Stressed out with Anxiety

[mard101]

Hi All,

first of all a big thank to all the modes and people associated with this board. its a great initiative and helps out people like me, who need assurances and need to put in place from their irrational thoughts is they can be classified as such.

now if some one could help me with my questions.

I live in Australia and am a 35 yo healthy male.

Last thursday after drinking too much i went to a brothel and had sex with a korean working girl, during sex or as soon as i inserted she asked me to take it out as the condom was broken, and it was from the side, thereon she changed it and i carried on and the scond one was fine, i dont know her status. some how i managed to convince the doctors to put in on PEP. and at the moment i am taking Truvada once a day, the side effects are bad, with constant nausea and tiredness, I want to check how likely is it for me to be infected. i was in her for less then 10 seconds. and should i carry on PEP?

cheers
MM

[Matty the Damned]

Hi All,

first of all a big thank to all the modes and people associated with this board. its a great initiative and helps out people like me, who need assurances and need to put in place from their irrational thoughts is they can be classified as such.

now if some one could help me with my questions.

I live in Australia and am a 35 yo healthy male.

Last thursday after drinking too much i went to a brothel and had sex with a korean working girl, during sex or as soon as i inserted she asked me to take it out as the condom was broken, and it was from the side, thereon she changed it and i carried on and the scond one was fine, i dont know her status. some how i managed to convince the doctors to put in on PEP. and at the moment i am taking Truvada once a day, the side effects are bad, with constant nausea and tiredness, I want to check how likely is it for me to be infected. i was in her for less then 10 seconds. and should i carry on PEP?

cheers
MM

You do not need PEP for this brief encounter and if I were you I would stop taking the medication. I'm surprised that you were prescribed PEP at all.

You should be tested for HIV purely as a formality. HIV is a fussy virus which is difficult to transmit, particularly from female to male. I have never heard of someone becoming HIV positive following a condom break.

You need to know that PEP extends the window period and you will need to have your HIV test 12 weeks from when you cease taking the PEP. The sooner you stop taking the PEP the sooner you can be tested.

You should expect your test result to be negative.

MtD

[mard101]

Thanks mate,

i know  you are right, and i know i worry way too much. but i think its more guilt and anxiety then anything else. i will take your advise and stop PEP.

[Matty the Damned]

Thanks mate,

i know  you are right, and i know i worry way too much. but i think its more guilt and anxiety then anything else. i will take your advise and stop PEP.

Good oh!

I'm not sure where you found the sex worker, but if she was from a legal brothel or escort agency then it's unlikely that she has HIV. Australian sex workers have a very low prevalence of HIV infection. And those working for legit operations are routinely examined and certified by public health authorities.

It's an OH&S issue and the Australian sex industry is rightly proud of it's good record.

That said, we here at AIDSmeds always assume the worst case scenario in these situations so I'm making my advice on the presumption that she is HIV positive.

Even taking that into account, I expect that you will test negative and so should you.

Regarding the PEP, I should note it's medication prescribed by your doctor. For obvious reasons I have to advise you to consult a doctor (preferably a sexual health physician or the prescriber) before discontinuing prescribed medication but if I were in your situation I would stop taking it.

Good luck!

MtD

[Andy Velez]

I'm in complete agreement with Matty. Yours was not an incident which required PEP.

You had a very brief, very low level risk for transmission in that incident. HIV is not an easy virus to transmit. It is significantly harder to transmit from female to male than the other way around. Given all of the circumstances I do expect you to test negative. But you should test if only for your peace of mind.

As for guilt, well you did what you did and it can't be undone. Do all concerned a favor and see that, let it go and get on with your life.

[mard101]

Hi All,

thanks for your kind advice i took it to my heart and let it go albeit for a few days. but today a bit of anxiety returned, i seem to have slightly enlarged lymph nodes in my groin area, its more like a dull ache. would this be something i should be concerned about? its just the full anxiety coming back.

tks
M

[Ann]

Mard,

Symptoms, or even the lack of symptoms, will not tell you a single thing about your hiv status. Only testing at the appropriate time will. Your risk was very much on the lower end of the scale and I have yet to see the insertive partner end up positive over a condom break.

You said that the condom was broken on the side, so can I assume that the head of your penis was actually still covered? If this is true, then that is very much in your favour. As long as the head of your penis is covered, you're protected against hiv infection.

It is possible that you picked up one of the much more easily transmitted infections such as chlamydia. If you have swollen glands in your groin, it would be worth getting checked out for STIs other than hiv. You can do that now.

But as far as hiv is concerned, a negative result at the appropriate time (three months after the incident) is the most likely outcome for you.

Ann

[mard101]

Hi All,

i did a rapid test yesterday ( apparently they are new in Aus and will be the way to go in the future), as suggested by all of you it was a negative test. before i sign off i would like to ask 2 questions.

how accurate are the rapid tests?
i stopped PEP 4 days after i started, by how much would it reset the test window if it would.

thanks

MM

[Ann]

Mard,

The rapid tests are accurate. If anything, they're more prone to false positive results, but any positive result must be confirmed with a Western Blot. The WB catches the false positives.

Your short time on PEP isn't really going to affect your testing window period. You can add four days if you want to nit-pick.

As long as your recent test was six weeks (give or take a few days) after your incident, it will be a good indication of your hiv status, but if negative, it must be confirmed at the three month point. The three month point is where the four days on PEP become a rather moot point.

Good luck. I'm expecting a negative result and so should you.

Ann

edited to add... I forgot you said you already know your result from yesterday was negative. As long as it was done at roughly the six week point, I do not expect it to change.