Unprotected Sex with Thai CSW - Completed PEP & Very Worried :(

[NervousNerd]

Hi Ann, Andy and others,

I have been looking through posts on this forum for a while now! Its amazing how much information there is on one website, thank you all for your hard work!

I am wondering if someone can try and ease my troubles and help put my mind at rest. At the beginning of last December I had unprotected sex (regrettably) with a Thai CSW which I am unsure of her HIV status. When I asked her about any STD's she replied "no, nothing" and then asked the question back. Which I have never had any type of STD.

The morning after the event, I rushed to the nearest hospital in Bangkok and started a course of PEP (Truvada and Kaletra/Aluvia). This was approx. 13-14 hours after the event which i took with 100% adherence for the full 28 days! (Completion on 28/12/12).

Just under 2 weeks ago, I have had major surgery on my bowels. I had a condition of Ulcerative Colitis where I have had my large bowel removed and reconstruction of my small bowel - I don't know if this makes any significance whatsoever!

I have heard and seen all of the chances of infection after a single exposure of unprotected vaginal intercourse. They look real slim, but cant really be targeted to individual cases. Initially I only have a few questions:

1. What are the chances of me being infected now with 100% adherence of PEP?
2. The doctor at the clinic in the UK has planned in a HIV test at 4 weeks post PEP and 12 weeks post PEP. How accurate are these tests, over these time periods?
3. Have you seen any other individuals with a case similar to mine, which have gone on to become HIV positive?

Many thanks and Best Regards,
NervousNerd

[Andy Velez]

You did have a risk with unprotected intercourse. However, certain factors weigh in your favor for ultimately testing negative. As the insertive partner your risk is significantly lower than for the receptive one. And it was a one-time incident. Plus you got started promptly on PEP. All of which points strongly towards getting a negative result.

We recommend testing initially at 6 weeks after completing PEP. Assuming you test negative at that point then it is very likely you will test negative at 3 months after completing PEP for a conclusive result.

Your having had surgery since the incident is irrelevant in terms of risk for HIV. Given everything you reported I would say the odds are in your favor that you will test negative.

You can avoid going through this in the future by always without exception using a condom everytime for vaginal and anal intercourse.

Good luck to you.

[NervousNerd]

Hi Andy,

Thank you very much for your prompt response! Much appreciated!

I always wear condoms, I really don't know what happened this time!

I forgot to mention, the intercourse was only brief.. 2-3 minutes maximum... But I guess this doesn't really matter.

I have had some of the same symptoms some of the other guys have mentioned on this forum, but I have put this down to anxiety and being worried sick about HIV and my surgery. I am still very anxious and nervous - my own fault really! :/

Have you seen many people testing positive after a situation like mine?

Many Thanks,
NervousNerd

[NervousNerd]

Hello Again Guys,

Sorry to be a worry wart... But while I'm here, can I please ask how effetive is PEP in your experience and has anyone ever tested positive following PEP and this sort of exposure?

Many Thanks!

[Andy Velez]

The brevity of the time unprotected during intercourse does make a difference. PEP has a significant margin of success,particularly the earlier it is started.

All I will say is all things considered I think it is likely you will test negative. Now you just have to wait for that first 6 weeks after completing PEP to test initially. If that result is negative then it will mean you while likely test negative again at 3 months for a conclusive result.

While waiting you need to make a real effort to focus on other things in your life.

Good luck to you and keep us posted.

[NervousNerd]

Good Evening All,
I hope you are well!

Thank you again for all the work you do and support you provide for troublesome minds!

Just an update on my situation, and possibly some of your experienced knowledge.

I had a possible exposure to HIV through unprotected oral and vaginal sex (1/12/12) and started PEP the same day (14 hours after the event). I have taken your advice and kept myself busy for the duration of the past 4 months. I have been attending my local GUM clinic I believe as required.

