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Author Topic: Possible subtype E exposure  (Read 6603 times)

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Offline jc1995

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Possible subtype E exposure
« on: November 21, 2008, 12:57:05 am »
I am traveling in the far east where subtype E is most prominent, and I had unprotected sex with a local woman.  I've read rather authoritative suggestions that female-to-male transmission is far easier with subtype E than with the usual subtypes most people on this board are talking about.

I am especially concerned because the woman I had sex with has a history of sex with many different foreign (white) men here.  I assume that white male travelers like me are more likely than others to have engaged in unsafe sex with sex workers around SE Asia, which would increase the risk that this particular woman has HIV.  Also, since she had unprotected sex with me, I can safely assume she always has unprotected sex with the men she encounters.

In addition, the day before I had unprotected sex with this woman, I received oral sex from another woman.  She was kind of rough and left my penis feeling raw and sore, and perhaps more susceptible to HIV from the woman who I had unprotected sex with.

Four days after the encounter, I have a sore throat, although I understand that this is not suggestive of ARS in any way.

I decided my risk was so low that I did not consider starting PEP.  I wonder if this was a mistake, considering that female-to-male transmission of subtype E happens quite a bit.

Offline jkinatl2

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Re: Possible subtype E exposure
« Reply #1 on: November 21, 2008, 01:20:31 am »
All subtypes are susceptible to the ELISA screening. If the margin of error in the oral test makes you uncomfortable (and it is exceedingly small, almost ALWAYS veering on the side of the false positive) then request a blood draw.

At three months, such a test is considered definitive.

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline jc1995

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Re: Possible subtype E exposure
« Reply #2 on: November 21, 2008, 02:18:23 am »
Thanks for the response, but nothing in my post has a thing to do with testing.  I assume that subtype E is detectable just like anything else.

The thing is, my exposure was four days ago.  Testing isn't of much use to me yet.  I'm just trying to assess my risk.

Does anyone on this board know much about female-to-male transmission of subtype E?

Offline Ann

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Re: Possible subtype E exposure
« Reply #3 on: November 21, 2008, 07:31:06 am »
jc,

Regardless of subtypes, you've put yourself at risk and you do need to test. The earliest you can test is at six weeks, as the vast majority of people who have actually been infected will seroconvert and test positive by that time. However, following a risk such as yours, you MUST confirm a six week negative at the end of the three month window period.

The bottom line here is that the odds are in your favour, subtype E or no subtype E, because this was a one-off incident and hiv is still much more difficult to transmit from a woman to a man.

Or was it a one-off? If you're having unprotected intercourse with sex workers, I can only imagine you're not someone who uses condoms regularly. You need to use them with ANYONE. Can you be sure you're not already hiv positive? Hiv doesn't discriminate and neither should you. Use condoms!

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together. To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex with a condom lasts only a matter of minutes, but hiv is forever.

Have a look through all three condom and lube links in my signature line so you can use condoms with confidence.

Anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs. Only a test three months or more past your last unprotected incident will be conclusive.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results. Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple.

Ann
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

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HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline jc1995

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Re: Possible subtype E exposure
« Reply #4 on: November 22, 2008, 02:18:53 am »
Well, I know the odds are in my favor, but I'm trying to figure out what kinds of odds I have.  Is exposure to subtype E most similar to, say, having sex with a female in the US, or having insertive sex with a male in the US?

I should clarify a few things here:

1)  The woman I had unprotected sex with was not a sex worker, and indeed, I have never had contact with sex workers;

2)  My condom broke and I didn't realize it, so I may have been inside her for as much as five minutes without an intact condom;

3)  I had no prior risk of HIV, and I have never had unprotected sex with anyone who was not a long-term, tested gf in any other incident.  I tested negative for HIV before coming to the far east.  The woman I had sex with claims she's tested negative within the past year for a panel of different stds in the course of a regular checkup, but this may not be useful or true information.

After realizing the disaster of the broken condom, I rinsed off my penis with water and hand sanitizer, although I doubt that had any impact on my odds of infection.

What I want to know is, is there some sort of common wisdom that an encounter like this in the far east poses significantly added risk when compared to a similar encounter in the United States?

Offline RapidRod

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Re: Possible subtype E exposure
« Reply #5 on: November 22, 2008, 02:36:29 am »
Enough with your subtypes. There are no true subtype E, they are CFR subtypes and tests don't look for subtypes they look for antibodies.

Offline Ann

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Re: Possible subtype E exposure
« Reply #6 on: November 22, 2008, 07:06:27 am »
jc,

We cannot give you exact odds. We're not bookies, you know!

You said in your first post that she willingly had unprotected intercourse with you. ("Also, since she had unprotected sex with me, I can safely assume she always has unprotected sex with the men she encounters." ) Now you say you were using a condom and it broke. Which is it? Not that it matters a whole lot.

The bottom line is that you've had a risk and you need to test.

As far as I'm aware, the reports you're reading about subtype E is a hypothesis from scientists trying to explain the prevalence of hiv in SE Asia. I do not believe this has been proven without doubt.

Your additional information about whether or not this was a one off points to the fact that you are most likely NOT going to test positive over this encounter. Test at the appropriate time and collect what I fully expect to be a negative result.

Ann
« Last Edit: November 22, 2008, 07:08:20 am by Ann »
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline jc1995

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Re: Possible subtype E exposure
« Reply #7 on: November 24, 2008, 03:08:54 pm »
I should have been a little clearer.  When I realized the condom broke, she didn't seem the slightest bit concerned, and in fact asked me to keep going.  That scared me.

In any case, the reason why I asked this question was to see if east Asia (not Thailand) was widely considered a place where HIV transmits more easily from female to male.  I guess there is no conclusive answer as far as people on here are concerned.

I realize it may seem like a frivolous question, but I actually engaged in behavior that put me at a clear risk for infection, so my worry has some basis.

Now I just have to wait and test.  Thanks for your help.

Offline Ann

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Re: Possible subtype E exposure
« Reply #8 on: November 24, 2008, 03:12:53 pm »
jc,

I have yet to see the insertive partner end up positive due to a condom break. I don't expect you to be the first, but the only way to be sure is to test at the appropriate time.

And thanks for the clarification.

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

 


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