Is an HIV test at 9 months after PEP entirely conclusive?

Hello doctor,

I have got a very important issue to discuss. I need your help. I had sexual intercourse with a female sex worker nine months ago. Within 24 hours of exposure, I started a PEP course based on FTC/TAF (Emtricitabine and Tenofovir alafenamide) and Darunavir Ritonavir. I confirmed by reading the US CDC guideline, which says that FTC/TAF is not approved for PEP use. So, I am considering my PEP has gone to complete waste. Two days back, I again tested for HIV. I am attaching my report. This test is done after nine months and one day after exposure.

Is the report conclusive and final?

I also read that non-occupational PEP can increase the window period of HIV testing. If this is so, please tell me the exact timing of my HIV test in my case. When can I test conclusively for HIV, and with which test?

Kindly advise.

Hello doctor,

That is great news for me. One doubt that has been eating away at my head for the past nine months is of the delayed window period of tests in the case of non-occupational PEP. Kindly address my following doubt.

1. I heard many doctors saying that one year is the minimum time to wait after exposure to test conclusively for HIV, especially if one has taken non-occupational PEP. How accurate is this?

2. Is delay seroconversion really possible, or is it just a theoretical thing?

3. Even if we consider a 0.1% chance of delayed seroconversion, then is delayed seroconversion possible beyond six months?. My test is nine months after exposure and eight months after the last dose of PEP.

4. By seeing my case of an unapproved PEP course, kindly include even a 0.1% possibility of delayed seroconversion while giving your answer.

5. Is there the slightest possibility that because of my unapproved PEP course, I need to wait for a year or even more, like two years, etc., to test conclusively for HIV, or will my present test be done after nine months (eight months after the PEP course) from exposure is final and I am free from HIV?

Kindly help.

Hello doctor,

Thanks for the reply.

I just made one observation from your response that delayed seroconversion is possible. Is it possible in hepatitis coinfection and cancer patients, or is it possible in any other scenario as well? I am just asking for informational purposes. Kindly tell me in what cases delayed seroconversion is possible.

Thank you.

Hello doctor,

Thank you for your reply.

I need to clear up some doubts about my HIV test report. You have seen my HIV test report, which I have attached.

1. When I went to a laboratory to test, they mentioned the name of the test was the HIV 1 and 2 antibodies screening test. I thought there would be only an antibody test checking for antibodies in the blood. Still, in the report, they have also mentioned antibodies and combo P24 by CLIA. What is it?

2. I was thinking of getting tested with a simple HIV antibody test, but they have done some different tests as well. So, is it required for me to test solely with antibody tests at another laboratory, or does this report genuinely test for antibodies?

Kindly advise.

Hello doctor,

The reports show antibodies negative in the test, but in the second test, there are some values. It is given as 0.114. What is this value? Is everything okay in the report?

Kindly help.

Hello doctor,

My exposure was protected, but I made a lot of mistakes while using a condom. I used the same condom that I was using for oral sex. Can teeth damage a condom? I applied oil as a lubricant on the condom. I read that oil as a lubricant can damage the condom and lead to micropores in the condom, which cannot be seen with the naked eye. I did not see the expiry date. I kept the condom packet in the back pocket of my jeans and sat on a sofa for one hour before intercourse. Pressure on the condom can also lead to micropores and can damage the condom.

By seeing all these mistakes while using a condom, I feel like I have done completely unprotected sex.

What do you think these mistakes while sex can transmit HIV? Do I need to worry now as I have tested negative for HIV nine months after exposure and eight months after the last dose of PEP? I think PEP was also faulty, as I told you. When I finished intercourse, I checked the condom, and it was intact. But I fear micropores due to oil lubricant.

Please clarify here.

Thank you.

Hello doctor,

Thanks for the reply.

I forgot to tell you that before using a condom, I suspect that there was a penis-vagina contact or insertion for some seconds. So, with this high-risk exposure to the above-mentioned micropore issues, even if I consider the worst-case scenario that my exposure is full-blown unprotected sex. Also, am I not infected with HIV because I have tested conclusively negative after nine months from exposure and eight months since the last dose of unapproved PEP?

Kindly help.

Hello doctor,

Can I start having unprotected physical relationships with my spouse? And can I now completely forget this one episode of exposure and start focusing on my life, career, and goals ahead?

Kindly suggest.

Thank you.

Hello doctor,

But I am just asking for the safety of my spouse. Can I now engage in unprotected sex safely with her? It is safe to have unprotected sex with her?

Kindly help.

Hello doctor,

Thank you for patiently clearing my doubts and making me believe that my HIV test is final after 9 months from exposure and 8 months after the last dose of PEP, and I am not infected with HIV, and there is also no need for any further tests. You made me believe that I am completely safe and HIV-free and can start having a normal life as usual as it was earlier before exposure.

Kindly advise.