I messed up big time, please help me

[gandhi]

I' don't know where to start, I'm so devastated. I am 33 yo single bi male. On 03/13/11 I hooked up with this guy offline at my hotel room (not something that I do, but it's a mistake). After, fooling around and me performing oral sex on him for few seconds, he wants to top me. When I asked him if he brought the condoms with him like I asked him to, he said he forgot. So, I refused to do any anal. We fooled around some more and all of sudden he started getting ready to perform anal sex  on me and this time I objected furiously is when he pulled the condom from his pocket, he had it the entire time (that should have been a sign for me not to trust him). He asked me for lube. All we found is Vaseline. Also, I noticed the condom was small for his size.
After the penetration, he only lasted few minutes 3 tops. After his ejaculation, He did not pull out for a min or two. So, when I reached with my hand to help him pull out without any incident, he said: “oh shit the condom broke” I freaked out. I went to the bathroom tried to go number 2 and squeeze myself to push anything out. I noticed some of his semen came out.
I pleaded him to tell when the last time he got tested all I got from him that he got nothing yet he couldn’t tell me the last time he got tested.  I offered that we both go get tested and even pay him extra to do so. By the time I checked out at the hotel lobby, he was gone and didn’t wait for me like he agreed to.
I was lost didn’t know who turned to or what to do. All the heath and HIV clinic were closed (it was Sunday); I am so embarrassed to tell anyone .  I called my older gay friend who advised me to use an enema.  He helped me with it (40 min from the exposure).  I searched online for help, and your site offered me a lot of informations. At mid night I went to Emergency Room where they couldn’t start any PEP. I called the CDC and looked online for any site that perform the treatment but no luck. I called my family Dr and admitted my dilemma. He asked me to wait until the morning and he will see what need to be done. As I am typing,  my story he suppose to be looking for what prescription he suppose to offer me since he sounds like he doesn’t know much about the PEP and just learning.  I know I F … up big time. I know my chances are slim to none if any.  I just needed someone to talk to. I am a wreck. I can’t function.
 Please, can someone help me with a site or information on PEP treatments and maybe I can refer my Dr. to go on it to search it and decide an ideal regiment for me. By the way, I have no insurance to cover any of this. 
Thank you guys for this site and all the help you are offering.   

[Ann]

Ghandi,

The usual PEP meds are Truvada and Kaletra. You can read about them here. They should be taken for 28 days - and you should have a rapid test done before you start taking PEP to make sure you're not already hiv positive from a previous incident.

You need to start PEP no later than 72 hours after the possible exposure.

You also need to know that taking PEP will mean that you won't have a conclusive negative result until three months after your last dose of PEP.

Good luck.

Ann

[gandhi]

Dear Ann,
My Dr just sent the prescription for those 2 medications the same as you have mentioned the only problem is I'm having problem locating the pharmacy that does have them.
And they are very expensive. Is there an on line site that shows what pharmacy carries them?
And for the Rapid Test, where do I get it? is sold at the pharmacy? cause I'm competing against time.
And thank you for reply,

[Andy Velez]

Call your doctor and ask where you can get the meds. Tell him you're having a problem locating a pharamacy that carreis the.

Getting the Rapid test is not relevant at this time. Focus on getting the meds as quickly as possible within the 72 period.

Where are you located?

[gandhi]

As of 6:15 PM 03/14/11 I got the result from the 20 min swab test which was negative. They informed me that these result are accurate up to 99.3% covering from birth until last December 12/10. And that I need to be tested in 6 weeks, 3 months and 6 months.
Around 7 PM I started my PEP regiment, 2 pills of Kaletra 200-50 twice a day (with or without food) and 1 Truvada 200-300 per day (on empty stomach). One week supply cost me $549.00 until I find resources to pay for the remainder which is one month treatment.
Since I started the pills late of the day, should I double the 1st dose? Or it doesn't work that way?
What's the major side effect and how to minimize them if possible?
Does anyone here have an Idea on how I can get some help to pay for these meds?
Taking these meds for more than one month does it increase my chances of protection from any possible infection? Or the one month is the max?
Thank you guys for everything you have done and still doing. You guys are great million times better than The ER I went to.

[Ann]

Ghandi,

Sorry for the delay in response. I've been a little under the weather.

You might go to a local ASO to find out if anyone can help you out with the remainder of your script. You can find one near you by putting your zip code into POZ.com's Health Services Directory. Scroll down to the second search area.

I hope you didn't double your first dose - it doesn't work like that. Same thing for taking it longer than a month. Doesn't work like that. You can read a lay-man's explanation on how it does work here.

You can read about possible side effects by going to the link I gave you earlier this week.

As for follow on testing, you should not test until six weeks after your last dose of PEP. If that is negative, it is highly unlikely to change but must be confirmed at the three month point after your last dose of PEP. You don't need to test out to six months, post exposure OR post PEP.

Ann

[gandhi]

Thank you Ann for your reply, Actually, I doubled the first dose. My initial PEP dose when I finally got the prescription was 2 pills of Kaletra & one Truvada at 7PM.  The next day I was suppose to take 2 Kaletra in the morning and 2 pills of Kaletra and 1 Truvada at 7pm again instead I added one extra Truvada to morning dose, but that was just a onetime thing before I got your message. Even my Doctor says it won’t help me, just waste of money to double or extend the dose.
Yesterday, Thursday, March the 17th I went to my family Doctor to get his opinion regarding a white discharge from my penis. The tip of my penis was tingles / itchy feeling or some pain not really much. Thus, he prescribed me some antibiotics, Doxcycling 100, and Ceflaxine 400 for either Chlamydia or Gonorrhea.
My new question, do these medications have any interaction with the PEP functions’ and results’?
He also wants me to get tested for Syphilis, Hepatitis A, B, and C.
Thank you all for this great service, I would have been lost without your guidance.

[Andy Velez]

No, those additional medications will not affect the efficacy of PEP.

Other STDs are much easier to acquire than HIV. So if you should test positive for any of them that is NOT an indication of a greater likelihood to test positive for HIV.

Good luck with your test results.

[gandhi]

Thank you very much Andy,
Do you know of any other forums where I can acquire more information on other STD's?
 :-[By the way the white discharge or and itchiness from my penis is not there anymore I only had it for 2 days. So far I only took one pill of Suprax yesterday at 10 pm.
by the way my Dr prescribed 1 pill of Suprax 400 mg per day for 2 days only. is that enough to cure me from whatever bacteria? ...... and once I finish Suprax I am suppose to start Doxycycline hyclate 100mg twice a day for 14 days. Does it sound reasonable to you? What’s your take on it?
 

[Andy Velez]

Our focus here is strictly on HIV. We can't diagnose other STDs or situations. You should be askingyour doctor about the medication prescribed as well as any other questions about STDs which you have.

[gandhi]

Dear Ann and Andy,

I got tested for the first time after finish the PEP meds on Saturday, July 16. And the results were negative. They used rapid blood test by poking my finger.
What should I do next?
Thank you for being there for us.

[Ann]

gandhi,

You are conclusively hiv negative. You do not have hiv from this incident and you do not need further testing at this time.

What you should do next is learn from this experience and do not have unprotected intercourse again.

Here's what you need to know in order to avoid hiv infection:

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 without a condom lasts only a matter of minutes, but hiv is forever.

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

ALTHOUGH YOU DO NOT NEED FURTHER TESTING AT THIS TIME, 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.

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