occur.

Instant HIV tests have a window period of 4 weeks to 3 months with an accuracy of 99.6%. When tested negative, results are considered to be accurate for the window period [1]. In Canada, all laboratories use 4th Generation tests as screening tests [2]. 4th Generation tests have an accuracy of 99.9% and are considered conclusive at 6 weeks post exposure. We recommend doing a 4th Generation test for even more conclusive results.

Recommendation: Refer to Physician for HIV test. If you are continuously engaging in high risk activity there are biomedical approaches such as PrEP and PEP that help lower your risk of acquiring HIV. Refer to your physicians for further information.

Regards, AIDS Vancouver Helpline/Online, Ashley

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about the conclusiveness of the tests you received up to 101 days post exposure.

Most HIV specialists agree that 4th Generation Tests are conclusive at 6 weeks. Yet, official HIV testing guidelines recommend re-testing at 12 weeks with an antibody test (1). In your case, you have received three individual tests which exceed the 12 week recommendation for a completely conclusive result. With this in consideration, you can regard your test results to be completely conclusive.

Recommendation: No need for HIV test with the scenario provided, refer to a physician for other health related questions.

All the best, AIDS Vancouver Helpline/Online, Cody

Hello and thank you for contacting the AIDS Vancouver Helpline

We understand that you are wondering if you can consider your negative test result at 136 days post exposure to be conclusive. You do not mention what type of HIV test you received and this was your 9th test. Since you don't say what activity you engaged in, we are unable to assess your risk level.

The type of HIV testing you received will depend on where you live. It was very likely one of the following:

EIA (Enzyme Immunoassay) antibody 3rd generation aka ELISA: This test has a window period of 4 weeks to 3 months (although up to 95% of infections are detectable within 4-6 weeks). Most people develop detectable antibodies in 21-25 days. (1)

Fourth Generation EIA test (antigen-antibody combination test or DUO test): Fourth-generation HIV tests can detect HIV infection in 50% of people by 18 days after infection; 95% of people by 34 days after infection; and 99% of people by one and a half months after infection (1). Fourth-generation HIV tests have a sensitivity of about 99.9%. (1)

Rapid test (INSTI test): The window period of the INSTI test is estimated to be the same as, or up to one week longer than, the window period for third-generation HIV tests. (1)

At 136 days post exposure, you are well beyond the window period for all three of these tests, and can therefore consider your result to be conclusive. No further testing is required.

When you engage in an activity that carries a risk for HIV transmission, it is only necessary to be tested once, as long as you wait for the window period to pass. During the window period, you should refrain from engaging in activities that could potentially transmit HIV.

Regards, AIDS Vancouver Helpline/Online, Dyson

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about the conclusiveness of your test results. From your description, you have received a number of HIV screening tests following your exposure, ending with the negative 4th Generation EIA at 154 days post exposure.

Although you received many tests, I will focus on the final and most recent of your test results. Fourth-generation testing methods can detect HIV infection in half of people by 18 days after infection, 95% of people by 34 days after infection; and 99% of people by one and a half months after infection. In this case, you received this same testing method 154 days (approximately 22 weeks) following your exposure which produced a negative result. The fourth-generation HIV tests and INSTI rapid tests have a sensitivity of about 99.9%, meaning that results produced are highly reliable (1)

Symptoms such as swollen lymph nodes, headache, fever, and burning, have all been known to be associated with HIV infection. However, it is nearly impossible to attribute these symptoms to HIV without adequate testing confirmation.

While you had received a number of negative results previously, your mention of a positive serum control band on December 2nd with two consecutive negative results appear to be conflicting. Further interpretation of your results may require the expertise of a physician.

Recommendation: Please refer to a physician for further analysis of your test results.

All the best, AIDS Vancouver Helpline, Cody

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about the conclusiveness of your test results at 65 days following your exposure.

Most HIV specialists agree that 4th Generation tests are conclusive at 6 weeks, yet, official HIV testing guidelines recommend re-testing at 12 weeks with an antibody test for complete confirmation (1).

Recommendation: Refer to Physician for HIV test at 12 weeks post exposure for completely conclusive results.

All the best,

AIDS Vancouver Helpline/Online, Cody

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about the reliability of the test results you received from the rapid antibody test 8 weeks post exposure.

This test is typically performed between 4 weeks to 3 months and can detect 95% of infections between 4-6 weeks at a high accuracy rate. However, official HIV testing guidelines recommend re-testing at 12 weeks post exposure for completely conclusive results.

Recommendation: Refer to Physician for HIV test at 12 weeks post exposure for the most accurate results.

All the best,

AIDS Vancouver Helpline/Online, Cody

Hi there,

Thank you for your inquiry. From what we gather from the question you were asking about the conclusiveness of your negative HIV 4th Generation test results at approximately 10 weeks post exposure, and 42 days after PEP completion.

Most HIV specialists consider this HIV testing method conclusive at 6 weeks post exposure. However, official HIV testing guidelines recommend re-testing at 12 weeks post exposure for completely conclusive results. This testing method has an extremely high accuracy rate, and although you are recommended to seek re-testing at 12 weeks post exposure, you have also received a number of tests prior to your last in conjunction with the effective use of PEP.

In your case, it is safe to say that the combination of these results are very encouraging, and in fact, you should consider yourself HIV negative.

Recommendation: Refer to a physician for other health related questions.

All the best,

AIDS Vancouver Helpline/Online, Cody