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CDC Error and Confusion
Mar 8, 2006

Dr. Bob,

Recently, I was reviewing the CDC guidelines for HIV Counseling for Rapid Tests. (www.cdc.gov/hiv/pubs/rt-counseling.htm) On this page, the CDC states, under the heading "Negative HIV Test Results," the following: "During the initial visit, the provider [HIV Counselor] can DEFINITIVELY tell clients whose rapid HIV test result that they are not infected, unless they have had a recent (within three months) lnown or possible exposure to HIV. Retesting should be recommneded for these clients because sufficient time needs to elapse in order for HIV antibodies develop that can be detected by the test. (June 19, 2003). Then, on the CDC website,(www.cdc.gov/hiv/pubs/faq/faq9.htm) there is the standard 3 month and 6 month quote. When I asked the CDC Hotline about the different statements, I was told "the longer the better," by an information specialist, and "there have been cases taking up to a year." Of course, we know these are historical cases, being qouted, going back to a 1997 CDC report. My questions are simple. Who do we believe, if, the CDC states two seperate opinions? Secondly, the "information specialist" stated "nobody knows how long it takes for antibodies to develop," so, when should be stop testing for HIV?

I, for instance, tested negative at between 28-30 weeks following unprotected anal sex (top) with a man who said he was negative. Statements he has made, since the incident, make me curious as to his true HIV status. So, should I get tested, again, to make sure I have not contracted the virus? As far as I know, I have no immune system problems and no underlying health conditions to create a variance. In fact, my doctor stated my bloodwork was perfect at the time of my test in January 2006. In fact, I am starting HIV Counselor training and how can I, in good conscience, tell someone a "definitve" answer, if the CDC is contradicting itself--Thanks, Confused in Cordova, Tennessee!!

Response from Dr. Frascino

Hello,

Chances are you'll learn a great deal about this topic in your upcoming HIV counselor training. It can indeed be confusing, and guidelines are changing as our testing techniques and methods improve. At this point, without extenuating circumstance (you'll learn all about these), I would agree with the CDC rapid test advice, i.e. tests taken prior to three months are not considered definitive. I would consider your negative test conclusive; however, the option to retest at six months is always open to you. Personally, I don't feel it's warranted in your situation.

Hope that helps.

Dr. Bob



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