Abstract
A 27 year old man presented with a history of weight loss and generally feeling unwell for more than 2 years. He had several negative HIV rapid tests. His wife had a positive HIV test in 2023 during screening while she was pregnant with their first child. When HIV RNA test was requested, it was positive with a viral load of 1,740, 000 copies/ml. In patients in high HIV prevalence settings suspected to have HIV infection with repeated negative rapid antibody diagnostic tests, HIV RNA testing should be requested to exclude infection.