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if Dr. Bob was French... ? (SIX WEEKS VERSUS THREE MONTH HIV TESTS)
Feb 10, 2009

Doctor Bob,

suppose for a minute you were French - or just being in doctor in France. The authorities there consider an Antibody/Antigen test conclusive at 6 weeks. (For standard Ab tests, they say 3 months, like CDC). Ok. Now, someone asks you in this forum, is a 6-week Ab/Ag test conclusive? Do you still reply that only a 3-month test is conclusive?

(My exposure: wild making out with another guy - but no penetration of any kind (neither oral nor anal). We did however deep kissed and tight embracing while naked, in the possible presence of cuts on our bodies. Got an 8-week negative Ab/Ag test).

Would French Dr.Bob advise me to retest? What about the real Dr.Bob?!

Thank you. You're an awesome person.

Dan

Response from Dr. Frascino

Bonjour Monsieur Dan!

Je parle la langue de Molière. Alors, peut-être je suis français !!!??

My job as "Dr. Bob," whether French, Italian or Zimbabwean, is to provide science-based factual information. I'm really not here to criticize or support one set of guidelines versus another. Also, guidelines are only that: "guide"-lines. They are not absolutes. For instance, if someone decides to calculate three months as 90 days (3 months x 30 days) rather than 84 days (7 days x 12 weeks), does that make his method more accurate or definitive than the other? And of course if someone is comfortable with an 84-day test result, what about a negative test at 83 days? If I were to say 83 days is fine, then someone would write in immediately and ask about 82.5 days, etc., etc., etc.

That was a longwinded introduction to a specific answer to your question. I don't make the guidelines and I have no reason to criticize the French guidelines. Obviously those who devised and approved these guidelines have sufficient data using their specific type of combination HIV-antibody plus HIV p24 antigen tests to support their recommendations. One of the reasons I cannot/do not generalize this recommendation is that all the eyeballs currently reading this response do not reside in France. HIV testing is not exactly the same worldwide. The availability of different generations of HIV tests varies considerably from place to place. So if you and I were both in Paris, I would advise if the French guidelines suggest a six-week "test" is conclusive, then a six-week test is conclusive; however, I would also advise many other published guidelines recommend a three month test for a definitive result. I would then review the level of HIV risk and make a recommendation for the specific situation. The patient, of course, always has the option to retest at three months or six months (old guidelines), if he so desires. That said, if you showed up in my office in Paris, San Francisco or Zimbabwe with a risk of "wild making out with another guy but with no penetration of any kind . . ." I would advise "A l'aise Blaise," (in Paris) "Relax Max" (in San Francisco) or "whatever relax is in Ndebele, the language of Zimbabwe" (in Chitungwiza), your HIV risk is nonexistent and HIV testing of any type is not warranted medically. The only reason to consider testing is a psychological one: to put your unwarranted HIV fears permanently to rest.

Hope that helps.

Dr. Bob



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