Should I be worried?

[terrifiedmwm]

I'm sure you get hundreds of threads like this a day, so I appreciate any help you can give me.

Here's what happened:
2 days ago I went into an adult bookstore/theater at 6am. There was only one other person here. I've used the GHs here for oral sex but nothing more. I noticed the other man's penis was clean, no evidence of sores or other external symptoms. His hand had a cheap "prison-like" tattoo on it. This leads me to think he's been incarcerated. I offered him my penis for him to perform oral sex on. I noticed after a while his oral felt different. I look down at the hole to see myself in his anus and he's "riding" me.  (I've never had anal, much less barebacked before which is why I didn't catch it sooner).  By the time I realized what had happened I ejaculated in him. I pulled out, and left, terrified.

A few months ago I tested neg for HIV and Hep C.  I had no sores or open wounds on my penis. I believe he lubricated my penis with his saliva by performing oral sex. I recall his anus feeling lubricated similar to a mouth (another reason I didn't immediately realize I was in him).

This individual doesn't mind risking his personal health. Had I known what was to transpire I would've stopped him.  I know very well a condom should've been worn. But what's done was done.

An hour or so after the incident I masturbated using OTC hydrogen peroxide and thoroughly cleaned my urethra more so for my own sanity. I don't know if it helped or not.

Questions:
As the anal-insertive partner in a 1 time only encounter of unprotected anal sex with what can be an assumed (but not confirmed) HIV+ male, what is the true chances I need to worry?  Aren't the chances of me getting it 6 in 10,000 or something like that?

Should I get PEP? Where can I get PEP?  My 72 hour window will be up at 6am on Jan 20. I need to act fast if I need PEP.  Out of fear, I did go to the local emergency room and they informed me they don't provide PEP or testing.

I do plan on getting tested at 13 weeks and again at 6 months. While I know it's not too reliable, I will be paying careful attention to any physical symptoms during the 2-6 week mark.

I am married, and I will not have unprotected sex with my wife until I know I'm negative.

[Andy Velez]

I'm sure you get hundreds of threads like this a day, so I appreciate any help you can give me.

Here's what happened:
2 days ago I went into an adult bookstore/theater at 6am. There was only one other person here. I've used the GHs here for oral sex but nothing more. I noticed the other man's penis was clean, no evidence of sores or other external symptoms. His hand had a cheap "prison-like" tattoo on it. This leads me to think he's been incarcerated. I offered him my penis for him to perform oral sex on. I noticed after a while his oral felt different. I look down at the hole to see myself in his anus and he's "riding" me.  (I've never had anal, much less barebacked before which is why I didn't catch it sooner).  By the time I realized what had happened I ejaculated in him. I pulled out, and left, terrified.

A few months ago I tested neg for HIV and Hep C.  I had no sores or open wounds on my penis. I believe he lubricated my penis with his saliva by performing oral sex. I recall his anus feeling lubricated similar to a mouth (another reason I didn't immediately realize I was in him).

This individual doesn't mind risking his personal health. Had I known what was to transpire I would've stopped him.  I know very well a condom should've been worn. But what's done was done.

Questions:
As the anal-insertive partner in a 1 time only encounter of unprotected anal sex with what can be an assumed (but not confirmed) HIV+ male, what is the true chances I need to worry?  Aren't the chances of me getting it 6 in 10,000 or something like that?

Should I get PEP? Where can I get PEP?  My 72 hour window will be up at 6am on Jan 20. I need to act fast if I need PEP.  Out of fear, I did go to the local emergency room and they informed me they don't provide PEP or testing.

I do plan on getting tested at 13 weeks and again at 6 months. While I know it's not too reliable, I will be paying careful attention to any physical symptoms during the 2-6 week mark.

I am married, and I will not have unprotected sex with my wife until I know I'm negative.

Hi,

OK. A few thoughts...

The risk for the insertive partner is significantly lower than for the receptive partner during unprotected intercourse. If you are circumcised it is even lower risk. Of course low(er) risk is not the same thing as not risky, so you have the right idea about getting tested.

The average time to seroconversion iss 22 days. All but the smallest number of those who are going to seroconvert will do so within 4-6 weeks after an exposure. That means you could initially re-test at 6 weeks. A negative at that point would be very encouraging and an indication that it would be most ikely test negative again at 13 weeks. It would not be necessary to test beyond 13 weeks.

As for PEP, that's a decision you will have to make. It's not one to be entered upon lightly as the drugs are potent and often with uncomfortable side effects. You take them for 28 days and your waiting period to get tested would start from when you finish PEP. In other words an additional 28 days are added on to when you can test for an all clear.

Now, the question is how risky is risky. Given that this was a single incident, and you had no sores or such on your penis, that's also good, but it's really through the urethra that transmission occurs (or the inside of the foreskin for someone who's not circumcised). If you're going to do it, then begin as soon as possible. The potentially effectiveness of PEP is higher the sooner it's begun after a possible exposure. 48-72 hours is the maximum outside time frame after an exposure to begin it.

Good luck and keep us posted.

[terrifiedmwm]

I'm now at 48-72 hours on my PEP window. Planned Parenthood doesn't administer it. Every clinic I've called is closed for the holiday.

Based on other stats I was reading the chances I did not catch an STD from this incident are really positive.  I'm just concerned about being that one who got it just that one time.

I'm married and right now I'm trying to figure out how to tell my wife we cannot have sex for another 6-7 weeks.  It would do a lot of emotional damage to her - my fault entirely - that may not be necessary if this is just a scare, and not the real deal.

[Andy Velez]

I don't know what city you're in but many emergency rooms are equipped to initiate PEP.

