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windowperiodfun
Unregistered

Window Period Blues
      #208007 - 09/22/06 05:08 AM

Hello. After my brief amatuer study of the risks of receptive fellatio, I decided that I might as well do one for the window period, which I think, as well, as oral sex, is the biggest grey area in regards to HIV.

Here we go again:

3 MONTHS vs. 6 WEEKS

If one was to only test based on the guidelines of the country they live in, they would wait out the 3-month window, take the test, and then (hopefully) forget about the whole incident and move on (this is of course suggesting that they get a negative result at this time).

If the the taste-taker was unlucky and yielded a postive HIV result, the doctors would not know the exact time of seroconversion. For all they know, the guy could have seroconverted 4 weeks post exposure, or even as long as 8 weeks. You can NEVER tell for sure. So I believe waiting out the 3-month window (however hard it is) is the ONLY way of confirming your status.

"But what about all the doctors that claim to never having seen anyone test negative with the modern tests at 6 weeks and then come out positive later?" I hear you ask.

The fact is, these statments, however truthful they may be, are not reliable. This is because I still believe the majority of people get tested ONCE and only once at 3 months, not once at 4 weeks, then again at 6, then 9, then 12. This kind of frequent testing is typical of worry-well syndrome, and although being negative at 6 weeks is a very good indication of your status, you can only be sure, no matter what the risk is, at 3 months.

Maybe health services should adopt a double window period policy whereby it actually becomes reccomended to test TWICE after exposure - once at 6 weeks, and once at 3 months. This way they can gather more reliable data with effects the majority rather than the minority. This, of course, has its flaws, as some people may not bother to come back and get tested after 6 weeks. Health services are probably aware of this, which is why they make up false infomation such as the 6 week window only being 50% reliable and a waste of time.

3 MONTHS vs. 6 LOOOONG MONTHS

Incase you haven't worked it out by now. 3 months is conclusive.

I know I am not an expert on HIV testing, so I am not asking you to trust my opinion. Instead, trust this document:

http://www.bashh.org/guidelines/2006/hiv_testing_june06.pdf

"It is recommended that patients have a baseline HIV test done at presentation and if necessary this be repeated at 3 months from the time of any risk activity. People exposed to the risk of HIV should not be fully reassured until at least 3 months have passed during which they remain sero-negative (the window period)."

---

"Observational data are limited, but in ten years of application of the 'three months rule' by all members of the UK HIV Laboratory Forum no reports of its failure have been received, and thus it is recommended that in general the three month rule continues to be applied. Patients may be infectious to others during this period and should be advised of this."

---

That document isn't from some random commerical HIV site that only gets their infomation by simply copying out-of-date infomation (heh. how many times have we seen those CDC guidlines cut + pasted across throusends of sites). This is an official document gears towards the health proffesionals, not the worry-well. This is real stuff, and if this doesn't kick you out of you worry-well syndrome I don't know what will.

Some typical what-ifing:

"What about the CDC, though? their reccomendation is still 6 months or more"

Being a Brit, I'm trying to ignore the CDC completely, but if you're an American, it's okay! I haven't really researched the CDC's approach competely (why should I?), but from what I understand, the infomation on their main HIV site is, according to just about every medical proffesion, out of date.

Also, there is a another document travelling around the net somewhere designed to for medical student (don't have the link, though, sorry) which usues the 3-month guideline, even, as I recall, stating that seroconversion up to as long as 3-months is considered rare.

I frequently see on these forums people say that the chance of seroconverting later than 3 months is something like between 97 to 99.7%, but this 3 - 0.3% area of doubt only applies to people with depressed immune systems and ... blah, blah, blah. I'm sure you know it by now. Check out the forums on AIDSmeds if you don't believe me.

"What about the lack of medical certainty? Doctor never say you are 100% not HIV postiive. Why is this?? I want to be 100% damnit!!"

No Doctor would guarantee you that you will not die tomorrow of heart-attack or stroke despite being young and healthy. Go figure.

Sorry for spelling mistakes.

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Anonymous
Unregistered

Re: Window Period Blues new
      #208033 - 09/22/06 09:30 AM

If you want to wait till 3 months so be it. the fact is 6/8 weeks is almost double the time that most need to produce anti-bodies. yes a very small minority will take longer but most of those will have health problems to begin with. it is more damaging to the mental heath of people to wait 3 months when there is really no need for it. I guess most of you simply do not understand the way Governments work and how these window periods were put in place. What is so hard about understanding the advances in testing and the shorting of the window period. get a six or eight week test and be done with it. D.J.

