High risk HIV exposure with male prostitue (male to male) - Sydney, AUS

[iggyb9]

Hi there,

It's great to see that there are still some solid, and most importantly of all, free web resources for people undergoing the standard anixety while waiting for the 3 month period to clear. I respect medhelp as a reliable resource but I dont think it's awfully fair to profit off a person's fear. Hence why I'm here, from what I have been reading the members here are more than qualified to answer my question concisely and directly.

I have been reading a lot of information non-stop for the past 1.5 weeks regarding possible early HIV infection symptoms, treatments, risks and modes of transmission etc. So I will not go into those too much as I realise that this will not help my state, especially considering as I have a year's worth history of anxiety disorder.

I will simply describe my situation in the hopes that my questions can be answered.

I had sexual intercourse with a male transvestite prostitute close to 6.5 weeks ago now. I'm a heterosexual 22 year old (though I guess this is now debatable) and have never had any other high risk exposures. Though I have had numerous intercourses with female sex workers over the last year I've always practiced safe sex and am not concerned about those occassions.

On this particular occasion I was having sex with the person in question and the condom broke completely exposing my penis inside his rectum. I dont know how long it was before he noticed that it broke but I am supposing that it was not that long at all, possibly two minutes at max. I pulled out and took off the remaining condom (pretty much just the ring left on) and replaced with a new one, after which I continued having intercourse though I did not ejaculate. I only had a shower about 4-5 hours after the exposure. I asked if they were infected, he said no. Can't trust that but it didn't seem they were suffering from lesions and the tell-tale signs. I couldn't see any tears in the skin of my penis and though I have HSV1 I dont think I have HSV2 as I've never noticed any herpes symptoms in the genital area.

A full 5 weeks after the exposure I developed what seemed to be a flu. At that time I had a girlfriend who was sick around that time and I may have easily become infected from the extensive kissing. She was sick for about two weeks. At the start of the 6th week after exposure I had a very sore throat, slightly swollen glands under the jaw and neck (nothing in armpits or groin area), a consistent cough though it was mostly dry, wekness in legs, tiredness, pimple-like itches here and there (not really localised to any area and hung around for a couple of days), slight underskin flat red dotted rash in about a 2cm radius on the last two fingers on the top of hand, and itches on the legs. The little rashes went away after an hour at most. Almost all of these rashes were itchy, I dont think Ive had any flat spot discolourations. There were none on my chest and to this day there arent. Two pimple like itchy bumps on the very side of the rib cage. I've had a pretty good body temp throughout except on two occasions were it rose to 37.3 Celsius (once was on a close to 40 degree celsius day after a game of baskteball). Also present as discovered by the doctor are small, painless mouth ulcers in the back of the mouth (quiet possibly due to flu/throat infection as I also have HSV1). After about 6-7 days I feel much better.

I had a an ELISA test done at exactly 5.5 weeks after exposure and it came back negative for HIV, Hep B and C, Syphillis and the blood picture was all good. A slight raise in white cell count was detected which may be attributed to the flu/virus I was undergoing.

Assesing these symptoms and my -ve result at 5.5 weeks after exposure how do you feel about my risk and chance of being hiv infected? I have read 5.5 weeks can be fairly reliable but I won't leave nothing to chance. I will test again at 8 weeks and then at 12.

Hope you can take the time to answer my simple question, I would appeciate some support from those who know more about the virus as I have only been able to converse with my best friend about it who has no knowledge.

Cheers and thanks in advance,
Iggy

[Ann]

Iggy,

You have had a risk, although it's not a huge one as you were protected up until the condom broke and as the insertive partner, your risk was lower to begin with. But this is not to say that you have not had a risk.

The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, with the average time to seroconversion being only 22 days. With this in mind, it's safe to say that your 5.5 week negative is an EXCELLENT indication of your true status and you are very likely to continue testing negative. You do need to have that result confirmed at twelve weeks. You really don't need to test again at eight, wait for the conclusive one at twelve.

Forget the symptoms. Symptoms, or even the lack of symptoms, means nothing when it comes to hiv infection. Only the tests will reliably reveal your hiv status.

