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Author Topic: please evaluate my risk, very concerned  (Read 2125 times)

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Offline achilles

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please evaluate my risk, very concerned
« on: April 28, 2012, 08:02:49 PM »
hey guys, im a 23 yr old male, had a possible risk with thai SW. i had unprotected oral sex but i used a condom for intercourse but it was dark and after the 10-15min vaginal intercourse i checked it in the bathroom and the end of the condom covering the head had a big gaping hole (i would have noticed had it not been so dark/ me not been as drunk)

can yo guys please help me out and take my word that this breakage happened during intercourse at some point rather than telling me im crazy and did it somehow myself.

after some thought i decided to take PEP, started at 36th hour post possible exposure.

i finished the course and had no symptoms of ARS (i know you dont like to use symptoms as an indicator but just thought id say i didnt seem to get sick at all in the three months after)

at the 3 month mark i developed genital warts (to be confirmed at a GUM) but v itchy small bumps at the end of my penis, v sure its genital warts :s

Q1) would pep effect symptoms at all?
Q2) shouldnt PEP have reduced risk of all virus type STD's?
Q3) you may say risk is low for a brief one time vaginal exposure but as i was drunk and it was tailand i can not rule out the possibility of this being a post op transexual...what is the risk for that with condom breakage?

also please take the information i have given you and dont assume that im wrong and must not have broken the condom during sex, i am kind of distressed and would appreciate not to be dismissed as an idiot/liar when it comes to the facts i have given you. please give me some feedback, i am going to test as it has been over 12 weeks since the exposure.

Offline jkinatl2

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Re: please evaluate my risk, very concerned
« Reply #1 on: April 28, 2012, 08:13:28 PM »
PEP was designed specifically to fight HIV. It has little effect on other viruses (there is some crossover with a few HIV meds and Hep C, but that's not the issue here).

PEP is actually the same medical treatment people who have HIV use to keep viruses at bay. And believe me, people with HIV on treatment atill develop HPV, herpes, and a host of other STDs.

You took PEP, finished the regimen, and tested reliable negative three months after the completion of PEP (taking PEP adds a month to the testing window, as it suppresses viral replication). It has an outstanding success rate.

HIV is also much more difficult to transmit through vaginal intercourse from a female to a male. That, combined with the fact that the condom protected you until it broke, made your risk very very low. Possibly low enough not to even warrant PEP. But you took it, finished it, and are reliably HIV negative.

There are a couple common reasons why condoms break. When putting one on, it's important to squeeze the reservoir tip to make sure you aren't getting air trapped in there. Also, using lubrication if needed (water based/latex friendly) is important.

And of course, being pretty drunk when you put on a condom is a potential recipe for disaster. Or, as my brother knows, babies. My suggestions are either A) Watch the drinking when looking for sex, and/or B) practice putting on a condom when you are sober. Practice until you can do it without fumbling, in the dark, with most of your cerebral cortex offline. It's possible.

You have performed due diligence. YOu have tested at the appropriate time. And in the ten years I have been giving risk assessment on this forum, I have yet to see the insertive partner trst positive after a condom break, even without PEP.

"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 achilles

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Re: please evaluate my risk, very concerned
« Reply #2 on: April 28, 2012, 08:36:22 PM »
no no no....i have not tested yet, i will test but havent tested since the incident

Offline jkinatl2

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Re: please evaluate my risk, very concerned
« Reply #3 on: April 28, 2012, 08:40:17 PM »
no no no....i have not tested yet, i will test but havent tested since the incident

I have every faith that you will be fine.

"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 achilles

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Re: please evaluate my risk, very concerned
« Reply #4 on: April 29, 2012, 09:46:10 AM »
thanks for your kind words, does anyone else know the answers to my question?

Offline Andy Velez

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Re: please evaluate my risk, very concerned
« Reply #5 on: April 29, 2012, 09:55:35 AM »
Achilles, JK has covered the bases for you. You had a low level risk and by doing PEP you reduced the risk even lower.

For a conclusive negative result you should test at 3 months after the completion of PEP. And I do expect you to test negative.
Andy Velez

Offline achilles

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Re: please evaluate my risk, very concerned
« Reply #6 on: April 30, 2012, 02:30:34 PM »
i really appreciate replies from both of you, but i was hoping to have a specific answer to my 3rd question?

Offline RapidRod

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Re: please evaluate my risk, very concerned
« Reply #7 on: April 30, 2012, 03:13:17 PM »
i really appreciate replies from both of you, but i was hoping to have a specific answer to my 3rd question?
The risk would be the same even if it were a transsexual.

Offline achilles

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Re: please evaluate my risk, very concerned
« Reply #8 on: May 05, 2012, 12:39:57 PM »
after further researching I am very worried that as i have contracted hpv from this encounter than it is very likely another to be infected with hiv if the SW was infected?

does anyone know how likely it would have been to pick up that virus as well?