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mpo131
Unregistered

Re: Window Period Blues new
      #208067 - 09/22/06 11:43 AM

It all depends on how you choose to look at it. Obsessing over the window period is down right worthless. I'm going to present what I've learned over the past six months.
1. Over 95 percent of individuals test positive at 30 days using a 3rd generation test.
2. Over 99 percent test positive at 8 weeks using any generation test. Maybe even 6.
3. People DO, although uncommon, take longer than 3 months to test positive.
4. A test at six months will pick up all infections except for that one in ten thousand or hundred thousand.
Conclusion, if I was worried about a HIGH RISK (I'm talking receptive anal with known HIV or sharing needles with a gay habitual drug user dude -not vaginal sex with a girl I took home from a bar) exposure with flu like symptoms occuring about two to three weeks after, was married (therefore needing 100% conclusiveness) this is what i would do.
1. Test at 4 weeks with 3rd generation ELISA and DNA PCR
2. If negative, test at 3 months with 3rd generation ELISA and DNA PCR
3. Test at 6 months with antibody test
Now most people would and SHOULD be satisfied at 3 months with negative results, However, if you want 100% assurance, I see no other way.

Keep in mind, DJ is right in what he reported, however the problem is there are people who got infected stating that it took them 4 months or 6 months to finally test positive, and we have no other choice but to be conservative. Are they telling the truth? Who knows for sure? Science would say they are lying, but then again the studies done on the window period consist of rather small populations.

It all depends on how much certainty you want/need.

Peace

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windowperiodfun
Unregistered

Re: Window Period Blues new
      #208088 - 09/22/06 12:56 PM

You can give me a bunch of statistics on the liklihood of seroconverting after 3 months, but the fact is, these are not consistent with the fact that NO ONE has seroconverted past 3 months for 10 years in the UK. Even with 10-year old tests, 3 months is conclusive. It's not as if the UK don't care about cracking down on HIV, the document also mentions that it is their aim to reduce the number of undiagnosed HIV people by at least 50% by 2007.

It's perfectly understandable for someone to lie about time of serocnversion. If you had unprotected sex AGAIN straght after or during the first window period, how ashamed would you be?



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windowperiodfun
Unregistered

Re: Window Period Blues new
      #208100 - 09/22/06 01:33 PM

Also, how do you know that the late seroconverters are drug users etc.

I see not problem with someone wanting to test at 6 months following a very high risk expsure, but I see it more as an "overkill" test simply for peace of mind.

But then, to be fair, I have never been in a high risk situation - my exposure was receptive fellatio without ejaculation, which was low to non-existent risk. Maybe if my exposure was higher risk, I would want to get tested at 6 months for overkill (in the old anxiety driven days of the window period, I tried to convince myself that my exposure should be considered high risk because of possible cuts on the lips and gums etc.)

I think that, despite the evidence to the contary, I see not problem with people testing again a 6 months (heh. I'll probably end up doing it), but the original post was aimed at people that had tested at 3 months, but are still worried they still have HIV, which I'm sure even you would admit is over-the-top.

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mpo131
Unregistered

Re: Window Period Blues
      #208102 - 09/22/06 01:42 PM

Hate to say this but.....
How often do you think people have sex one time, then test out the rest of thier lives after being told "It's been three months, you are conclusively negative." Continue to test while abstaining, and discover they are positive at 5 or 6 months down the road and then report to the UK authorities. I think it is more realistic that the person continues to have sex afterwards making it impossible to learn which encounter led to the infection.
In fact, the study done in the 90's, which used 1st and 2nd generation tests, (WHICH ONLY DIFFER BY 10 AND 5 DAYS RESPECTIVELY TO THE NOW USED 3RD GENERATION TEST) where the exact date and time of exposure was KNOWN, two of the individuals first tested positive past SIX months. The average was 42 days. Given that the two individuals jacked up the average with their "delayed" seroconversion. Take those two out and the average would have been much closer to 35 days which would be right on par with the 22 day average 3RD generation test.
So you see, testing positive after 3 months is a REAL possibility (about 3 out of a 100). Please don't respond with this outdated and testing advancements over the last few years have closed the window. Wrong, not where antibody tests come in. The BIG advancement came in the early 90's between the 1st and second generation test. However the difference between 2nd and 3rd generation tests only differ by about 5 days. Research the net, you'll find it.
The best way to go, is DNA PCR. All the research I have seen, state this test is at least 99.9 if not a 100 percent sensitive after 2 months. Doctors, especially at this site, will not recommend it, even though they know it is reliable, because it drives up health care costs for people who really NEED it, and they are right.

