Q. My last HIV risk exposure was three to four years back. Am I safe now?

Answered by
Dr. Sushil Kakkar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 07, 2018 and last reviewed on: Nov 03, 2022

Hello doctor,

I am a 65-year-old white male who tested negative for HIV 1 and 2 in a one-time test three to four years ago. I am not sure if it was a third or fourth-generation test. I tested negative with a fourth-generation test four months back because I thought I might have some symptoms. And I remembered the flu-like illness about six months after exposure.

I weighed 204 kg three months back, and now I weigh 191 kg. I have worried a lot (pacing the floor, sleep loss) for the past five months, took Paxil, and realized my worry could account for some weight loss. Shortly after the test, I had the following symptoms:

  1. I started having a small patch of 8 to 10 pinpoint-sized pink-light red dots under the skin of my left wrist that had been there for two to three weeks.
  2. I also had a smooth, flat spot about 3/8 inch in diameter that appeared on the back of my right hand about a week ago that has now faded to a pinkish brown. I have read about Kaposi sarcoma being a definer of AIDS, but I do not understand how that could happen with a non-reactive fourth-generation test four months back.
  3. Three months back, I had sinus-type headaches multiple times that would sometimes be severe. After three rounds of antibiotics and a CT scan two months back that showed shadowing in a sinus, my ENT doctor just told me this week that there is something in my sphenoid sinus. He is treating it with a rinse for inflammation for three weeks before I see him again. I have had blood in the mucous from my nose for the past three months. It dries out in my nose and causes blood almost every time I pick at it. The ENT doctor said that the lining of my nose had been worn down from this, but did not seem concerned about it. I do mess with it a lot and blow my nose a lot.
  4. My PSA elevated quickly in the last six months, going from 1.2 to 3.5. A biopsy two months back showed early cancer in one of the 12 regions biopsied.
  5. I had lithotripsy on an 8 mm kidney stone this month, and I am still passing dark urine. I was told that I do have several small stones still in each kidney. I have had multiple stones over the years.
  6. I have a swelling sensation all the way around my waist down into my groin at times that has been there for about two months, but no noticeable swelling. Several doctors have felt in my abdomen and detected nothing abnormal. A CT scan with no contrast ten days ago showed no abnormalities other than a little swelling in the right kidney where the 8 mm stone was blocking the passage into the ureter. A CT with contrast five months back was normal except for showing stones. But I have had microscopic blood in my urine since then.

My vital signs have consistently been normal for the past five months, including temperature, BP, and oxygen. I know I am getting old, and some of these symptoms happen with age. But it is driving me crazy that so much has happened since my negative fourth-generation test, which is supposed to detect antibodies, may not be conclusive after three to four years of exposure. I had Zoloft 100 mg daily earlier, but I am currently on Paxil 40 mg and Propranolol 60 mg daily.

After nearly four years of exposure and a negative antibody test four months back, would that test have detected antibodies if I were in a stage of HIV or AIDS? Do you think it was conclusive? Or is there another test I should have done? I have read about an HIV RNA test, but it says early detection. I understand that it detects more than antibodies. What are your thoughts on my next step?



Welcome to

Your test done before four months is certainly conclusive and final. Three months intervening period/window period between risk exposure and a fourth-generation HIV screening test is good enough for it to be considered conclusive. 95 % of those infected with HIV will have detectable antibodies by four weeks, and by 12 weeks or three months, 100 % of HIV-infected individuals will have detectable antibodies. Antibodies, once formed, will remain detectable by screening tests. In fact, antibody-based HIV screening tests are the gold standard tests for the diagnosis of infection whereas an HIV RNA PCR test is more commonly utilized as a measure of response to antiretroviral therapy in HIV AIDS patients rather than as a diagnostic or screening test.

Thank you doctor,

I meant to say that my exposure was three to four years ago, not for three to four consecutive years. Does that make any difference in your answer?



Welcome back to

Yes, I got that. You said that your last risk exposure was three to four years ago, and you last tested with a fourth-generation HIV screening test four months back. Earlier, you tested three to four years ago. My answer is the same. Antibodies to HIV develop within 4 to 12 weeks in all those who are infected, and they remain detectable throughout the infection. So, if someone is screened for HIV after three to four years of infection, a fourth-generation HIV screening test should be able to detect the antibodies.

As far as the skin lesions on your wrist are concerned, I request you to kindly upload a few clear images of the affected area so that I can have a look at the spots and let you know what exactly they are due to.

Was this answer helpful?


Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Related Questions:
Is it possible to have hairy leukoplakia three months after risky sexual activity?

.. not appear to be hairy cell leukoplakia. It appears like a normal ulceration or papule only. I suggest applying Triamcinolone ointment over it twice daily and observe if it goes down. Eat a healthy diet rich in folic acid and all other vitamins. T...   Read full

What is the frequency to do HIV testing while taking PEP?

.. to your queries are: For PEP (post-exposure prophylaxis) efficacy, adherence to the medications prescribed for PEP is the most important thing. PEP is really efficacious, To the best of my clinical practice, I have not seen any case of a patient w...   Read full

I am at the risk of HIV AIDS. Please help.

Hello doctor, My wife is 13 weeks and 5 days pregnant at present. She vomits in the mornings, and she has continuous light stomach pain. Once or twice a day, she has intense stomach pain for 5 to 7 minutes. She takes Doxinate tablet once a day. Is t...   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read

Coronavirus Variant Arcturus: | Omicron XBB.1.16 Variant
Arcturus is an emerging variant of the Omicron virus that causes various symptoms and spreads rapidly across the world. ...  Read more»
Adrenaline Rush - Symptoms, Causes, Effects, and How to Control
Adrenaline is a hormone responsible for fight or flight response. It is also a neurotransmitter and medicine. It is also...  Read more»
Fatty Liver - Types, Symptoms, Stages, and Treatment
The liver is the largest gland in the body. Its primary function is to process the food and drinks we consume. and filte...  Read more»

Ask your health query to a doctor online?

Ask a HIV AIDS Specialist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.