Something you said worries me - "but it didn't seem they were suffering from lesions and the tell-tale signs." Tell-tale signs? Buddy, that's dangerous thinking. You absolutely CANNOT tell a person's hiv status by looking at them. You'd never in a million years guess that I'm hiv positive and have been for nearly ten years now just by looking at me. You need to assume that ANYONE you have intercourse with is positive and protect yourself accordingly.  I don't care how healthy they look.

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 STIs together. To agree to have unprotected intercourse is to consent to the possibility of being infected with a sexually transmitted infection.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence. Chances are good that you either didn't get the air out of the tip of your condom, or you didn't use enough lube, or both. A correctly used condom rarely breaks, so get reading.

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 by making your recent tests the first of many. 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.

You do need the confirmatory twelve week test, but your 5.5 week negative is unlikely to change.

Ann

[iggyb9]

Iggy,

You have had a risk, although it's not a huge one as you were protected up until the condom broke and as the insertive partner, your risk was lower to begin with. But this is not to say that you have not had a risk.

The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, with the average time to seroconversion being only 22 days. With this in mind, it's safe to say that your 5.5 week negative is an EXCELLENT indication of your true status and you are very likely to continue testing negative. You do need to have that result confirmed at twelve weeks. You really don't need to test again at eight, wait for the conclusive one at twelve.

Forget the symptoms. Symptoms, or even the lack of symptoms, means nothing when it comes to hiv infection. Only the tests will reliably reveal your hiv status.

Something you said worries me - "but it didn't seem they were suffering from lesions and the tell-tale signs." Tell-tale signs? Buddy, that's dangerous thinking. You absolutely CANNOT tell a person's hiv status by looking at them. You'd never in a million years guess that I'm hiv positive and have been for nearly ten years now just by looking at me. You need to assume that ANYONE you have intercourse with is positive and protect yourself accordingly.  I don't care how healthy they look.

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 STIs together. To agree to have unprotected intercourse is to consent to the possibility of being infected with a sexually transmitted infection.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence. Chances are good that you either didn't get the air out of the tip of your condom, or you didn't use enough lube, or both. A correctly used condom rarely breaks, so get reading.

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 by making your recent tests the first of many. 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.

You do need the confirmatory twelve week test, but your 5.5 week negative is unlikely to change.

Ann

Thanks a lot for your most welcome and encouraging comments. I am optimistic about the outcome of the upcoming tests but there is always a bit of lingering doubt.

I agree with what you said about my thought patterns with regard to being able to judge if a person is hiv +ve. I have been stupid in the past. I am staying away from prostitution for life if I survive this ordeal and I intend to continue praticing safe sex only, which I'm proud to say I've stuck to like glue. Thanks for the links I will check them out.

I was not aware that you are +ve, though I'm sure you've adapted to such a different lifestyle I still wish you the best of luck in the future. Thanks again for taking the time to reply to my question.

Cheers,
Iggy

[Ann]

Iggy,

Glad to help.

Ann

[iggyb9]

Aug. 15, 2006....
Hey Guys not really sure how to post a reply in my own string of messages so here is my update from last Thursday..
Well when I went to my doc she walked in and told me that she had very good news.. I was thinking, "oh I must have a high cd4 and low viral load & don't need meds yet," but she told me i must be in the 2-5% population that has been exposed to the virus but because of my gene makeup or for someother reason, I didn't contract the virus... Has anyone ever heard of such a thing....

Unlike the people here I am still waiting for conclusive test results to know my status but I wish to shed some light on your question here. There is a small percentage of the population that have a genetic mutation which makes them essentialy immune to the hiv virus.

I have limited knowledge about this but the HIV cell binds to the T4 helper cells via two receptors or docking points if you will. First it docks with one receptor, change it's genetic makeup and then binds to a second T-cell receptor. This allows the HIV cell to enter the helper cell, convert it's RNA into DNA and reproduce itself many time before killing the T-Cell itself. In a small percentage of people the second of two receptors is not present at all so the HIV cell is docked with one but is rejected from entering the T-Cell because of the absence of another receptor. The hiv cell cannot bind to the t-cell and therefore is rejected and goes off into the bloodstream attempting to bind to another t-cell. I guess this makes the person a potential virus carrier for a certain amount of time because AFAIK HIV cells can surive for a while. However without the ability to enter the t-cell they cannot reproduce and will eventually die out.

