Is HIV still a risk years after safe sex and testing negative?

Hi doctor,

I am a 26-year-old male. I had three protected sexual exposures eight years ago with female sex workers and one protected sexual exposure five years ago with a female sex worker. From then till now, there was no sexual exposure. I was feeling good, and I had no problem regarding sexual exposure.

But three years ago, I developed COVID-19 (Coronavirus Disease of 2019) phobia and started symptoms like palpitations, weakness, a burning sensation in my hands, and a low mood. So I consulted a psychiatrist and took medicine. I felt good in the next three months, but in that period I lost three kilograms of weight. I thought that it was due to HIV (Human Immunodeficiency Virus). I searched for symptoms of HIV on the internet.

For the last two years, I have been experiencing symptoms like a burning sensation in my hands, feet, legs, and thighs, weakness, low mood, and concentration issues. So I started testing myself for HIV with HIV rapid test kits. Till now, I have tested myself with five different manufacturers' rapid test kits. I tested with 40 rapid test kits, and the result came out negative.

I have a few concerns I wanted to ask. Please answer my following questions:

1. Is this result conclusive after eight or nine years of sexual exposure?
2. Can a rapid HIV test detect HIV infection if sexual exposure occurred nine years ago?
3. Is the test I performed accurate and conclusive, and am I 100 % HIV-negative?
4. I tested with the whole blood finger-prick method. Can HIV antibodies be in the same amount as in whole blood, serum, and plasma?
5. Does whole blood give an accurate result like a serum specimen?
6. Do the symptoms I mentioned above resemble the last-stage symptoms of HIV infection?
7. I have been experiencing these symptoms for the last 1.5 years. Do you think these are last-stage HIV symptoms?
8. In the last 3-4 years, I have not had long periods of fever, diarrhea, or similar symptoms, only the ones mentioned above. I fear lab testing because I think the result might change if done in a laboratory. I have used home-based HIV rapid test kits about 40 times, all negative. If I take an ELISA test in a laboratory, what result should I expect?
9. I feel huge anxiety daily, and these symptoms persist. I want treatment and am gathering the courage to do the ELISA test. Will the ELISA result be negative or positive?
10. The rapid test instructions say to use 20 µl of blood. Sometimes I use 20 µl with a dropper, sometimes just one drop or half a drop, and the result was negative. Is this the correct procedure?
11. I read that in the late stage of HIV, antibodies might not be detected. Is this true?
12. I only have the symptoms mentioned, no other serious ones. If I am HIV-negative, why do these symptoms continue?
13. I am attaching my CBC report. Could you check if it shows any signs of immunosuppression?
14. Do I need any other HIV tests apart from the ones I have done?

Kindly assist.

Thank you.

Thank you.

Hi doctor,

Thank you for your answer.

Please answer my question point-wise.

1. Can 3rd- and 4th-generation HIV rapid test kits detect all types, strains, and subtypes of HIV?

2. The test manuals say these kits detect subtypes. How reliable is this?

3. I tested using whole blood from a finger prick, but labs use serum. Are HIV antibodies present in similar amounts in whole blood, serum, and plasma?

4. Does whole blood testing give results as accurate as serum testing?

5. I have had a burning sensation all over my body for 1.5 years. Can last-stage HIV symptoms last this long without serious symptoms like prolonged fever, diarrhea, or weight loss?

6. I have not had diarrhea or fever lasting 3+ days in the last 4 years.

7. A friend who might be HIV positive spat saliva that touched my tongue. Can HIV be transmitted this way?

8. What serious symptoms do patients experience in the last stage of HIV?

9. My lymphocyte counts have been near 20% for 2 to 3 years. Does this suggest my CD4 counts are within a normal range?

10. If I get an ELISA test in the lab, what is the chance it will be negative?

11. Can I take the ELISA test without fear?

12. If ELISA is negative, do I need further tests like Western blot or DNA/RNA PCR?

13. Four years ago, I had white blisters on my face and saw a dermatologist. Could this be herpes zoster or an insect bite? (Pictures attached)

Please help.

Thank you.