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mpo131
Unregistered

Re: Window Period Blues
      #208103 - 09/22/06 01:47 PM

Oh yeah,
and BE SURE to follow up that DNA PCR at three months with a 3rd generation ELISA antibody test. That IS the current guideline and recommendation as of TODAY.
Peace

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mpo131
Unregistered

Re: Window Period Blues
      #208104 - 09/22/06 01:54 PM

If that was your risk, dude, testing is OPTIONAL. i.e. NOT necessary. Surely a 3rd generation ELISA at 6 weeks would suffice if only for peace of mind.

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windowperiodfun
Unregistered

Re: Window Period Blues
      #208106 - 09/22/06 02:05 PM

Even cosidering the statement you said innitially, 3 in 100 is simply too high a number to suggest the possibility of late seroconversion.

Yeah, most people ressume normal sexual activites after the 3-month negative, but most also learn from their mistakes and protect themslves properly. I think that this would make a sudden HIV diagnosis very unusual and worthy of further testing and counceling. You act as if everyone always has unprotected sex, which makes it impossible to tell what was the source of infection, considering you use condoms properly, you will always know for sure what exposure made you positive siimply because "it was the one inwhich I didn't protect myself".

Anyway, I'm sure health services across the globe have considered the possibiliy you mention. If you are indeed right, and the window period was infact 6 months, counires would change their policy to fit this. They simply cannot afford to let the so-called "3 in a 100" slip, as they may infect others while believing they are negative. But do you see any country still adopting the 6-month rule? No.

Let's face facts here. Your support of the 6-month window is based on assumptions, "what-ifs", and unreliable evidence. Mine is based on the policy of a country wanting to crack-down on HIV. They want to be sure that no infections seep through, so 3 months is reccomended to catch the rare person that seroconverts later than 6 weeks. On top of that, you have the respected advice of Dr. Bob and the experts at AIDSmeds.

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oralsexfun
Unregistered

Re: Window Period Blues
      #208107 - 09/22/06 02:12 PM

oops ... everything is jumbled up. My latest reply is the 6th message down.

Anyway, in responce to your latest post. I realise that testing may not have been necessary, but I could not shake off the fact that precum could have got into hole in my lips or gums.

I know that depite that possibility it should still be considered low risk, but I would someitmes wonder why this is the case. I still wonder sometimes, to be honest.

Although my first thread set out to reassure those with the same exposure to mine, I feel that I was a special case due to POSSIBLE cuts lips and gums.

But, yeah. I am going off-topic.

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oralsexfun
Unregistered

Re: Window Period Blues
      #208108 - 09/22/06 02:14 PM

Wait nevemind. Everything looks fine in "flat" mode.

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mpo131
Unregistered

Re: Window Period Blues new
      #208109 - 09/22/06 02:15 PM

Once again, you have missed the boat.
We are talking HIGH RISK here. Most of the individuals on these sites Have LITTLE risk in the first place, but because they are suffering from mental disorders such as Generalized Anxiety Disorder, OCD, or they are married and suffering major guilt or shame or whatever. Their is no secret about the window period. IT's right in front of you. However, people interpret it different ways. like you for instance, you HAD a NON EXISTENT risk -you even called it that-but you are still on this site. Why?
Dr. Bob's window is the same as the CDC's, SIX MONTHS. Just view the reply's directed at people with real risk, real exposures. As far as you are concerned, you don't even have a window.
PEACE

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mpo131
Unregistered

Re: Window Period Blues new
      #208110 - 09/22/06 02:24 PM

1. Saliva contains no less than 12 proteins which inhibit HIV
2. Check the studies on serodiscordant couples and oral sex, you will find them most reassuring.
3. Precum is a theoretical transmission risk. Just ask Dr. K on planetout.com

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windowperiodfun
Unregistered

Re: Window Period Blues new
      #208111 - 09/22/06 02:29 PM

Thanks for the reassurance, mate.

I actually mentioned all those three things in my original thread, but continue to believe I was a flashing red light, or something. I would ask myself, "what if there were cuts on my lips (which is quite common for me) - not as much, if any saliva is situated there". I don't know.

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mpo131
Unregistered

Re: Window Period Blues new
      #208112 - 09/22/06 02:39 PM

The window period is the window period. It's posted everywhere for people to see.

LIke I said. It all depends upon how much certainty you need.
OR how much your willing to pay for it.

Good Luck.

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