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Author Topic: Please help me,I'm going out of my mind  (Read 13399 times)

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Offline pep4hiv

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Please help me,I'm going out of my mind
« on: October 23, 2008, 08:53:57 AM »
Hi,I'm a new member,I had a possible exposure about 9 days ago on the 14th of October.I was with a transsexual/cross dresser prostitute in India.The unimportant stuff is that we gave each other handjobs,I performed fellatio on him/her.
                         Now here comes the troubling part.He had a condom on and put another one on top of that,i.e. he now had two condoms on.He tried to penetrate me anally once,but it did'nt go in at all,he tried again and this time it went in slightly and suddenly he stopped.I turned around and saw him looking at his penis.I asked what happened and he said the condom was broken,I panicked.I panicked like crazy,I just put on my clothes and got the hell out of there(also FYI this was my first time ever,I mean absolute first time).The next day I went to a doctor who is a HIV specialist and told him everything.He put me on a regimen called PEP,which includes (Lopinavir 200mg+Ritonavir 50 mg) in one tablet and another tablet which contains (Lamivudine 150mg+Zidovudine 300mg).
                      He also gave me some stuff for nausea and some stuff for diarrhea and a B complex.
Now,my questions are,

1)Keeping in mind my risk,what are my chances after PEP
2)Do I need to worry about delayed seroconversion?
3)How long do the results of p24,or DNA PCR test take?
4)What if a p24 antigen test/DNA PCR test show positive/negative at the end of 2 weeks?Should PEP be continued in either case?

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #1 on: October 23, 2008, 09:12:06 AM »
Also,I think I should add as soon as I got home,less than 20 mins later,I washed the rectum and poured dettol(that's an antiseptic) all over it.I also felt the area and felt something sticky there,it may have been pre-cum or lubricant,I'm not sure,I couldn't have been sperm as I'm pretty sure the person didn't ejaculate.

Offline Andy Velez

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Re: Please help me,I'm going out of my mind
« Reply #2 on: October 23, 2008, 09:40:49 AM »
Pep, from what you have reported I would say your risk level in this incident was very low.  Personally I think it was an overreaction for you to be put on PEP in relation to what you have described happened.

It sounds like the insertion was so brief and without ejaculation, so the risk would have been extremely low.

Now that you are on PEP, that does extend the testing time. To get a final negative result that's reliable you would need to test at 13 weeks past when you complete the PEP cycle of 28 days. I know that must sound like a really long time when you're so anxious. You can test prior to that just for reassurance, but for an all clear you would need to follow what I have suggested.

Doing a PCR is not a good idea. It's a highly sensitive test and not infrequently because of the high sensitivity it may yield a false positive, although not a false negative after 28 days. But it was never intended to be a diagnostic tool so you would still need to do an HIV test too.

For future reference, doubling of condoms is absolutely not the thing to do as you have found out. Rather than adding greater protection, they result in breakage. A single latex condom will give you all the protection that's needed. And if you choose to have anal sex again  (or vaginal too), the insertive partner must always without exception wear a latex condom. They provide very effective protection against HIV.

Given what you have reported I am expecting that ultimately you will reliably test negative.

Cheers.
Andy Velez

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #3 on: October 23, 2008, 10:18:46 AM »
Thank you so much for saying that Andy,just three things,
1)What about the sticky stuff on my rectum?I mean if it was lubricant from the condom then no problems,but what if it was pre-cum/seminal fluid?
2)Is the testing by a p24 antigen test at the 2-3 week period at all affected by PEP?What about the PCR DNA test?
3)Not that I'm doubting your analysis,but if you could just explain how you say the risk level is low,given that the person was a high risk individual.I just wanted some clarification.

I have to say,after this I'm never having sex again.It's just not worth this panic I have right now.

Offline Andy Velez

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Re: Please help me,I'm going out of my mind
« Reply #4 on: October 23, 2008, 10:44:39 AM »
Let's stick to what you've reported. Your moment of insertion and a breaking condom was very brief. Which means it's extremely unlikely that semen was involved nor even precum.

I've already told what I think about PCRs. The PCR DNA is actually more prone to false positives.

It isn't about so-called "high risk individuals." It's about what you do with whomever you are with. And from your detailed description it seems to me he was being cautious himself and the risk of a POSSIBLE exposure was so extremely brief as to make transmission EXTREMELY UNLIKELY. As I said earlier. ultimately I expect you to test negative.

Now if you're going to make yourself nuts about this then you're going to make the waiting time really hard. What you need to do is to get busy productively with other things in your life. And you can do that so don't tell me you're too worried. That won't fly here.

And again, I expect you to come out of this ok.
Andy Velez

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #5 on: October 23, 2008, 10:55:21 AM »
Thanks a lot for the clarification Andy.I really appreciate it.You are right,I need to be doing things but I just can't get myself to open the door and leave the house.Also today morning I woke up with a white tongue and in the past week I have lost 4 Kgs(That's about 9 pounds/lbs).Any comments?I mean from what I have read,it's too early to be ARS,but then again I don't know for sure.Could both of these be because of PEP?Just curious.Would you reccomend any blogs/educational websites I could check to know more about what happens to a person on PEP?

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #6 on: October 23, 2008, 11:16:57 AM »
How about talking to the person that put you on PEP for a starter?

