Aa
Discordant Test Results
I am a homosexual male who regularly engages in protected receptive anal intercourse- I always use condoms, without exception. I also regularly perform oral sex on men and occasionally receive ejaculate in my mouth, something which I've been assured has a risk so low as to approach zero. So on paper, I've always considered myself someone with no real risk under his belt.
On April 23 I went in for my regular semi-annual rapid hiv test at a free clinic.The test performed was a clearview complete hiv1/2 rapid test- the counselor pricked my finger as usual and we waited 15 minutes. After the time had elapsed, my counselor looked distressed/confused and showed me the test strip- a huge dark puple blemish was bleeding down vertically from the control line, along the length of the test strip, and towards the bottom an extremely faint, almost imperceptible partial grey line had formed. he said he had never seen a result quite like this- although they're instructed to interpret any second line as reactive, he said the control line discrepancy along with the odd placement/faintness of this second line warranted an immediate retest. He pricked my finger a second time and the result was negative. He, along with the director of the clinic who examined my first odd test, were both comfortable giving me a negative result, and both agreed that something went wrong with the first test which would implicate it as "INVALID."
This gave me comfort for all of about 5 minutes. With one potential invalid positive and one subsequent negative in tow, i drove across town to the LA Gay and Lesbian center, where they performed a third rapid blood test which came out negative. additionally, they drew blood for a pooled NAAT test, the results of which I received a week later- no HIV RNA detected. This again gave me some comfort- I viewed the third rapid test as a tie breaker, and my pNAAT came back negative, which would imply that i was truly negative, since no virus/RNA was detected.
Nonetheless my anxiety continued to nag, so I got retested with rapid tests about twice weekly for the next month, all of which came out negative. Negative blood oraquicks, negative clearviews, and negative INSTI tests, 13 negative rapid tests total.
Exactly four weeks after April 23, the date the first test discrepancy, i went to another clinic which performed a drawn blood Fourth Generation test. Also on that day, I returned to the Gay/Lesbian center to get a second pooled NAAT test. After a week I received the tests from both- my fourth generation antigen/antibody test came back non reactive, and my second NAAT came back negative, no virus detected.
This gives me one potential positive result, and 16 combating negative tests (13 rapids, 2 NAATs, and 1 fourth gen ag/ab test) taken over the span of a month thereafter. The only potential exposures i could indict as somewhat "risky" were instances where i performed oral sex with ejaculation, 3 instances total, which occurred 17 days, 21 days, and 30 days prior to April 23, the date of the "bad" test. So with those exposure dates in mind, i've had one potentially invalid, possibly reactive result either 2.5/3/4 weeks after an exposure. I asked for western blots, but I was told they're only offered as a reflex to positive EIAs, and the 4th gen EIA I had 6+ weeks after my most recent potential "exposure" was negative.
So do these negative tests exonerate me and disprove that first weird result, that could have potentially been interpreted as reactive (because there was a potential second line, no matter how the counselor tried to spin it. I think he was just panicked). Part of me has to consider that I may be early in the infection, in a way wherein my body has yet to produce a high enough antibody titre to generate consistently positive results (making the first test the "lucky" test, that just happened to detect a trace amount of antibodies floating around, something which the subsequent tests somehow failed to do). However if i was acutely infected somehow, or in the middle of seroconverting, wouldn't I have had reactive NAAT tests? The lower detection limit of the PCR used for my pooled NAAT was 40 copies/ml- if I was pooled with a high enough multiple of tens of specimen, is it possible my viral load was diluted by all of the HIV-negative sera, below the test's detection limit? I calculated that if they pooled my sample with 50+ other patients, I could have a viral load in the low single-digit thousands fly under the radar. But again i'd expect someone acutely infected to have a viral load in the tens of thousands, if not hundreds of thousands or even millions. Additionally the p24 component of my fourth gen test obviously didn't react either. I really can't reconcile any of these results with each other. I want to believe I really am negative and that first test was a fluke, but a false positive hiv test on a promiscuous gay bottom seems like a REALLY hard sell, no matter how safe I was.
Whatever advice I do or do not receive, i'm going to re test at the 3 month mark from the last potential exposure, that is a given. Said 3 month mark will be approaching in 3 weeks.
thank you for your time, whoever responds.
On April 23 I went in for my regular semi-annual rapid hiv test at a free clinic.The test performed was a clearview complete hiv1/2 rapid test- the counselor pricked my finger as usual and we waited 15 minutes. After the time had elapsed, my counselor looked distressed/confused and showed me the test strip- a huge dark puple blemish was bleeding down vertically from the control line, along the length of the test strip, and towards the bottom an extremely faint, almost imperceptible partial grey line had formed. he said he had never seen a result quite like this- although they're instructed to interpret any second line as reactive, he said the control line discrepancy along with the odd placement/faintness of this second line warranted an immediate retest. He pricked my finger a second time and the result was negative. He, along with the director of the clinic who examined my first odd test, were both comfortable giving me a negative result, and both agreed that something went wrong with the first test which would implicate it as "INVALID."
