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DEFINITE Exposure
Oct 24, 2000

I am not a person who goes around sleeping with a variety of people. I reunited with an ex boyfriend, of three years, and had unprotected sex with him twice, as a result of his coaxing, convincing me that he was tested every six months. Six weeks after this, he informed me of an HIV+ test. So, I tested the same day, as I had not been tested since our relationship years ago, and I was negative. Good sign, I had a baby two years ago. So, I went to my county clinic at three months and they REFUSED to test me, claiming that a 13 week result does not "Do any good". So, I went to my doctor, who said that if I wasn't positive at that time, it is highly unlikely that I will be at six months. I tested negative again. I have been researching this matter of the "window period" since. I have just reconciled with my husband and we want another baby soon. I have heard six months, six months, and six months again. Is the window period simply a matter of opinion, or what???? New York Health Department says 99.9 at three months. So does GMHC. I'd like to think that the oldest AIDS organization and the state with most cases know what they are talking about. I know everybody asks about the window period, but I guess I'm asking- who can I believe about the window period? Thank you very much for your time.

Response from Mr. Kull

I am a little confused about the chronology of events that you present. If you were negative three months after your exposure, I would trust that result. The clinic acted irresponsibly in not testing you at 13 weeks.

Like I have said in other responses to questions about the window period, health professionals should form their own opinions about the length of the window period based upon research and clinical expertise. Other factors might interfere with making sound judgements: inexperience with HIV, not being aware of recent data, and personal biases. This is why you should always base your opinion on information from trusted, and sometimes several, resources.

Different sources will probably vary to certain degrees on the length of the window period. I agree with the New York Department of Health and GMHC. I also agree with studies that suggest that the test has 95-99.9% in three months. I also agree with the following excerpt from the publication Medical Management of HIV Infection by John G. Bartlett, MD at the Johns Hopkins AIDS Service:

"Seroconversion with positive HIV serology generally takes place at an average of 3 weeks after transmission with the recombinant antigens now used in standard third generation EIA (AIDS 1995;9:597). A healthcare worker with occupationally-acquired HIV infection was EIA negative at 9 months and seroconverted at 11 months post exposure; this is one of the longest delays in seroconversion reported to the CDC (NEJM 1997;336:919).... It now appears that using standard serologic tests, >95% of patients seroconvert within 5.8 months following HIV transmission (Am J Med 1994;96:42; BMJ 1988;296:593; Lancet 1989;2:637; JAIDS 1993;6:1339)."

I don't think any of those answers are wrong. The small variation in percentages is so small that it is clearly insignificant when it applies to you. Your situation sounds like it was scary, but try not to obsess about the tiny variations in details from scientific studies. Do what you are comfortable with in determining your status and try to move on with your life.

RMK



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