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #7 on: October 23, 2008, 11:27:51 AM »
Hi rapidrod,I was just reading some of your replys on other questions,the HIV specialist I went to while is an awesome person,isn't exactly the most internet savvy person in the world,he just told me to go to the CDC  website for further information and gave me a help-line number to call,unfortunately that's all and since I live alone I don't really have anyone to talk to so...........but I did ask him about the weight loss,he said it was mostly the stress.I didn't really ask him about the rest of the stuff because they didn't show up till today morning.If you could tell answer these for me,it would just put my mind slightly at ease.Thanks in advance rapidrod.

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #8 on: October 23, 2008, 11:43:29 AM »
You are correct about symptoms, they came on to quick. Your doctor was correct about the stress. There is no reason to worry, there is nothing that you can do by worrying.

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #9 on: October 23, 2008, 11:45:51 AM »
Also just a little curious,even if the the person was positive,PEP should keep me safe right?Like I said this was my first time ever and I'm not really someone who ever checked up or even tried to learn about stuff like this before(I know I sould have and believe me after the last 9 days I have enough to do a thesis on).And infact part of the reason I'm going insane with fear is because I have tried to process so much information.

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #10 on: October 23, 2008, 12:12:41 PM »
There is no guarantee that PEP will prevent you from contracting HIV.

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #11 on: October 23, 2008, 12:26:39 PM »
Yeah,I get that PEP is effective about 80% of the time,but I meant keeping my case in mind and the fact that I plan to strictly adhere to the course,I was just wondering.You see nobody really tells me anything in a way I can understand and it's the confusion that scares me just as much.I'm just a graduate level student with nothing to do with medicine and or HIV?AIDS,so you can understand why I'm so freaked out.

Offline Andy Velez

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Re: Please help me,I'm going out of my mind
« Reply #12 on: October 23, 2008, 01:10:08 PM »
I can promise you that between now and the time that you do your final test, lots of physical events are going to occur with your body. They do all the time but now that you're anxious about HIV, your head may mistakenly tell you, "Oh my God, another sign of infection." Wrong, wrong, wrong. Nothing you have reported nor are likely to report is going to tell you anything about your HIV status.

Particularly since ultimately I expect you to test negative.

Also, I don't know if the person who prescribed PEP for you told you that these are powerful medications and often cause uncomfortable side effects. You need to be aware of that.

You began it very early, your risk was minimal if any, and at the end of the day I expect you to have a happy result. Now, get busy with other things. Get yourself up and out into the world. And keep on doing that. Believe me it will make the waiting time pass much more easily than you may imagine possible at this moment.   
Andy Velez

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #13 on: October 23, 2008, 09:27:26 PM »
I also meant to ask,what if I take a p24 antigen test between the 14 day and 21 day mark?I read at that time period,the test is accurate,and a DNA PCR test is accurate at 5-7 days after possible infection,although the DNA PCR Test is expensive.I was wondering incase of a positive/negative result,should I continue with PEP after that?

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #14 on: October 24, 2008, 12:48:06 AM »
You started PEP, no test is reliable until 3 months post the LAST dose of medication.

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #15 on: October 24, 2008, 03:49:41 AM »
Hi,I was just going through some of the other questions here and I saw this one about HIV-RNA testing
http://forums.poz.com/index.php?topic=20586.0,I was just wondering if it was warranted in my situation.I mean,I was having sex with a high risk individual and the condom broke right,so................Now it says the test can be taken after 7 days,I'm on my 10th day now.Any suggestions?

Offline Ann

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Re: Please help me,I'm going out of my mind
« Reply #16 on: October 24, 2008, 07:00:21 AM »
pep,

I can't help but wonder about something. You said in your first post that TWO condoms were used - are you absolutely certain that BOTH broke? Because chances are good, considering the time frame where he stopped immediately, that only one of the condoms broke. It was most likely only the top one. If this is the case, you're worrying unnecessarily.

If you insist on PCR testing, RNA is the way to go, not DNA. However, RNA testing is expensive and time consuming and it may not be available in your location.

You also need to realise that as you're taking PEP, and let's say you HAVE been infected, there's an excellent chance your viral load is already undetectable due to the meds. This means you'd have a false negative result. Bottom line? In your case, RNA testing would be a waste of time and money at this point in time. I do NOT recommend you use RNA testing. The result would be meaningless.

You also need to get this idea of "risk groups" out of your head. This false notion is one that continues to drive this epidemic. The ONLY REAL risk group is that group of people who have unprotected anal or vaginal intercourse with people of unknown hiv status. It's the ACTIVITY that counts, not who the person is or what they do for a living etc.

BTW, I totally agree with Andy that your risk was minimal (or NO risk if only one condom broke) and combined with starting PEP in a timely fashion, you are most likely to test negative when you test at the appropriate time.

And make sure you read through all three condom and lube links in my signature line so you can be sure of using them properly in future. A correctly used condom RARELY breaks. I've never had one break on me - because I use them correctly. If you do the same you won't have this problem happen again.

Ann
« Last Edit: October 24, 2008, 07:02:55 AM by Ann »
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #17 on: October 24, 2008, 07:33:17 AM »
See,that's the thing.I don't know which condom broke or if both broke or what.Like I said,I panicked so badly that I just put on my clothes and ran out of there.Also like I said,the scary thing was that I felt something sticky around the rectum,and I don't know what it was.As an expert on condoms,could you tell me if lubricant feels like pre-cum/seminal fluid?The councilor I spoke to on the phone said something about mucous membranes around the rectum.Would they have created the substance I felt?Would it smell similar to the seminal fluid?
On a slightly different topic.what's your opinion about the p24 antigen tests?I'm going to ask the doctor about it on my next appointment,but wanted to know from an external source who also has experiences in these matters,by the way on a separate note I was just reading your blog.you write really well.Where is The Rock?If you guys want some indication of how tense I am,I haven't slept properly for over a week now and this is my 17th hour online straight in this stretch.
Ann,when you say I might have a false negative result.what does that mean?I am talking in the context of the RNA test only,not the other tests.If I am infected(I really hope and pray to God I am not)then shouldn't the PEP stop and abort the infection and isn't it doing that right now?

