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Me and my buddy have got a bet will you decide the winner
Jun 23, 2008

Hello my best friend and I was researching hiv and got into a little debate and we need you to settle the score, we have a fifty dollar bet and the winner will send it to your foundation. Ok im sayin that if i have repeated unprotected sex with a person of unknown status for 4 months and tested on the 5th month and if the test came back negative or positive that the test would be accurate. I think that if the person was positive and you got infected and didnt know it and you kept on having unprotected sex with that person that would not delay the antibody process right. Just a guess wouldnt it make your body produce antibodies faster?

Response from Dr. Frascino

Hi,

Well, this may be a tie, based on how you and your buddy understood the basic question. (This, of course, means you each send 25 bucks?!?)

Here's the scoop. From your perspective, you are correct. If a person were to become infected during the first month of a relationship, for example, and continued to have unprotected sex with same individual, that would not delay the antibody-production process. In other words, they would begin the seroconversion process from the moment of initial infection. Most folks who become HIV positive have detectable levels of anti-HIV antibodies in their bloodstream within four to six weeks from the moment of primary infection. We recommend a three-month test to make sure we catch even those few individuals who may take a bit longer to develop detectable levels of anti-HIV antibodies, because some people's immune systems are just a bit slower to react than others, for a variety of reasons.

Now, looking at your question a bit differently, say from the point of view of your buddy, he might be correct. Here's the logic. If a person has unprotected sex repeatedly with an HIV-positive partner and gets tested during the 5th month of the relationship, the test, if positive, would be considered accurate. However, if he tested negative, this would not be considered definitive, because he could still be in the "window" period. Not every exposure to HIV results in transmission of the virus. Consequently, it's possible the person could have had unprotected sex with the positive partner for three or four months, but not acquire the virus until the end of the fourth month (or whenever). In this scenario, if he were to get an HIV test in the 5th month (only several weeks after primary infection), he could still test HIV negative, as his immune system hasn't had time to "kick in" and develop detectable amounts of anti-HIV antibodies.

Finally, your assumption that repeated exposures would result in your body's producing antibodies faster is not accurate. Once the virus finds its way into the host, the immune mechanisms kick in and proceed in an orderly fashion. Repeated exposures may increase the likelihood of getting infected, but they don't speed up the immune-system response to infection.

So you both are correct. You both win! Congratulations!

Dr. Bob



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