A good friend of mine works as a doctor in the area of sexual health in the UK. He was kind enough to answer some questions on misconceptions and thoughts about HIV for me.

Clinics are now saying 6 weeks is the length of time after infection that a positive result will show up. Can it take longer?
The traditional ‘window period’ for testing after a specific risk is 12 weeks. However a large number of people who contract HIV have developed antibodies by 6-10 weeks. This has been known for ages. The test that we are discussing is the antibody test,however a viral load test can be positive within a week of the virus infecting someone.
The advice is the same as it always has been
1. HIV test but wait 12 weeks after the risk
2. Occasionally if someone is very anxious can do the HIV antibody test after 6-10 weeks as long as they know to come back at 12 weeks for a repeat test if the first test is negative
3. If someone is having a seroconversion illness we do a Viral load test which is different to the hiv antibody test and not done routinely.

I’ve been told that you will know when you are sero-converting by one person and by another that he didn’t have any idea. Does it affect different people differently?
Studies suggest seroconversion illness occurs in approx 20-30% of patients but the symptoms are very non specific and easily mistaken for a flu/sore throat/diarrhoea ie very common symptoms…which is the problem ,at their most infectious ,most people dont recognise or know they have HIV.

What is your opinion on the theory that there are people who are “immune” to HIV? I do occasionally see people who are having huge risk or long tem partners of known hiv infected partners who never got the infection themselves.

People are living longer and healthier without medication these days. Why do you think that is?
Hmmmmmm not sure we can make a general statement like that….people in Africa may not agree! Patients may be getting tested earlier and so,appear to live longer post diagnosis. In the early days of the epidemic,people were diagnosing in very late stage (AIDS) disease and die shortly after.

How many different strains of HIV would you estimate there might be out there now?
Apart from HIV 1 and HIV 2 , HIV 1 is subclassified into subtypes or clades,the list of wich is growing as different clades recombine and produce what we call recombinants. At the moment approx clades A-G exist plus an endless list of recombinant clades wich have not been classified as yet.

People still think it’s nearly impossible to catch HIV being the “top”. Do you have any statistics on infection rates for the varying sexual roles?
Check the following resource from http://www.bashh.org/guidelines.asp and click the second link under HIV to download a pdf.

go to table 2

Table 2 The risk of HIV transmission following an exposure from a
known HIV-positive individual
Type of exposure
Estimated risk of HIV
transmission per exposure (%)
Blood transfusion (one unit) 90–100
Receptive anal intercourse 0.1–3.0
Receptive vaginal intercourse 0.1–0.27
Insertive vaginal intercourse 0.03–0.09
Insertive anal intercourse 0.06
Receptive oral sex (fellatio) 0–0.04
Needle–stick injury 0.3 (95 CI 0.2–0.5)
Sharing injecting equipment 0.67
Mucous membrane exposure 0.09 (95 CI 0.006–0.5)

Is there any data on the percentage of the gay population currently living with HIV? Seroprevalence in london suggests 15-20% of all gay men london are positive. Not too sure in sydney…check the ASHM website