Offline Ann

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Re: Please help me,I'm going out of my mind
« Reply #18 on: October 24, 2008, 08:08:08 AM »
pep,

The sticky feeling could well have been from the lube on the condom, or it could have been your own anal mucus. It could also have been his pre-cum, yes. Stickiness on the outside doesn't necessarily mean stickiness on the inside though.

No test exists that will give you an accurate result while you're on PEP. This includes p24, antibody and either of the PCR tests. Sorry, that's just the way it is. You're taking drugs to suppress the virus. Suppressed virus means your body might not be alerted enough to make antibodies. It also may not produce the protein the p24 test detects.

You asked about what I mean by a false negative on the RNA test. (this answer assumes you did end up with hiv in your bloodstream) The function of the meds you are taking is to stop hiv replicating. If you initiated PEP quickly, this may be enough to eradicate hiv from your body. However, if hiv had the chance to find its way into areas of your body where the meds don't reach, when you stop PEP the virus will get back into your bloodstream and begin to replicate again. This means while you might test undetectable on the RNA while taking the meds, it doesn't mean that hiv isn't in one of the reservoirs. For example, a person with an undetectable viral load in the blood may have a detectable viral load in seminal fluids.

It's difficult to know just how effective PEP is. You're in the medical field, think about it. How would you construct a study to get to the bottom of it? There is no way of knowing if the person on PEP would have tested positive or negative had PEP not been initiated. It's impossible.

What we do know, however, is that most people who have been on PEP test negative at the end of the three months post treatment. What we don't know is how many would have tested negative anyway, regardless of PEP.

All that said, your situation is definitely on the lower end of the risk scale. As long as you've not been engaging in unprotected anal or vaginal intercourse that you've not told us about, I fully expect you to test negative - at the appropriate time. There's no point in ANY testing while you're on PEP.


I suggest you talk to your doctor about a sleep aid. You're not doing yourself any favours sitting at your computer for hours and hours. You need to be eating right, exercising and getting enough rest to help your body cope with the meds - so the meds can do their job properly. Turn your computer off and unplug the darn thing. You'll end up making yourself sick through stress.

The Rock is aka the Isle of Man. It's in the middle of the Irish Sea.

Now go get busy with other things. All the fretting in the world will not change the ultimate outcome - and I DO expect the ultimate outcome to be a negative result.

Ann
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #19 on: October 24, 2008, 08:31:16 AM »
Thanks a lot Ann,I promise after this post I'm putting off my computer for some time.Transformers is playing tonight and I've been looking forward to it all month,I'm just going to lie in bed and watch it.Just a small clarification,I'm not in the medical field.I graduated in something else altogether.I have to ask though,what could I do to get some peace of mind?I mean I have 3 months and two weeks to go before I can get a conclusive negative test I can rely on and given how the past 10 days have gone,it seems like a life time.And I have to say,I'm never having sex again.It's just not worth it.
« Last Edit: October 24, 2008, 08:33:40 AM by pep4hiv »

Offline Ann

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Re: Please help me,I'm going out of my mind
« Reply #20 on: October 24, 2008, 08:39:30 AM »
pep,

I suggest you speak to your doctor about a referral to a therapist/counselor. You can also ask at your local ASO, if there is one where you live, and get some counseling there. If you don't know of an ASO near you, you can query the database of Aids Service Organisations world-wide at http://www.aidsmap.com/cms1038779.asp You don't have to fill in all the fields, just the country will suffice.

It will also help if you keep yourself productively busy. Clean the house. Do some gardening. Help your elderly neighbour with their cleaning or gardening. Read a book. Read twenty books. Watch a DVD. Watch 50 DVDs. Volunteer at a soup kitchen. Go to the beach. Exercise. KEEP BUSY!

As for never having sex again, that's a pretty tall order - one you're unlikely to be able to fulfill. As I said before, read through the condom and lube links in my signature line so you can use them correctly and with confidence. A correctly used condom rarely breaks. And I MEAN rarely. You don't need to forgo sex, just play safe. As long as you're using condoms for anal or vaginal intercourse, you will avoid hiv infection. It REALLY is that simple. There are plenty of no-risk ways of playing too - like mutual masturbation. Just make sure the condoms are on for intercourse, and make sure they're being used correctly. If anyone ever tries to put two on before entering you again, STOP them and EDUCATE them. They'll thank you for it.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #21 on: October 24, 2008, 10:40:20 AM »
Hi Ann,I just came online to check an e-mail and saw your post,why are you recommending that I see a therapist?I mean is it because of what I did/to get more information and stuff,or is it because you think I might be at a larger risk then you are letting on?I really started to worry when I saw your post,because it has a lot of interpretations,and some of them are scary,so if you could just clarify the comment.Thanks.

