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9 months pregnant - Please Answer -
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SerenityCourageWisdom posted:
Earlier this year I had a 4 month sexual relationship with a man who used to be an IV drug user. Mostly unprotected vaginal intercourse, and very brief one time anal. I know for a fact that he did get tested for HIV before our relationship, but can only go by his word that he is negative (I never saw the printed results).

To get the point, the relationship did not work out and I am now in my 9th month of pregnancy. I have done hours and hours of research on the HIV testing window period, to the point where it is controlling most of my waking hours. (Once I get a definitive answer I plan on seeking counseling for possible OCD.) I am terrified I contracted HIV, and even more terrified it could be passed to my baby. All the conflicting ideas on window periods is literally driving me insane! I have tested negative at 5 week & at 3 months after the last encounter.

I am due any day now and plan on breastfeeding my baby, I just want to make sure that I am indeed HIV negative, because I've read HIV can be transmitted from mother to child through breast milk.

On almost all the forums I have read, doctors consider the 3 month test to be both definitive and conclusive to some, yet recommend 6 month follow up testing to others. Like I said, I am going crazy over here. I need to know what to do now. I will not reach the 6 month mark until December. Please help.
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SerenityCourageWisdom responded:
Also, I don't know if this is relevant, but I don't want to leave anything out. As for symptoms go, the only problem I have had is diarrhea. It has been going on for at least the last 7 months. I think it started before the relationship but I can't remember 100% when it started.
 
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Nieciedo replied to SerenityCourageWisdom's response:
Your 3 month test was conclusive. You do not have HIV.

If it is any comfort to you, most hospitals routinely run HIV tests on pregnant women as part of the preparations for child birth. If you remain concerned and are unable to shake these fears, then speak to your OB/GYN about testing.

Dan
 
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SerenityCourageWisdom replied to Nieciedo's response:
Thank you Dan for your quick response.

I have a midwife, and I have already consulted with her about my concern. She did my 5 week test, and then told me that tests are only accurate at 6 months.

I also consulted my doctor, who also told me tests are only accurate at 6 months and she would not test me until that time.

I ended up having to go to a same day testing facility and pay out of pocket for my 3 month test because neither doctors would test me.

I came to this forum because I didn't know where else to go. After consulting with these medical professionals I feel more confused than ever, and my fears have been multiplied.

As of now, it has been 4 months since any encounter, and I will be having the baby any day. So getting a routine HIV test before labor doesn't seem any more comforting than the 3 month test results I have already received- unless 4 months is more accurate than 3 months?

Like I was saying, I came to this forum because I didn't know where else to go. For my sanity I need to get advice from a HIV expert who knows what they are talking about.

What do you suggest I do from here? Should I seek medical help for the anxiety I am feeling over this matter and move on, or seek a new doctor and consider further testing?
 
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Nieciedo replied to SerenityCourageWisdom's response:
Both your midwife and your doctor are operating with outdated information. A very tiny minority of people can require up to six months to develop enough antibodies to test positive for HIV if they become infected, but this group largely consists of people whose immune systems have already been suppressed due to diseases, cancer treatment, or organ transplants.

For everyone else, 3 months is the conclusive end of the window period. In fact, most people who get infected will be able to test positive by 6 weeks. The 3 month window period is the standard held by, among others, the Centers for Disease Control, Planned Parenthood, Gay Men's Health Crisis, and the NYC Department of Health and Mental Hygiene.

I feel 100% confident in saying that you do not have HIV, but I understand why you feel so distressed. I honestly don't believe that you need any further testing and I really think that the OCD (if indeed that is what you are suffering from, and not the understandable nerve-wracking stress-mixed-with-joy of impending childbirth) is what you should be focusing on instead of a virus you do not have.

Dan
 
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SerenityCourageWisdom replied to Nieciedo's response:
Thank you so very much Dan.

I would like to ask one more question if you don't mind. I apologize for needing excessive amounts of reassurance, I guess all the fear I've had for the past 4 months is proving difficult to shake.

Would you mind telling me your education/experience on this matter. I've read Dr Malebranche's post saying both you and Gail are trained HIV experts. Could you elaborate on this please?

Thanks again for your answers and reassurance. It is very much appreciated.
 
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David J Malebranche, MD, MPH replied to SerenityCourageWisdom's response:
Hello,

I'm sorry to hear you are going though this, it sounds very stressful. First of all, Dan is correct and I think you can ease your mind if your HIV test was negative at 3 months. It is EXTREMELY RARE that someone would seroconvert to positive after being negative at 3 months post exposure.

That said, however, you are about to have a baby so I would recommend you do this:

- go back to your OB/GYN and ask them to do what's called an HIV RNA PCR test, or a viral load - if the main issue is that you and your doctors are scared that the regular HIV antibody test won't be accurate until 6 months, the best way to put the question to bed is get a viral load, which will absolutely show virus if you were, in fact, exposed. Then you don't have to think about timing of how long it takes to make antibodies, etc - you'll have a direct test that looks for copies of the virus.

And you don't have to apologize about the questions - you wouldn't be human if you weren't worried about your health, and more importantly, the health of your soon to be newborn. But demand your doctors order the viral load test instead of just saying that the antibody test is not conclusive yet and letting you struggle with your anxiety. If they still put up blocks, ask to speak to the medical director of the clinic, and go higher and explain the situation til you are satisfied they are running the appropriate tests to rule out any infection that the HIV antibody test may miss if this is a "window period."

Like we've said, I don't think you have HIV, but your situation is unique, and the viral load results will give you MUCH more certainty that you aren't putting your baby in harm's way. And if the viral load comes back positive (which I don't think it will), you can take meds and give meds to your baby to prevent transmission during childbirth IF it comes to that. But I don't think it will.

Please keep us updated on what happens and good luck to you. Hope this helps.

David
 
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SerenityCourageWisdom replied to David J Malebranche, MD, MPH's response:
If that is recommend, that is what I will do. I need 100% certainty and closure on this matter.

I've read that pregnancy can cause false positives for antibody tests. Is the same true for the test you recommended?
 
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David J Malebranche, MD, MPH replied to SerenityCourageWisdom's response:
Pregnancy can cause false positives just for the antibody test - this is a test of the copies of virus in the blood, so NO, pregnancy will not cause a false positive for the RNA PCR test for viral load.

Hope that helps. Please keep us updated.

David
 
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SerenityCourageWisdom replied to David J Malebranche, MD, MPH's response:
I got the test done today. I should have the results by early next week, I will let you know.
 
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SerenityCourageWisdom replied to SerenityCourageWisdom's response:
The test results to the HIV RNA by PCR test came back NEGATIVE! Does this mean I can completely 100% stop worrying about HIV?
 
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georgiagail replied to SerenityCourageWisdom's response:
Yes, completely! Enjoy the remainder of your pregnancy and your soon-to-be-born new baby!

Gail
 
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SerenityCourageWisdom replied to georgiagail's response:
Thank you very much Gail

Dr. Malebranche, do you agree? Do I have my 100% certainty?
 
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SerenityCourageWisdom replied to SerenityCourageWisdom's response:
Dr. Malebranche, I am trying my best to patiently wait for your response, but I am getting induced tomorrow. I need to know that I am 100% safe to breastfeed my baby. Please respond.
 
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Elle0317 replied to SerenityCourageWisdom's response:
Please trust in Gail. No need to worry anymore, just enjoy being a mother.


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