Offline jkinatl2

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Re: please evaluate my risk, very concerned
« Reply #9 on: May 05, 2012, 01:08:57 PM »
after further researching I am very worried that as i have contracted hpv from this encounter than it is very likely another to be infected with hiv if the SW was infected?

does anyone know how likely it would have been to pick up that virus as well?

HPV is super easy to pick up. The virus can be shed even when no visible warts are present. A ridiculous percentage of sexually active people have it. If you get tested for it, and happen to be negative, you might want to consider the vaccine. It's not perfect, but it protects against many of the more common strains.

Being infected with hpv will not increase your risk for HIV. HIV does not "piggyback" onto other viruses. If you have, for example, an open herpes or syphilis lesion/chancre, then your risk for contracting HIV is higher - not because of the NATURE of the lesion, but because of the obvious breach of the skin, which is your body's first and best protection.

As for your third question, the risk for HIV (and other STDs) with a post-op transsexual from Thailand is exactly the same as the risk for any other female.

I hope this conversation has given you the fortitude to get tested. You really need to do that. Going around and around with this theoretical stuff will make you crazy.

"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 achilles

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Re: please evaluate my risk, very concerned
« Reply #10 on: May 21, 2012, 07:24:15 PM »
hi guys, sorry to keep posting questions, i havent been able to test yet as i have been busy but will do soon.

I have been doing what probably i shouldn't (in terms of anxiety) and researching on the net about the sort of risk etc involved with my kind of exposure and have come across a few medical notes about hiv in thailand (subtype e) being much more infectious for hetrosexual transmission than other types, is this true? i am not on the brink of suicide or anything so dont worry about scaring me i just want to know if im reading reliable stuff or not?

Offline Matty the Damned

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Re: please evaluate my risk, very concerned
« Reply #11 on: May 21, 2012, 07:37:16 PM »
hi guys, sorry to keep posting questions, i havent been able to test yet as i have been busy but will do soon.

I have been doing what probably i shouldn't (in terms of anxiety) and researching on the net about the sort of risk etc involved with my kind of exposure and have come across a few medical notes about hiv in thailand (subtype e) being much more infectious for hetrosexual transmission than other types, is this true? i am not on the brink of suicide or anything so dont worry about scaring me i just want to know if im reading reliable stuff or not?

As you rightly note, you shouldn't be scouring the intert00bz looking for information. You might think it will assuage your fears but in fact it will only make your anxiety worse.

As JK noted above, you had a very minor risk, you took PEP and your HIV test returned a reliable negative.

You do not have HIV.

Subtypes, clades and all that other stuff do not matter. Your test result trumps all that.

MtD

Offline achilles

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Re: please evaluate my risk, very concerned
« Reply #12 on: May 21, 2012, 07:51:10 PM »
Your test result trumps all that.

MtD

i have not tested yet, not before i took pep as you re not required to do that in thailand.

basically if i test positive it will be resistant to meds which is making this whole thing worse

i wouldnt worry but since it seems i have devoloped genital warts (not confirmed) and the subtype e being infections i think i could have a higher chance of an infection, i know im a paranoid kind of guy and my knowledge could be patchy and misleading me but this is making me think now

Offline Matty the Damned

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Re: please evaluate my risk, very concerned
« Reply #13 on: May 21, 2012, 08:05:26 PM »
i have not tested yet, not before i took pep as you re not required to do that in thailand.

basically if i test positive it will be resistant to meds which is making this whole thing worse

i wouldnt worry but since it seems i have devoloped genital warts (not confirmed) and the subtype e being infections i think i could have a higher chance of an infection, i know im a paranoid kind of guy and my knowledge could be patchy and misleading me but this is making me think now

Sorry about that Achilles, I mis-read your earlier posts.

Still I don't think you need concern yourself about subtypes in this situation. Like JK I believe that you will test negative because your risk was very very low and you've taken PEP.

MtD

Offline Ann

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Re: please evaluate my risk, very concerned
« Reply #14 on: May 22, 2012, 04:39:55 AM »
Achilles,

What are you waiting for? Just go get the damn test done already. "I'm too busy" doesn't cut it. Go. Test. NOW.

I can't believe they don't give you a rapid test before initiating PEP in Thailand (I'm not calling you a liar, I'm expressing my surprise). For all you know, you may have been hiv positive BEFORE you ever went to Thailand.

We see it all too often here - people don't use condoms with people they date and only freak out over hiv after they've had sex with a sex worker. You need to be using condoms with ANYONE you have anal or vaginal intercourse with. It doesn't matter where in the world you are - hiv will be in the population. I live in the Isle of Man, a place where many people would not expect to find hiv, yet I'm only one of many living here with hiv. It's EVERYWHERE!

Go get tested. While we fully expect you to test hiv negative, you must test to make sure. And get those suspected warts checked out while you're there, and test for all the other STIs as well. Many can be present with no obvious symptoms, so the ONLY way to know for sure is to test. Ring your local GUM clinic NOW and get an appointment, or find out when their drop-in hours are.

I don't want to hear from you again until you come here to report your test results. Got it? Good.

Ann
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