This gave me comfort for all of about 5 minutes. With one potential invalid positive and one subsequent negative in tow, i drove across town to the LA Gay and Lesbian center, where they performed a third rapid blood test which came out negative. additionally, they drew blood for a pooled NAAT test, the results of which I received a week later- no HIV RNA detected. This again gave me some comfort- I viewed the third rapid test as a tie breaker, and my pNAAT came back negative, which would imply that i was truly negative, since no virus/RNA was detected.
Nonetheless my anxiety continued to nag, so I got retested with rapid tests about twice weekly for the next month, all of which came out negative. Negative blood oraquicks, negative clearviews, and negative INSTI tests, 13 negative rapid tests total.
Exactly four weeks after April 23, the date the first test discrepancy, i went to another clinic which performed a drawn blood Fourth Generation test. Also on that day, I returned to the Gay/Lesbian center to get a second pooled NAAT test. After a week I received the tests from both- my fourth generation antigen/antibody test came back non reactive, and my second NAAT came back negative, no virus detected.
This gives me one potential positive result, and 16 combating negative tests (13 rapids, 2 NAATs, and 1 fourth gen ag/ab test) taken over the span of a month thereafter. The only potential exposures i could indict as somewhat "risky" were instances where i performed oral sex with ejaculation, 3 instances total, which occurred 17 days, 21 days, and 30 days prior to April 23, the date of the "bad" test. So with those exposure dates in mind, i've had one potentially invalid, possibly reactive result either 2.5/3/4 weeks after an exposure. I asked for western blots, but I was told they're only offered as a reflex to positive EIAs, and the 4th gen EIA I had 6+ weeks after my most recent potential "exposure" was negative.
So do these negative tests exonerate me and disprove that first weird result, that could have potentially been interpreted as reactive (because there was a potential second line, no matter how the counselor tried to spin it. I think he was just panicked). Part of me has to consider that I may be early in the infection, in a way wherein my body has yet to produce a high enough antibody titre to generate consistently positive results (making the first test the "lucky" test, that just happened to detect a trace amount of antibodies floating around, something which the subsequent tests somehow failed to do). However if i was acutely infected somehow, or in the middle of seroconverting, wouldn't I have had reactive NAAT tests? The lower detection limit of the PCR used for my pooled NAAT was 40 copies/ml- if I was pooled with a high enough multiple of tens of specimen, is it possible my viral load was diluted by all of the HIV-negative sera, below the test's detection limit? I calculated that if they pooled my sample with 50+ other patients, I could have a viral load in the low single-digit thousands fly under the radar. But again i'd expect someone acutely infected to have a viral load in the tens of thousands, if not hundreds of thousands or even millions. Additionally the p24 component of my fourth gen test obviously didn't react either. I really can't reconcile any of these results with each other. I want to believe I really am negative and that first test was a fluke, but a false positive hiv test on a promiscuous gay bottom seems like a REALLY hard sell, no matter how safe I was.
Whatever advice I do or do not receive, i'm going to re test at the 3 month mark from the last potential exposure, that is a given. Said 3 month mark will be approaching in 3 weeks.
thank you for your time, whoever responds.
COMMUNITY LEADER
It is true that receptive anal is the riskiest of the riskier behaviors however the risk vanishes when a condom is used correctly and consistently, that's what you do as you mentioned.
In your case, you have "over done" on tests. Your one isolated, "Indeterminate" of False Positive test was was nullified by a series of other tests and that should be enough.
Looking at your lifestyle, it is suggested that you continue to use condoms correctly and consistently, with plenty of water based lubes, every time. Avoid unprotected performing oral with ejaculation involved. Better to use protection in such cases, here through the risk is very low but it is always better to remain careful. Play safe, stay healthy
In your case, you have "over done" on tests. Your one isolated, "Indeterminate" of False Positive test was was nullified by a series of other tests and that should be enough.
Looking at your lifestyle, it is suggested that you continue to use condoms correctly and consistently, with plenty of water based lubes, every time. Avoid unprotected performing oral with ejaculation involved. Better to use protection in such cases, here through the risk is very low but it is always better to remain careful. Play safe, stay healthy
Have an Answer?
You are reading content posted in the HIV Prevention Community
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
Can I get HIV from surfaces, like toilet seats?
Can you get HIV from casual contact, like hugging?
Frequency of HIV testing depends on your risk.
Post-exposure prophylaxis (PEP) may help prevent HIV infection.
