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Q. HIV RNA was negative on 21st day? Can it be positive later?

Answered by
Dr. Bharatesh Devendra Basti
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 09, 2017 and last reviewed on: Oct 05, 2019

Hi doctor,

I had unprotected sex with a woman for two to three minutes around four weeks ago. I took HIV 1 RNA test on 11th day which was negative. Again I took complete STD panel tests on 21st day with HIV-1 RNA and HIV fourth generation tests, all of the results were negative. But, I can notice small rashes near tip of my penis which are appearing and going away for the past couple of days. Am I HIV positive? I am worried. Can HIV RNA be positive after negative at 21st day?

Dr. Bharatesh Devendra Basti

Community Medicine Dermatology HIV/AIDS Specialist Preventive Medicine Venereology
#

Hi,

Welcome to icliniq.com.

  • I have gone through the photo (attachment removed to protect patient identity). Though the photo is not clear, I can make out slight redness on the glans. It may be due to irritation or fungal infection.
  • Do not over clean the area. Clean the area with warm water twice daily. Observe if any rash develops.
  • The chance of transmission of HIV (human immunodeficiency virus) by single unprotected intercourse with a positive person is 1/200 to 1/1000. Here, it is low. She may be negative too. Then the chance is nil.
  • HIV-1 RNA PCR is sensitive after 7 to 10 days. So, the chance of HIV-1 is almost nil.
  • Duo test is considered sensitive after one month. It detects both antigen and HIV 1 and 2 antibodies. Some consider conclusive after one month.
  • You can go for HIV 1 and 2 RNA PCR at this stage. The chance of HIV-2 is very rare.
  • You can get the women's history or get her tested to allay fears totally.

For further information consult a HIV AIDS specialist online --> https://www.icliniq.com/ask-a-doctor-online/HIV-AIDS-specialist


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Hi doctor,

The redness has gone away now. I observed it in the morning. It has become normal. Could you please tell can I relax as the RNA test is negative? Is there any case where RNA test has turned positive later after negative at 20 days? I am planning to take Duo test on 30th day. Can I be relaxed if it comes negative?

Dr. Bharatesh Devendra Basti

Community Medicine Dermatology HIV/AIDS Specialist Preventive Medicine Venereology
#

Hi,

Welcome back to icliniq.com.

  • It is good if the rash has subsided. Observe the area. The rash is not related to HIV. You can allay fears about HIV and rash.
  • HIV-1 RNA PCR is very sensitive (more than 99%) after 10 days exposure. The chances of it coming positive later is almost nil.
  • It does not detect HIV 2. So, you can go for HIV 1 and 2 RNA PCR.
  • HIV Duo after one month is considered conclusive by many. With given history and tests it may be considered conclusive after one month.
  • You can go for final antibodies test (HIV 1 and 2) after three months to totally be free from anxiety. The chance of HIV tests becoming positive later is nil.

For further information consult a HIV AIDS specialist online --> https://www.icliniq.com/ask-a-doctor-online/HIV-AIDS-specialist


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Hi doctor,

I have attached pictures with red dots. Are these related to HIV?

Dr. Bharatesh Devendra Basti

Community Medicine Dermatology HIV/AIDS Specialist Preventive Medicine Venereology
#

Hi, Welcome back to icliniq.com.

I have gone through the photos (attachment removed to protect patient identity).

  • There is no significant rash now. It may be due to irritation or fungal infection. Just clean the area with warm water twice daily. Wear loose cotton inner wears.
  • These are not related to HIV. You can allay fears of HIV.

For further information consult a HIV AIDS specialist online --> https://www.icliniq.com/ask-a-doctor-online/HIV-AIDS-specialist


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Hi doctor,

My HIV 1 RNA and 4th generation tests on 31st day came as negative. Can I relax now?

Dr. Bharatesh Devendra Basti

Community Medicine Dermatology HIV/AIDS Specialist Preventive Medicine Venereology
#

Hi,

Welcome back to icliniq.com.

  • With the given history, details, test reports I would take it as HIV negative.
  • The chances of HIV tests coming positive later is nil. You can allay fears of HIV.

For further information consult a HIV AIDS specialist online --> https://www.icliniq.com/ask-a-doctor-online/HIV-AIDS-specialist


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Hi doctor,

I had one more duo test on 52nd day after exposure and it came negative. But, I am having body pains for three days and yesterday a lymph node near my groin got swollen and I got rash on penis again. Is this due to HIV?

Dr. Bharatesh Devendra Basti

Community Medicine Dermatology HIV/AIDS Specialist Preventive Medicine Venereology
#

Hi,

Welcome back to icliniq.com.

  • There is no need for repeating the duo test. There will be no difference. It is better to get the test after three months to have conclusive results. It is negative reiterate that you are free from HIV.
  • The fungal infection or allergic rash is known for recurrence. If the rash is different from earlier rash, you can send clear photos for clarification. Otherwise follow same treatment.
  • Any simple infection in genital area or lower limb can lead to inguinal lymph node swelling. So, do not relate it to HIV. The symptoms are not due to HIV. Allay fears of HIV.

For further information consult a HIV AIDS specialist online --> https://www.icliniq.com/ask-a-doctor-online/HIV-AIDS-specialist


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Hi doctor,

I have attached the pictures. Do I need to believe my HIV 1 RNA at 31 days and duo test at 52 days to be conclusive? I have seen many doctors saying six weeks duo is conclusive. Could you please advise me? Is RNA test conclusive and accurate? Have you seen any one turned positive after negative duo at seven weeks?

Dr. Bharatesh Devendra Basti

Community Medicine Dermatology HIV/AIDS Specialist Preventive Medicine Venereology
#

Hi,

Welcome back to icliniq.com.

I have gone through the photos (attachment removed to protect patient identity).

  • It appears to be either due to fungal infection or irritation. Clean the area with warm water twice daily.
  • You can apply Clotrimazole cream like Candid cream after consulting your doctor.
  • HIV RNA PCR after 10 days exposure and duo test after one month is very sensitive test. It is considered conclusive by many.
  • The chances of tests coming positive later is nil. You can allay fears of HIV.
  • To relieve your anxiety and get final conclusive result, it is better to get tested after three months.

For further information consult a HIV AIDS specialist online --> https://www.icliniq.com/ask-a-doctor-online/HIV-AIDS-specialist


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