Baseline test (05/12/12): Negative
Completion of PEP: 28/12/12
4 weeks after completion of PEP (28/1/2013): Negative
8 weeks after completion of PEP (27/2/2013): Negative
12.5 weeks (90 days) after the completion of PEP (28/3/2013): Negative
I believe that all tests were carried out with 4th Gen HIV DUO tests.

So, my questions are:

- I have seen guidelines explaining that a conclusive test can be taken at 6 months, is this old news? Are my results definitive and conclusive of my true status?

- I have suffered from Ulcerative Coltitis for many years and have had a stoma for the past 6 years, and as mentioned before I had major bowel surgery on 9/1/2013. Would this have any effect on my results?

The reason that I am still a little anxious, is that I have a partner and we are looking to start our own family in the near future. I do not want to put anyone at risk by not making yet another silly mistake.

I fully appreciate the work you guys carry out. Thank you again for all of your help and support with my situation.

[jkinatl2]

To your questions:

The three month window has been standard for over a decade now.

Your stoma will have had no impact on a testing window

You are conclusively HIV negative and are free to procreate. In fairness, people with HIV procreate successfully as well, of course, and almost always give birth to healthy children if under a doctor's care.

You can rest assured that you do not have HIV.

[NervousNerd]

Wow, thank you for a very speedy reply!

Thank you for your answers, they are much appreciated!

I didn't mean to offend anyone with my family questions and putting anyone else at risk. I know that HIV+ people can procreate and have healthy children, and all the reading I have been doing over the past 4 months, I am fascinated with the medical advances around this area.

I  just wanted to ensure that I was out of the woods with HIV and didn't require anymore testing before I ventured down the family road.

Kindest regards.

[jkinatl2]

Wow, thank you for a very speedy reply!

Thank you for your answers, they are much appreciated!

I didn't mean to offend anyone with my family questions and putting anyone else at risk. I know that HIV+ people can procreate and have healthy children, and all the reading I have been doing over the past 4 months, I am fascinated with the medical advances around this area.

I  just wanted to ensure that I was out of the woods with HIV and didn't require anymore testing before I ventured down the family road.

Kindest regards.

Absolutely no offense taken. There have been so many advances in the last few years regarding couples who want to have kids. If the female is the positive partner and on meds AND has an undetectable viral load, then she's essentially uininfectious. Sometimes a doctor will prescribe antivirals specific to the fetus, sometimes not.

If the male is the positive partner, there's more gray area, as semen can still contain active viral particles even if an undetectable viral load is achieved, albeit there's controversy regarding if it's enough to actually infect. Nonetheless, many female partners in this situation take what's known as PrEP, which is essentially a pill, usually Truvada, during the time of conception.

Used to be that sperm-washing and in vitro fertilization were the only known options, but now that we understand the mechanisms of HIV and the drugs used to treat it, it's gotten a whole lot easier and less expensive.

Someone will correct me if I'm wrong, but in the ten years I have been on this forum there have been hundreds of couples who have conceived and there hasn't been a transmission between the partners or to the baby. That's powerful stuff

[NervousNerd]

I am glad I didn't offend anyone. That is very interesting and impressive stuff! Its incredible what is achievable now through advanced medicines!

Just for an extra peace of mind, have you or any of the other moderators have someones result turn from a negative to positive after the 3 months post-pep test. Similar to my situation and results?

I just want to be a 1,000,000% sure 

I hope you are having a good day!
Best Regards.

[Jeff G]

Just for an extra peace of mind, have you or any of the other moderators have someones result turn from a negative to positive after the 3 months post-pep test. Similar to my situation and results?

I personally haven't seen it in the 30 years I have been HIV positive and paying attention to these issues .

[jkinatl2]

Been on the forum for ten years, giving out risk assessment.

Never seen anyone test positive after three months.

I can't begin to count the number of people who have come here, but I am sure I have dealt with at least a couple thousand.

[NervousNerd]

Good evening all!
I hope you are well.

That is great, you guys deserve a medal for the work you do.

Thank you very much again for your comments.