Offline Ann

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Re: Please help me,I'm going out of my mind
« Reply #22 on: October 24, 2008, 10:52:18 AM »
pep,

I'm recommending therapy because you're so wound up and anxious. You asked me what did I suggest for you to gain some peace of mind, and therapy - along with keeping busy - was my answer. A therapist can also guide you through ways of getting to sleep. You need sleep. We all do.

I've already told you I think your risk is on the lower end of the scale and I fully expect you to test negative when the time comes. I wasn't lying when I said that.

The stuff you are calling scary isn't really, it was in answer to your question of why you shouldn't bother testing now while you're on PEP. Any testing now would be totally meaningless. The earliest you can test for peace of mind is six weeks post-PEP. A negative result at that  point needs to be confirmed at three months post-PEP. I fully expect both tests to return negative results.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #23 on: October 24, 2008, 11:00:50 AM »
Ohh,huge wave of relief spreading suddenly.Thanks a lot,That helped put my mind a little more at ease.I'll ask for a therapist's number the next time I see the doctor,and try to do stuff to relax,and I'll stay in touch with my progress too.Once again thanks.

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #24 on: October 25, 2008, 05:46:16 AM »
Hi,just a quick question,what does oral thrush look like?I'm asking because my tongue is white all the way,and I can't scrape it off with a tongue scraper and brushing it does nothing at all.Is there any chance this could have been caused by the PEP meds?Oh and what would the rash caused by Kaletra (lopinavir/ritonavir) look like?
« Last Edit: October 25, 2008, 05:52:18 AM by pep4hiv »

Offline Ann

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Re: Please help me,I'm going out of my mind
« Reply #25 on: October 25, 2008, 06:41:45 AM »
pep,

The only medications I'm aware of that can cause thrush are antibiotics. It's unlikely what you're seeing in your mouth is thrush, unless of course you are on antibiotics. Oral thrush hurts - especially when you eat something hot, spicy - anything with strong flavours really. Carbonated drinks and alcoholic drinks also hurt like hell. If you are worried about your tongue, you'll have to show it to a doctor.

Same with any rash you might get. We cannot diagnose your rash or any other physical problem over the internet. You'll have to see a doctor for that.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #26 on: October 26, 2008, 01:20:59 PM »
Hi guys,sorry to be such a bother,but I felt the area below the jawline all the way down to the collarbone swell up.It feels kinda weird and slightly painful,my entire neck is kinda stiff.I don't have a fever at al but the left side of my jaw hurts when I chew.I also have a slight headache,although the headache might be because of some noise from next door.Should I at all be worried about this?I would call the doctor,but it's kinda like Christmas time here in India(a really important local festival called diwali) and I don't want to disturb him if it might not be important.I also have a slight cough,but that's not exactly a cough yet,it's more like I have to clear my throat a lot. Thanks.
« Last Edit: October 26, 2008, 01:26:29 PM by pep4hiv »

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #27 on: October 26, 2008, 02:00:30 PM »
Also,I just noticed,I'm having trouble dry-swallowing  and I have diarrhea.Both are just sudden appearences as I didn't have them today morning or until lunch,they just suddenly popped up.Today happens to be my 12th day since exposure,so I'm really scared that this might be ARS popping up.

Offline Ann

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Re: Please help me,I'm going out of my mind
« Reply #28 on: October 26, 2008, 06:09:00 PM »
Pep,

Dwali or not, the ONLY person who can help you with this stuff is a doctor - one that you see in person. Nobody can diagnose you or tell you what is going on over the internet and we here at AIDSmeds are not even going to try.

What happened to you unplugging your computer? You had a relatively low risk, you're on PEP, and there's not much more we can do for you here. You can be given a time out just like anyone else in this forum. Please consider yourself warned.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #29 on: October 29, 2008, 09:25:25 AM »
So I went to the doctor today,and I showed him my symptoms and a new symptom that just popped up,the skin around the head of my penis is peeling and there's dark colored patches around the base and head,not that it hurts or itches,there's some foul smell though.The doctor prescribed some ointment for it and when I asked what it was,he said it could be either some form of herpes or it could be caused by condom irritation.So I wanted to ask,do these seem plausible explanations?If I could catch herpes,does that incerese the risk of HIV?If it is condom irritation then what can I do about it besides the ointment?See,I would have asked the doctor about this but he's on lleave for a while and came to the clinic only because I said it was an emerency.Oh and I apologise about the long post,but this is the only place I can go for information for a little while and I can't relax either,since I heard the word herpes,all my fears have multiplied. 

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #30 on: October 29, 2008, 09:53:51 AM »
This is an HIV forum. No one can diagnose your penis issues over the Internet.

Offline Andy Velez

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Re: Please help me,I'm going out of my mind
« Reply #31 on: October 29, 2008, 10:37:29 AM »
Your anxiety is still driving you and all with no basis in HIV science.

Your doctor gave you an answer and an ointment. Use it and see if it works. I don't see any reason to doubt his diagnosis. And in any case, as Rod has said to you, we can't diagnose your symptoms here. Period.
Andy Velez

Offline pep4hiv

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Why is the CDC so conservative about testing?
« Reply #32 on: October 30, 2008, 08:25:59 AM »
Why is the CDC so conservative about testing?I was talking to a counselor on the phone today and he told me that about 25 days is enough for getting a conclusive negative here in India,about 30 days tops.Unfortunately he didn't have any information regarding testing after PEP,but he said that he'd check and let me know.He put me in touch with a lab that does testing in my city and they said that 25-30 days after exposure is good enough here(I mean in the country)because the current generations of tests are that sensitive,unfortunately he didn't have an opinion on PEP either,but my question remains as to why the CDC is so ultraconservative especially when they are the ones that recommend the tests in use. ???

