Oral followed by Anxiety

[deirrow]

Hello Moderators, firstly thank you for an invaluable resource of knowledge and comfort for those affected and infected by HIV and AIDS.

I would like some comments and a risk assessment as I am in a considerable amount of distress about something that I did. Firstly I suffer from a chronic illness for which I take immune suppressants every day.

I am a heterosexual male and in a lapse in judgement, assisted by alcohol, received unprotected oral sex (blow job) from HIV+ lady. I am circumcised and the act involved ejaculation.

The following day I went to my doc who said that although the act is considered a low risk or even theoretical risk we should rather err on the side of caution and I was placed on a 28 day PEP program - first dose 20 hours after the incident. Worried about drug interaction I discontinued my other immune suppressants and am now only taking the PEP.

My general health in the last two weeks has deteriorated, I am sure as a result of the PEP and Anxiety. Problem is every little sniffle, soar throat or muscle ache is now associated with possible seroconversion. During the day I am occupied at work so am distracted but at night I start thinking all kinds of scenarios.

My questions are:

1. Although insertive fellatio is considered very low risk, could my compromised immune system make me more susceptible to infection?

2. I stopped taking my immune suppresants on the third day of PEP and am concerned that drug interaction could have possibly made the PEP ineffectual in the critical period of 72 hours post exposure.

3. When is the soonest I can test - is it three months post exposure or three months after the last PEP dose? Three months is a sure long time to stress, is there a preliminary test I can take to put my mind at ease sooner?

4. Are there any studies on the success rate of PEP after exposure?

Thank you in advance for your guidance and assistance.

[Ann]

Dierrow,

You do NOT need PEP. It is quite possible the deterioration of your health is down to you stopping your meds for your existing condition. Does your doctor know you've stopped taking them?

Getting a blowjob is NOT a risk for hiv infection. Not one single person has EVER been infected this way and you will NOT be the first.

Again, you do NOT need PEP!

You don't even need to test over a blowjob.

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.

ALTHOUGH YOU DO NOT NEED TO TEST OVER YOUR BLOWJOB, 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

edited to correct a glaring formatting boo-boo

[deirrow]

Hi Ann

Thank you for taking the time and trouble to respond to my question.

Do you suggest I stop taking the PEP?

Although your comments have gone a long way to quelling my anxiety, I am still in a lot of distress and do the "what if" nearly all the time. It does not help at the fact that I got cold like symptoms (sore throat, running nose, sore gland under arm) a week after exposure and now two weeks later have the same symptoms. I guess the mind is a very powerful thing and I cannot help but stress about my exposure taking into account my reoccurring cold!

Just an aside - this is the only hiv/aids resource I have found which categorically states that insertive fellatio is not a risk factor for infection of hiv to the insertive party - for my sake I hope this is the case!

Thank you again. I apologise if I am starting to come across as paranoid and neurotic but I think any rational person in my situation would feel uncomfortable with what they have done and the potential consequences.

[jkinatl2]

Wow, your doctor, through his ignorance, has really messed you up.

There have been ZERO documented instances of HIV through insertive fellatio. That's simple scientific and epidemiological fact. You do not get HIV from getting a blowjob.

almost thirty years of research, and your doctor is still in 1985 over this? Unbelievable. Even swallowing semen (receptive oral sex) is considered borderline theoretical, as the anecdotal evidence has yet to be borne out in long term studies of serodiscordant couples.

You are taking PEP for this? Might as well take PEP for a kiss. Its totally absurd.

And to STOP taking meds for a chronic illness that you have already been diagnosed with, in order to stay on a regimen you DO NOT NEED? Insane.

Insane. No wonder you feel bad.

Your doctor should be ashamed. or educated, or reported. Or replaced.

TESTING over insertive oral is NOT NECESSARY. Its a waste of time and energy and resources. You can certainly do so if you choose. Might as well test over a kiss, or drinking after someone.

Holy mother of pearl. And when you think you've heard it all.

You have been given some terrible advice. And worst thing is, you took it at your own peril.

This site, unlike many/most others, uses the most current first-tiered peer-reviewed science to validate it's assertions laid out pretty plainly in our LESSONS section, specifically laid out in the section on transmission.

That medicine you are taking? There are poor people with HIV who have to choose between food and their meds. There are people who are suffering form lack of insurance and lack of funds, or who have fallen into the infamous Medicare "donut hole" and risk developing resistance to their meds because they can't afford them. And your doctor throws them at you for insertive oral?

I could go on, and I am trying not to use the term "veterinarian"  or "quack" in a sentence. But you get the point.

ALL sexually active adults should have an STD screening, including an HIV test, once or twice a year. But to test over an incident with ZERO cases, whose label as a "risk" ridicules twenty five years of scientific fact? Frankly, I would not trust a medical professional who was that out of touch.

I hope you read the LESSONS section on transmission and educate yourself. Sad that you cannot rely on your medical doctor to have that information. No wonder you are paranoid. You might want to seek out a counselor (who is actually educated about HIV) for a bit. You have a little repair work to do on your psyche.

You do now, will not, can not get HIV from getting a blowjob. Or rather, if you DO, you will be the first in recorded history and get at least an hour on the Discovery channel and free medical care for life as a result.