Personally I think the odds are in your favor that you will ultimately test negative. But there is no question there was risk in your incident. You can of course have intercourse with your wife, but to do it the safer way you would need to use condoms until you get the all-clear.

Believe me, I do understand and appreciate your dilemma about what and how much to say in an explanatory way.

[terrifiedmwm]

At the last minute, the night of my last post, I called around and found a hospital ER that provided PEP. I was able to leave work and go over there. I explained the situation to the ER nurse/PA/MD.  They didn't seem too sympathetic. They took culture swabs of my urethra and told me to follow up with my doctor in a few days. They kept asking about symptoms. I tried to explain I still had less than 72 hours post-exposure, so "Duh, no, doc I don't have symptoms it's been less than 3 days." Seems like I knew more than they did. Even so.....  The doctor didn't prescribe any PEP.  I called my wife and told her I'd be home from work early........

I told her what I told ya'll. She was in shock, she cried, she was hurt, betrayed, and devastated. I apologized, over and over, I cried, I answered her questions as best I could.  I told her the odds, but she knows there's still that chance that exists.

I think she's still scared, more of what the verdict may be than anything. We're talking, hugging, laughing, and doing our usual things (except sex, or kissing - that's got her spooked - I'm not going to push it on her either). There is still an awkwardness at times but I expect that for some time.

So far I haven't lost my marriage, my family, my home.  I've got really strong job security in my profession. Now if God will just bless me with a clean bill of health....

[Andy Velez]

OK, so you made a choice and bit a big bullet  by disclosing to your wife. The likelihood is there is going to be an extended period of "fence mending." While maintaining honesty in your relationship I would also caution you about not "dumping." That is giving too much information in a misguided sense of what honesty.

You may ask what is "too much." You're going to have to use your instinct about that. Even a straying husband is allowed to set some boundaries. And if it becomes the indicated thing to do, you might consider some couples therapy or individual sessions to help you two work through this experience.

Meanwhile, although sex may not be high on the agenda today or tomorrow, it will eventually be back. Until you test negative at 13 weeks, (which is what I expect will happen), until then you need to use a condom everytime you have intercourse. And as you already know, there are many things to do together besides having intercourse, and those maybe a way for you to find your way back to intimacy together.

Cheers.

[Ann]

Terrified,

Even IF you end up positive - and that's unlikely - you and your wife need to know that kissing isn't a risk for hiv infection. And neither is protected intercourse.

Good luck.

Ann

[terrifiedmwm]

Thanks, Andy and Ann for your input. It's helped a lot. I've been sharing info with my wife, and she's been doing her own research. She's been taking it well.  We've laughed, hugged, and have been able to talk about this. I'm not nearly as depressed, and she seems to be - though worried somewhat - in better spirits.

As a precaution, I have informed her of what can be expected if I'm positive: current treatments, current life expectancy, etc. We're researching more into what we can both expect out of life should that be the case.

Regarding sex, at this time she's pregnant and we both agreed that no sex, even with a condom, would be in the best interest of our baby. She'll deliver at about the 3 month post-exposure mark.  By that point we should know the results - and hope they're negative.

Tomorrow I'll get the results of cultures taken for gonorrhea and chlamydia.

[terrifiedmwm]

Gonorrhea and chlamydia came back conclusively negative.

22 days post-exposure will be this coming Sunday. So far the only strange symptom I've noticed is tender and sore lymph nodes on my neck. None in my groin.

[terrifiedmwm]

One week left until the 6th week.

No overt symptoms of conversion yet.  I've had a little malaise, weakness, but it lasts for a few seconds and goes away. Probably due to all the "celebrating" we were doing for my cousins wedding yesterday

I'm starting to get nervous... again. What if the swollen nodes that come and go, plus these other random symptoms mean something. But then what if it's just me thinking there's something wrong because I'm in the 5th week. 

I'll update this when I get some test results unless something drastically changes.

[Andy Velez]

All the what ifs in the world don't matter. Get busy with other things while you're waiting. I still see the odds being in your favor that you'll come out of this ok.

Keep us posted and good luck.

[terrifiedmwm]

Long time no see... Which is a good thing

Other than a swollen lymph node, no other symptoms to speak of.  Not bad since I'm around sick people at work all of the time.

Due to expenses we decided not to do a full panel at 6 weeks and got a Home Access Health HIV-1 Home Test System.  My first blood sample I sent in didn't have enough blood.  Earlier this week (2 months post-exp) I sent it in again.  The results were negative.  I feel confident that the blood sample was good quality. 

After 3 months I'll do the whole full panel to make sure I'm completely STD free.

I understand and agree that the 13 week test is conclusive.  However my wife wants me to test again after 6 months for her own piece of mind.  Seeing as how I cheated on her and she didn't leave me (or kill me), I think it's only fair to honor her request.

Once again I appreciate everyones' help.  I'll post the 13 week results unless something changes before then.

[Andy Velez]

That's good news about your initial negative result. It's very unlikely to change at 13 weeks.

Testing to 6 months is totally unnecessary for you as far as HIV is concerned. But I don't leave in your shoes so if doing that will help to keep the peace in your household I can certainly understand your doing that.

Cheers.

[terrifiedmwm]

Per my wife's request I waited the full 6 month post-exposure to do anymore testing. This way we would be 100% certain of the results. I did a full-panel earlier this week. I got the results today and they are NEGATIVE!!!!!

It has been a long 6 months of uncertainty. I'm glad this is over.

Thank you to Andy and others who've contributed. I don't plan to be visiting here again

[Andy Velez]

It's a happy thing to get those negative results.

On with your life now and remember that should find yourself having intercourse outside of your marriage -- and I am not saying that you will -- but if you do, use condoms everytime. No exceptions.

Cheers.