Offline Andy Velez

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Re: Please help me,I'm going out of my mind
« Reply #33 on: October 30, 2008, 09:18:17 AM »
We aren't here to evaluate what's up with the CDC. We're here to evaluate risk and express an opinion about that which is based in HIV science and experience. You can accept what we say or not as you choose.

I can tell you for sure that if you continue to search the net and other "sources" you will absolutely get more fuel to feed your fears. All of that will of course not give you the answer that only a timely test result will. In fact it will only make you more anxious. We've told you what we think. Ultimately I expect you to come out of this ok. How miserable you make yourself during the waiting time is strictly up to you.

Andy Velez

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #34 on: October 31, 2008, 05:08:31 AM »
Hi Andy,Ann and Rapidrod,don't worry,I'm not asking a question this time,just here to tell you guys the results of a p24 antigen test and a Nucleic acid detection test(HIV-Proviral DNA,blood by PCR) that just came in today.I know,I know,and don't worry,I am going to get a proper ELISA test done in 3 months time,but I needed to get this done so I could try to get some peace of mind and try to move on with life with a little sanity.The results are as follows.
In the case of the p24 antigen:
Cut-off                  optical density :0.125
Sample(RPBE 9826) optical density:0.016
 and in the case of DNA PCR test,the results say NOT DETECTED.
I have to say this is a very comforting state to be in and the doctor told me that this is something to be very optimistic about,although just to be safe he told me to finish the PEP regimen,which I will and I'll get tested at the 3 month mark as well.I just thought I should come by and tell you guys about this before turning in for a good nights sleep after a long time.

P.S. The blood samples were given at  11/12 days,depending on the number of hours in consideration.
« Last Edit: October 31, 2008, 05:10:22 AM by pep4hiv »

Offline Andy Velez

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Re: Please help me,I'm going out of my mind
« Reply #35 on: October 31, 2008, 09:27:30 AM »
Good if not unexpected happy results. I expect them to continue that way. Hope you got some of that much needed sleep too.

Cheers.
Andy Velez

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Re: Please help me,I'm going out of my mind
« Reply #36 on: November 02, 2008, 12:17:16 AM »
Hi,I just woke up and the first thing I first thing I did was look at my test results just to make sure that they were not a dream,and something struck me,the DNA PCR test says not detected which is great,but the P24 antigen test shows 0.016,which if I read correctly means that there is P24 antigen present right?Would this mean that it might increase in a while?Or is that much present in the body at all times?I only ask because I couldn't find anything about interpreting the results of the P24 antigen test anywhere.Thanks in advance.

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #37 on: November 02, 2008, 01:56:40 AM »
What kind of test was you given?

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #38 on: November 02, 2008, 01:08:37 AM »
Hey Rapid,good to hear from you,I was given a Nucleic Acid Detection:HIV-Proviral DNA,blood by PCR test and a P24 Antigen test where the cutoff optical density was 0.125.The DNA PCR simply said NOT DETECTED and the P24 showed my optical density to be 0.016.The blood was given after 11 days,about 8-9 hours before the 12 day mark,which according to the doctor and the lab specialist was long enough after exposure.So what do you make of my Antigen test?I just mean shouldn't it be 0.000?Just curious.Thanks in advance RapidRod.

Offline Ann

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Re: Please help me,I'm going out of my mind
« Reply #39 on: November 02, 2008, 05:54:50 AM »
Pep,

If you want a detailed explanation of how to read p24 test results, I suggest you ask the lab tech. What's important is that you were told it read as negative.

I see you lurking here quite a bit. What happened to turning off your computer and getting busy with other things? You're going to make yourself sick with stress.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #40 on: November 02, 2008, 06:32:02 AM »
You were given the wrong test let alone you took the test to early when using PEP.

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #41 on: November 02, 2008, 06:49:12 AM »
Hey Ann,good to hear from you too,I asked the lab tech,but he couldn't explain it.He said the P24 was accurate between 1-3 weeks approximately and that the DNA PCR looked for pieces of the virus floating around.I'm sorry about lurking around so much but I just can't help myself,I am going to see a councler in a few days though.Just a quick question for Rapidrod,what do you mean when you say I was given the wrong test?Are you referring to the P24 or the DNA PCR?I took both because the doctor recommended them and he said that they would be accurate in the time period(The 10-14 day mark)Are you saying I should have gotten a RNA PCR instead?I read that the PCR would be able to detect HIV within about 48-72 hours of exposure,but it didn't say which one(RNA or DNA).And as far as the PEP is concerned,I agree and like I said I will get tested after 3 months,but you didn't tell me what you thought about the P24 antigen question I had,if you could just help clarify that point for me,like I said the lab tech couldn't make it clear so............Thanks in advance.

Offline Ann

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Re: Please help me,I'm going out of my mind
« Reply #42 on: November 02, 2008, 07:19:17 AM »
Pep,

RNA tests are preferred over DNA tests because DNA tests have a high rate of false positives. They are not approved for diagnostic purposes for this reason. You didn't get a false positive result.

As you've been told, there is NO POINT testing while you're on PEP. The results are essentially meaningless because of the antiretroviral drugs you're taking.

