HIV Testing: When and Why You Should Get Tested Again

Q: HIV Testing: When and Why You Should Get Tested Again

Hello： 1. <br>I saw online that some people mentioned it took two years to get diagnosed, so I would like to ask the doctor if I still need to get tested this year? -- The window period is not that long. <br>2. <br>I am concerned about what I read online, so I would like to ask t

HIV testing

About three years ago, I sought medical attention for a skin condition diagnosed as pityriasis rosea.
The dermatologist mentioned that a portion of cases could be related to syphilis and suggested that if I had engaged in sexual activity, I should undergo testing to assist in his diagnosis.
Due to my lack of time to visit a hospital, I went to a testing center instead.
The tests recommended by the center included HIV antigen-antibody (ELISA), VDRL/RPR, and TP-Ab for syphilis-specific antibodies.
The dermatologist only advised me to proceed with these tests.
After researching online and consulting with the testing center, I learned that if I had not engaged in sexual activity for three months, a negative result would be reliable.
However, I underwent another test a year later, and the result was still negative.
1.
Given that I previously saw online that some people only test positive for syphilis two years later, I would like to ask if I need to undergo testing again this year.
2.
I am concerned about the information I found online and would like to know under what circumstances it is possible for someone to test positive for syphilis two years later.
Thank you for your response, doctor.

Kunrao, 20~29 year old female. Ask Date: 2021/07/25

Dr. Du Shixi reply Urology

Hello: 1.
I saw online that some people mentioned it took two years to get diagnosed, so I would like to ask the doctor if I still need to get tested this year? -- The window period is not that long.
2.
I am concerned about what I read online, so I would like to ask the doctor in what situations it might take two years to get diagnosed? -- It would only give the illusion of a sudden discovery if there were no tests conducted during those two years.
Wishing you good health.

Reply Date: 2021/07/25

More Info

When it comes to HIV testing, understanding the timing and reasons for retesting is crucial for your health and peace of mind. Based on your situation, you have undergone HIV testing multiple times over the past few years, and all results have come back negative. This is certainly reassuring, but let’s delve deeper into your questions regarding the necessity of further testing and the potential for delayed HIV detection.

1. Should You Get Tested Again?
Given that you have tested negative for HIV on multiple occasions, particularly after a significant period without engaging in high-risk behaviors, the likelihood of being infected is very low. The general recommendation is that if you have not engaged in any high-risk activities (such as unprotected sex with multiple partners or sharing needles) since your last test, you may not need to retest immediately. However, if you have any new potential exposures or if you are experiencing symptoms that concern you, it would be wise to consult with a healthcare provider about retesting.

The Centers for Disease Control and Prevention (CDC) recommends that individuals at higher risk for HIV should be tested at least once a year. If you have had any new sexual partners or have engaged in behaviors that could increase your risk, it would be prudent to get tested again.

2. What Circumstances Could Lead to a Delayed HIV Diagnosis?
The phenomenon of delayed HIV detection is often referred to as the "window period." This is the time after infection during which HIV may not be detectable by standard tests. For most people, antibodies to HIV can be detected within 2 to 12 weeks after exposure, but in some cases, it can take up to 6 months for antibodies to develop.
There are a few specific scenarios where someone might test negative for HIV initially but later test positive:
- Recent Exposure: If someone has been exposed to HIV shortly before testing, they may test negative if they are still within the window period. This is why it’s essential to consider the timing of potential exposures relative to testing.

- Testing Method: Different tests have different sensitivities. For instance, the HIV antigen/antibody tests (like the one you mentioned, the "伊麗莎" test) are more sensitive than antibody-only tests and can detect HIV earlier. If you were using a less sensitive test, there could be a risk of a false negative.

- HIV Subtypes: While most tests are designed to detect the most common strains of HIV, there are rare subtypes (like HIV-2 or certain strains of HIV-1) that may not be detected by all tests. However, this is quite uncommon in most regions.

- Immunocompromised States: Individuals with weakened immune systems may take longer to produce detectable antibodies.

Conclusion
In summary, if you have not had any high-risk exposures since your last negative test and are not experiencing any symptoms, you may not need to retest immediately. However, if you have concerns or if your risk factors change, it’s always best to consult with a healthcare provider. They can provide personalized advice based on your health history and risk factors.

Remember, regular testing is a key component of maintaining sexual health, and staying informed about your status can help you make safe choices moving forward. If you have any lingering doubts or anxiety about your HIV status, don’t hesitate to reach out to a healthcare professional for further guidance and support.

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