HIV Testing: Choosing the Right Panel for Your Needs

HIV testing issues?

Hello, doctor.
I recently paid out of pocket for a sexually transmitted infection (STI) screening, which had two test panels.
The first panel includes: Gonorrhea DNA test, Chlamydia DNA test, Syphilis tests (RPR, TPPA), Urethritis screening (Trichomonas, Candida, general bacteria, Urine Sediment), and HIV Antigen + Antibody screening (HIV Ag+Ab Combo) for $2700.
The second panel includes: Gonorrhea DNA test, Chlamydia IgA test, Syphilis tests (RPR, TPPA), Urethritis screening (Trichomonas, Candida, general bacteria, Urine Sediment), and HIV Antibody screening (Anti-HIV 1/2) for $1800.
I informed them that my last sexual encounter was in July of last year, which was 16 months ago.
They recommended the second panel, stating that since a significant amount of time has passed, the results from the first panel would not differ much from the second panel and that both would be accurate.
The main difference between the two panels seems to be the Chlamydia and HIV tests.
They insisted that the second panel would suffice due to the elapsed time, so I ultimately chose the second panel.

I have a lot on my mind, doctor, and I would like to ask if the 16-month interval before taking the second panel is sufficient.
The results will be available the day after tomorrow.
If all results are normal, is there still a need for further testing? If any results are abnormal, which specialist should I consult? Thank you, doctor.

123, 30~39 year old female. Ask Date: 2021/11/23

Dr. Hong Yuanbin reply Internal Medicine

Hello, the main difference between Kit 1 and Kit 2 lies in the HIV testing, particularly regarding the window period.
However, since your last sexual encounter was 16 months ago, you have already surpassed the HIV window period.
Therefore, given your situation, Kit 2 is indeed sufficient.
If all results are normal, there should be no need for concern.
In the event that the HIV, syphilis, and urine bacterial tests are positive, you can consult an infectious disease specialist.
For any other positive results, you may see a urologist.
Thank you for your inquiry.

Reply Date: 2021/11/23

More Info

When it comes to HIV testing, understanding the different types of tests available and their implications is crucial for making informed decisions about your health. Based on your description, you have undergone two different testing panels for sexually transmitted infections (STIs), including HIV. Let's break down the components of these tests and their relevance to your situation.

Types of HIV Tests
1. HIV Ag/Ab Combo Test: This test detects both the HIV antigen (p24) and antibodies to HIV. It is effective in identifying HIV infection as early as 2-4 weeks after exposure. Given that your last sexual encounter was 16 months ago, this test would be highly reliable in determining your HIV status.

2. Anti-HIV 1/2 Test: This test specifically looks for antibodies to HIV-1 and HIV-2. It typically becomes positive within 3-12 weeks after infection. Since you have not engaged in any risky behavior for over a year, this test would also be a good indicator of your HIV status.

Choosing the Right Panel
Given the time elapsed since your last sexual encounter, the second panel you chose (which includes the Anti-HIV 1/2 test) is indeed sufficient. The healthcare professional's recommendation to opt for the second panel is reasonable, as the likelihood of a false negative result decreases significantly after such a long period without exposure.

Accuracy and Reliability
Concerns about the accuracy of cheaper tests are common, but it is essential to note that both panels you mentioned are standard tests used in clinical settings. The accuracy of these tests is generally high, especially when conducted in reputable laboratories. The HIV Ag/Ab Combo test has a sensitivity of over 99%, meaning that if you are HIV positive, it is highly likely to detect the virus.

Follow-Up Testing
If your results come back negative, it is generally not necessary to retest unless you engage in high-risk behaviors in the future. However, if any of the results are abnormal, it is advisable to consult a healthcare provider who specializes in infectious diseases or a general practitioner who can guide you on the next steps. They may recommend further testing or treatment based on the specific infections detected.

Conclusion
In summary, based on your timeline and the tests you have chosen, you are taking the right steps to ensure your sexual health. The second testing panel should provide you with a clear indication of your HIV status after 16 months without risky behavior. If the results are normal, you can feel confident in your status. If there are any abnormalities, seek further evaluation from a healthcare professional. Regular testing is essential for maintaining sexual health, especially if you engage in new sexual relationships in the future.

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