You are highly unlikely to come out of this positive. Now go get busy with something other than this or any other hiv website. As you've been told, if you need a time out to help you get out of the rut of coming here, that can be arranged. You're not doing yourself any favours hanging out here. Nothing you read is going to make the slightest difference to what your eventual outcome will be - and I fully expect that outcome will be a negative result.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #43 on: November 02, 2008, 07:43:19 AM »
Got it Ann,sorry I'm not exactly making like a hockey player and getting the 'puck' out of here(if you didn't find that funny,I'm sorry that's the best I could do in my current state)but I've never had a crisis like this before,ever.Also I just gave up smoking the day I started taking PEP because I read somewhere that cigarettes affect the performance of the ARV drugs.That and the fact that I can't drink because that might also affect the performance of the drugs and like I mentioned before,I live alone and have no one to really talk to about this just adds up to the insanity and new found attraction to my laptop like never before.Also,I have to tell you,I'm not a hypochondriac,in fact I hardly ever go to the doctors clinic and have only seen the inside of a hospital once.Sorry for rambling on for so long about nothing,but I just wanted to ask you not to give me a time out.I promise I'll behave myself and try not to take up too much of your time henceforth.Thanks.

Offline Andy Velez

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Re: Please help me,I'm going out of my mind
« Reply #44 on: November 02, 2008, 08:00:39 AM »
You really have to make an effort to direct your energies in more productive ways. It can be done. And although I am not encouraging smoking at all, this may not be the best time for you to quit smoking and thus add additional pressure on yourself. Just sayin'...

Getting yourself some professional help should help you.

...and always bearing in mind that at the end of the day we are are expecting you to continue to test negative. Hold that thought.
Andy Velez

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #45 on: November 03, 2008, 10:10:30 PM »
Ok,so I'm about to start my last week of PEP,I just bought my last bottle of Ritocom(that's Lopinavir and Ritonavir tablets),and I really hope that this is the last HIV related purchase I ever make.7 days more to go and the PEP regime will be over and the waiting game will begin.

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #46 on: November 04, 2008, 09:45:16 AM »
I was just curious,has anyone here heard about someone having a negative 12 day P24 antigen and DNA PCR and showing up positive later?I am going to have a ELISA done the day I finish my PEP just to check to make sure that it wasn't a complete failure,and the doctor said that a 6 week is good enough for here,given I have no history of drugs,I'm not an alcoholic and my liver/kidney functions etc are normal.Also I  just wanted to know,in theory is it possible to seroconvert while taking PEP medication or does it happen before or after or something else?
« Last Edit: November 04, 2008, 09:57:36 AM by pep4hiv »

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #47 on: November 04, 2008, 10:11:12 AM »
Knock it off. Sit back and wait to collect your conclusive test result.

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #48 on: November 06, 2008, 07:51:18 AM »
Ok,I am really freaked out right now,I just went in for what I thought would be my last doctor's appointment and told him that I had dizziness and a slight headache and tingling in both my hands and feet and pain in my groin and pain in my throat and other stuff I had and so he gave me a physical checking my lymph nodes and stuff,then he stepped out and started conferring with his colleague,I couldn't hear what they were saying but I could see them and it looked like they were talking about me.Then the doctor came back in and told me to continue taking the ARV medicines for two more weeks,i.e 6 weeks in total and I asked him why I was taking PEP for longer than required and he said that PEP was actually recommended for 6 weeks,but some people couldn't afford more than 4 weeks and so for them it was provided for 4 weeks,but it was recommended for 6 weeks for more safety.
                                  Now I'm not saying my doctor is right or wrong,but every article I've read on the internet and all the research I've done says that PEP is strictly a 28 to month long regime,so I don't know what to think,and I don't have another source to confirm this with.Also he(the doctor)recommended that I have another P24 antigen test done on the 28th day along with a ELISA at the same time,but obviously the results are not going to be conclusively accurate,so I don't really know what to think.I would ask someone else for a second opinion but I don't know any other HIV specialists here,so I was wondering if you guys could tell me what to make of this situation.Am I seroconverting and is it that my doctor doesn't want to tell me and wants me to keep taking ARV drugs to drive down the viral load and raise my CD4s or is taking PEP for 6 weeks being conservative like testing after 3 months?Why would my doctor recommend another P24 and an ELISA so soon?I asked him but like I said he said it was a question of affordability and I'm not really convinced.Any thoughts?

Offline Ann

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Re: Please help me,I'm going out of my mind
« Reply #49 on: November 06, 2008, 09:51:48 AM »
pep,

It sounds to me like your doctor doesn't know what the hell he's doing or talking about. I've NEVER heard of anyone taking PEP for longer than 28 days, and that includes needle-stick accidents in a health-care setting where the patient is KNOWN to be hiv positive. You don't even know if the person you were with was positive or not. You onlyl had a small risk to begin with, as he did not ejaculate inside you.

You're highly unlikely to come out of this positive. Stop with the obsessive testing and wait for your conclusive result. And maybe look for a different, more knowledgeable doctor.

You're this close to being given a time out. You really need to get off the internet and get busy with other things and if it takes not being able to view this site, then so be it.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #50 on: November 06, 2008, 10:09:27 AM »
Ann,I completely agree with you and I had no intentions of coming back until I was ready to have a conclusive test,it's just that the meeting with the doctor today threw me completely off balance and I just wanted to get a second opinion.Now that I have your opinion,I'm thinking of trying to find another specialist.And the testing wasn't my idea,it was the doctor's.Like I said I was just thrown completely off balance by today's meeting so.......But just so I know,do you recommend getting a second opinion or should I just straight away stop taking the medicines on day 28?I have 4 days to go on the PEP pills,and I have enough to last me for 2 days after that,so I'm covered till I find another specialist,but with the weekend coming up I'll have to start looking for one and making appointments right away.