If you are one lucky son of a gun, then this is possibly what is happening with you. Special lab tests can be performed to check for this.

Good luck with your future endevours.

Cheers,
Iggy

[Ann]

Iggy,

I removed the post you made in the Newly Infected forum and placed it here, in your own thread, which is the ONLY place you should be posting. Please read through the Welcome Thread and pay attention to our posting guidelines.

Thank you for your cooperation.

Ann

[iggyb9]

Thanks for moving that Anne.

I found the link to the vido about what I was talking about in the previous post. The video can be found there. Its just for everyone's information. I dont want anyone to get incredibly excited cos it's anything special!

http://www.teachersdomain.org/resources/tdc02/sci/life/gen/hivimmunity/index.html


I just wanted to up date on my situation.

Despite your advice I couldn't wait for the 3 month mark. I am having regular sex (not really, just on weekends) with my girlfriend and though its protected I always fear I might cause her harm not knowing my true status. I cant tell her about what happened for fear of losing her and for fear of her taking revenge on me by telling all my friends.

At 8 weeks I again tested negative. This puts me in the "less" likely bracket to still be infected with HIV, somewhere in the top 90%. Encouraging but nothing special... I dont like any chance at all! I again went for a another full screening at 11.5 weeks yesterday. (am very impatient).

I am still concerned though as after the 8 week mark I still had joint aches and pains in my armpits and now slight pains and sensations in the groin (where the lymph nodes are located).In the last 3 days I have been feeling very hot, and though my temp was normal and never went above 37.3 degress celcius (in the normal range) I am worried about it. I still get the occasional nightsweat and from time to time a slightly sore throat.  I know you guys always say symptoms are never good indicator but is it possible that you can experience symptoms for over 6 weeks?? I fear the worst still... I guess nothing will tell me better about my status then the tests but from the experiences of Poz people does my situation sound similar?

Also should I take my 13 week test as conclusive or test out to 6 months according to my exposure?

Thanks again for everything,
Iggy

[Ann]

Iggy,

If those symptoms actually had anything to do with hiv, you would have tested positive (or at the very least, indeterminate) at your eight week test.

Whether or not you take another test after you receive your 11.5 week negative is up to you. In the UK and most of Europe, the window period is twelve weeks, using the same tests as are used in the States. A couple days isn't going to make a difference. You absolutely do not need to test again at six months.

I fully expect you to continue testing negative. Do yourself a favour and go see a doctor about your symptoms. There are many other illnesses out there besides hiv and you could be missing something important by assuming it has to be hiv. With your test results so far, it ain't.

Ann

[iggyb9]

Haha, Ann you farking legend. (i trully mean that in a nice, caring way  . You sure know how to put a smiley on a worried guys face....

I know what you're saying and of course I take your words along with a few others as the bible on this kind of thing. Not only have you gone through it yourself but you deal with a LOT of noobie questions. Unlike the other "i kissed his bleeding finger, do I have aids" type questions mine at least was something to warrant a bit of attention and worrying! Of course I most probably took it a little bit too far... but that's what I am, a worry well. I'll see how my symptoms persist and I will see the doc (and possibly a counselor).

I wil take my 13 week as conclusive. I wont get too excited just yet or even with a 11 week neg. Will get back to you guys when I can finally exhale and relax.

Again thanks for the support and advice you've offered me and everyone else. You've been my solid rock that I've had the opportunity to lean on.  Shame on rapidrod and Andy for not taking time to answer!    Keep it up guys.

In peace and love,
Iggy

[Andy Velez]

Like Ann, I expect you will continue to test negative. The average time to seroconversion. With a negative result at 5.5 weeks it doesn't matter what physical symptoms you maybe having. The likelihood that you would be seroconverting at this late date is way more than unlikely.

Make sure the condoms you use fit you properly. Otherwise you have the right about using them everytime whether for vaginal or anal intercourse.

I expect you will come out of this incident ok. If you have troubling physical symptoms discuss them with your doctor. I don't see this as an HIV situation.

Good luck on your 13 weeks test.