[deirrow]

Hi Guys

Thank you again for the prompt response. I first ask that you be patient with me and I am sure I am not the first anxious wreck to be trawling this forum looking for answers and reassurance.

I spoke to my doc who said that after my visit he had consulted with a HIV specialist and he concurred that a PEP program of Combivir alone was not too heavy and appropriate for a low risk incident. He said that although the risk is measured at 0.04% for my specific incident that if the resources were available and could possibly prevent me from seroconverting if I were infected at all, then why not take them. He suggested I continue with my other treatment concurrently. I only got five more days of PEP so figure I may as well finish the course.

I am still quite anxious even after the two responses, which I guess should have left no doubt in my mind. My problem is that the CDC do assign a risk factor to the act and I am sure that the information which they disseminate is also based on the latest peer reviewed scientific research. The fact that since the incident I have had a reoccurring cold/flu is not helping with my anxiety!

I apologize if I am harping but the fact is that I had an unprotected sexual encounter with a HIV+  partner and I do not believe I am being irrational in being concerned. This is the first time something like this has happened to me and by my own admission up till now I have been ill informed about the disease - problem is that there is so many contradictions out there on the internet when looking for information - it is driving me crazy.

I once again thank you for a fantastic resource from which I have learned a lot - too bad I have not learned how to control my wondering mind from coming up with all kinds of scenarios about that night!

 

[Ann]

Deirrow,

Not one person has EVER been infected through getting blown and you won't be the first. Those numbers that were quoted at you were pulled out of thin air in a study that has since been discredited. Why the CDC continues to use it is a mystery.

You didn't have a risk and you certainly didn't need PEP.

You will not be permitted to use this website to wring your hands over this no-risk, unnecessary PEP situation. Make sure you read the posting guidelines and the Transmission Lesson linked to in our Welcome Thread and please, consider yourself warned.

Ann

[deirrow]

Sorry Ann

Thank you again for all the information.

[deirrow]

Hi Again

I am starting to believe that my real risk is getting barred for a month from the forums but I still do have a bit of anxiety about my incident. I guess the long and short of it is - I am concerned that my compromised immune system because of the medication I take has possibly made a no risk situation into a potential risk situation.

I apologize if you feel I am wasting the moderators time but having said that I regularly refer to this forum for reassurance when I feel the anxiety getting to much for me - it has been a great source of comfort.

Again I must comment on what a wonderful resource this site is and thank you for all that I have learned.

[Andy Velez]

It doesn't matter what medication you are taking. Getting a blowjob is absolutely not a risk for HIV transmission no matter what meds you are on.

How many ways can we tell you that you weren't at risk? You just seem to come around it with another reason to be worrying needlessly.

[deirrow]

Hi Guys, Me Again

I have decided to get a finger prick rapid test tomorrow. My heart is pounding and I am absolutely terrified. This is my only sounding board and I know some of you may think I am a bit of a drama queen based on my risk and the responses but having had every possible symptom of ARS since the incident there is that doubt in my mind and the what if question.

One thing through all of this is that I have found out how scary it is that clinicians and doctors all have differing opinions and it seems that many are ill informed or there information is outdated and they do not realize the implications of giving wrong advice.

I just hope I have the sand to follow through tomorrow and fear does not get the better of me! 

[Ann]

deirrow,

You are indeed a drama queen. Not one person has ever been infected with hiv through getting a blowjob and you certainly aren't going to be the first.

Ann

[deirrow]

Hi Guys

I would just like to document my testing history to have a record of it. One interesting thing that I found out is that cortisone can apparently effect the results of a standard antibody test. Anyway, could not find a rapid test so went to the Doc, he suggested a PCR test (17 days post PEP, 45 days post "exposure") which would not give a false negative by the cortisone. Result came back negative.

You guys may think my testing is overkill but if it is going to quell my anxiety then I don't mind laying out the cash or blood to do it!

Although you may be rolling your eyes at me, know that the moderators comments are regularly used to quell my anxiety (I carry around a print of this everywhere I go) and I can only imagine how much worse it would have been had I not found this site. If I continue to test negative - I have decided to stick with the CDC PEP guidelines of three months and six months, then I vow to never again take for granted my health and put myself in a situation which risk I am not comfortable with.

Thanks again for a great resource.


 

[Ann]

deirrow,

Overkill? You ain't kidding! You didn't need PEP and you certainly don't need further testing. You didn't need a PCR either. They're not approved for diagnostic purposes because they have a high rate of false positives. You're lucky you didn't get one of those, your drama queen quotient would have gone through the roof.

Don't bother posting your further unnecessary test results. They'll be negative. You didn't have a risk in the first place. You ARE hiv negative and it's time you got on with your life.

You sure wasted a lot of money (unnecessary PEP, unnecessary testing) over this blowjob. I wish I had money to throw around like that!

Ann

[deirrow]

I am ashamed to say that it has taken me this debacle to realize how privileged and blessed I am in every sphere of my life.

[Andy Velez]

You're fortunate to be able to say that. It would also be good if you could listen to science-based advice when you get it, instead of operating on fear-induced feelings which have no basis in reality.

As Ann has elquently expressed, you were never at risk and all of this uproar was totally unnecessary.