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #51 on: November 06, 2008, 10:26:37 AM »
PEP is give for 28 days PERIOD.. Not shorter nor longer. 28 days.

Offline jkinatl2

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Re: Please help me,I'm going out of my mind
« Reply #52 on: November 06, 2008, 01:26:49 PM »
It amazes me that your doctor would be so misinformed, and then so arrogant as to lie to your face. You do not require, nor is it recommended, for PEP to be taken longer than 28 days.

I still agreee with Andy, in that the PEP was an overreaction to the incident. And I fully believe you will test negative after this extremely low risk incident.

Obviously, in the future, please remember that wearing two condoms (called "double-bagging") is considered extremely dangerous, as the friction of latex against latex can -and often does - cause both condoms to break.
"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #53 on: November 18, 2008, 12:16:14 AM »
I just finished with my PEP 4 days ago,I took it for 30 days totally,and finished with it.The doctor wants me to wait for 2 weeks and have a P24 antigen test and a ELISA,I get why he would want me to have the ELISA 6 weeks after exposure,but why would he want me to have a P24?I mean at 6 weeks I'm out of the window period for it right?Also since yesterday evening I've had extremely watery diarrhea and a temperature of 101-102 degrees Fahrenheit and a really bad headache which is persistent.I went to the doctor and he said it might be Gastroenteritis.Now I would have ordinarily believed him without there being any two things about it,but this is the same doctor who recommended PEP for 6 weeks,so I have a little nagging feeling in the back of my mind that this might be something else(specifically seroconversion).Now I know that HIV cannot be diagnosed on symptoms,I get that this is an advise forum,but I was just wondering if I should just wait it out for a week and get tested as per my doctors recommendation,or get a a second opinion,or is there anything else you guys here can suggest?

Offline Andy Velez

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Re: Please help me,I'm going out of my mind
« Reply #54 on: November 18, 2008, 08:24:41 AM »
Our position here is that you ultimately will need to test at 13 weeks past your completion of PEP for a conclusive result. 

We've already expressed some opinions here which differ from your doctor's. I'm unwilling to get into a back and forth about that. I do expect you are going to test negative. And I repeat that from our point of view, which is one that I hasten to add concurs with that of the HIV scientific community, test at 13 weeks after completing PEP for a conclusvie result.

Your symptoms are neither HIV-specific nor surprising. You have just completed a course of very strong medications which often have strong side effects.

Good luck with your test(s). 
Andy Velez

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #55 on: November 24, 2008, 11:27:24 AM »
Hey Andy,Ann,JK,just swinging by to tell you guys that I tested negative on a  my 6 week ELISA,also according to a separate doctor and the helpline I consulted(it's a testing helpline)there's no difference between PEP timelines and non PEP timelines according to CDC guidelines,but I know I'm going to test twice after this anyways,but this is supposedly a really good indicator of my future test results,which makes me feel relaxed.I'll swing by with my 3 month result later.Thanks a lot for everything,God bless.

Offline Andy Velez

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Re: Please help me,I'm going out of my mind
« Reply #56 on: November 24, 2008, 01:12:36 PM »
Yes, it is a good indicator. And from our point of view your final all-clear will be when you test negative at 13 weeks after completion of PEP. And I do expect you will continue to test negative.

Cheers.
Andy Velez

Offline pep4hiv

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Quick testing question
« Reply #57 on: December 17, 2008, 06:59:54 AM »
Hi all,
I just got my exam time-tables today and found that they start about 8 days before my 3 months are up.I don't really want to wait until my exams get over to test,and so I was wondering if 10/11 weeks is the same as 13 weeks,and there is only a theoretical difference or there is a genuine difference.Also I had a cold and was wondering if that might give a false positive,seeing as how both are retroviruses.I previously had a negative 6 weeker and this test will be after the 10th week,the longest I could wait including the approximate time for the results would be about 10.5 weeks the day I get tested so that I know before my exams start.
Thanks in advance.

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #58 on: December 17, 2008, 07:37:49 AM »
You knew before you posted that 10.5 weeks is not 13 weeks.

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #59 on: December 17, 2008, 07:45:19 AM »
I agree rapidrod,I was just wondering if it makes a huge difference,that's all.Could you tell me if it does or not please?

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #60 on: December 17, 2008, 07:49:30 AM »
Take the test after your exams.

Offline Ann

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Re: Please help me,I'm going out of my mind
« Reply #61 on: December 17, 2008, 08:09:47 AM »
PEP,

There's not a huge difference between 10/11 weeks and thirteen. In fact, the window period in most of Europe is twelve weeks.

If it would help you concentrate on your exams, test before them. I'm fully expecting another negative result after your six week negative, and so should you.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline pep4hiv

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Just got my 11 week results.
« Reply #62 on: December 29, 2008, 09:03:57 AM »
Hi guys,I just got my 11th weeks results,and they were a complete negative,the report says non-reactive for HIV 1/2.Kit used 3rd Generation ELISA,now,I'm not questioning the negativity of my results,but just one more test sometime after about 3/4 weeks should be good right?I don't have to be monitored till 6 months right?I'm only asking cause on some article on the CDC I read the in case of PEP the patient should be monitored until 6 months later.Also I know this is a HIV forum,but could any of you tell me when an appropriate time for a full STD panel would be?I only ask because Ann(on some other topic) said that there are other STDs which also do not show up until much later.Thanks.

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #63 on: December 29, 2008, 09:08:46 AM »
You don't have HIV. MOVE ON.

Offline pep4hiv

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Re: Please help me,I'm going out of my mind
« Reply #64 on: December 29, 2008, 09:25:43 AM »
Thanks Rapidrod,will do.

Offline Ann

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Re: Please help me,I'm going out of my mind
« Reply #65 on: December 29, 2008, 11:40:23 AM »
Pep,

Ann(on some other topic) said that there are other STDs which also do not show up until much later.

???

Most STIs can be tested for ten days to two weeks following a risky incident, or sooner if you develop a discharge or lesion. One exception is syphilis, which shares a three month window with hiv for a conclusive negative result.

What you might be thinking of is when I sometimes say that some STIs often have no noticeable symptoms, just like hiv. This doesn't mean they can't be tested for in a timely manner. For example, it's quite common for people to not have any symptoms of chlamydia - and so they never bother to test for it. This is one of the reasons why it's one of the most prevalent STIs world-wide.

If you're going to paraphrase me, make sure you get it right. ::)

And by the way, you don't have hiv. No big surprise there, you never had a clear-cut risk to begin with as we've told you and told you and told  you. It's time you got on with your life, making sure you use condoms and use them correctly.

Ann
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline pep4hiv

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Thanks Guys
« Reply #66 on: December 31, 2008, 11:20:56 AM »
LOL,you're right Ann,I should have paid more attention.Thanks for all your support and help,and you too rapidrod,Andy and JK.I hope you guys have a great 2009,Happy New Year to all of you.

Offline pep4hiv

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Not too drag this on for too long......
« Reply #67 on: March 05, 2009, 01:12:28 PM »
Sorry I'm back again,but I just got what I hope will be my final test, the test showed a negative,however the values have doubled since my last test.The values on the latest test I took showed up as

Sample value:0.102
Cutoff value :0.332

My last test showed

Sample value: 0.047
Cutoff value : 0.325

This test was 100 days after I finished PEP and 4 months after exposure,can I take this to be conclusive and move on?Should I be even remotely concerned about the change and values?

Thanks in advance.

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #68 on: March 05, 2009, 05:09:51 PM »
You're conclusively negative. That's alll you need to know.

Offline Andy Velez

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Re: Please help me,I'm going out of my mind
« Reply #69 on: March 05, 2009, 05:53:18 PM »
Jeez man, give it up willya! Negative is NEGATIVE. Period. End of story.

Be happy about that, get on with your life and make sure you always use condoms for intercourse. No exceptions, whether you're in India or Indiana. They provide very effective protection against HIV.

 
« Last Edit: March 05, 2009, 05:55:15 PM by Andy Velez »
Andy Velez

Offline pep4hiv

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Delayed seroconversion.
« Reply #70 on: April 10, 2009, 04:47:25 AM »
Hi,I'm sorry to be back,but my doctor just mailed me a link that says that taking PEP can cause delayed seroconversion,and at first I thought it was just for exceptional cases,but posts on Medhelp which Teak(Rapidrod here)is present on,the doctor has replied to say that it is necessary to followup till 6 months after.Last month,I was pretty sick and I thought it was just the stomach flu,but now after reading the post and some threads on medhelp,I'm thinking otherwise,I have a lot of respect for the knowledge you guys have here and so I'll do whatever you guys reccomend,
                    Is it important or even relevant for me to test this later this month( at the 6 month mark)given the fact that I have taken PEP,or is the previous 3 month test good enough?The last test was properly after 3 months after finishing PEP.I'm only worried because of the varying information on post PEP testing time lines nothing else.This is the article my doctor mailed me

http://72.14.235.132/search?q=cache:tG83QGDRx3IJ:cfenet.ubc.ca/webuploads/files/SAS012909.pdf+Delayed+seroconversion+after+PEP+the+body&cd=8&hl=en&ct=clnk&gl=in

and this is the post on thebody.com

http://www.thebody.com/Forums/AIDS/SafeSex/Archive/Treatment/Q194795.html

The post on the body is quite recent,July 2008.

Thanks,and sorry for bothering you again with this.Happy Easter

Offline RapidRod

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Re: Please help me,I'm going out of my mind
« Reply #71 on: April 10, 2009, 05:15:44 AM »
3 months after your last dose of PEP. END OF Disussion. It's time you moved on.

Offline Ann

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    • Num is sum qui mentiar tibi?
Re: Please help me,I'm going out of my mind
« Reply #72 on: April 10, 2009, 06:44:11 AM »
Pep,

You have been told repeatedly you never had a clear-cut risk to begin with. I'm sorry if it disappoints you, but you have already tested more than conclusively negative. You don't have hiv and you're just going to have to deal with it.

If what your doctor told you puts doubts in your mind, then test out to six months. BUT. Do NOT expect to be able to come here and wring your hands while you wait for the six month point. As far as WE are concerned, you are hiv negative and that's that.

Post ONE MORE TIME about this this situation where you didn't have a risk that warranted PEP in the first place, one in which you have tested CONCLUSIVELY hiv negative, and you WILL be given a time out. Got it? Good.

Consider yourself warned for the absolute LAST time.

It's high time you got on with your life.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

 


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