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Author Topic: Nieve practicionar  (Read 1416 times)

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Offline JustNeedHelp

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Nieve practicionar
« on: September 24, 2012, 11:34:02 AM »
I am a new PA graduate and have acted immaturely which has placed my career and life at risk.  I engaged in consensual incentive anal sex with what at the time would be a partner with an unknown HIV status (this event happened early Saturday morning) started off protected but the condom was removed by the partner and stupidly I continued for a few more moments before stopping.  The whole sexual act lasted no more then 10mins (protected and unprotected) Of course alcohol played part in my poor decisions. Anyway, quickly after withdrawing I poured Peroxide on my penis (all that was insight) and got dressed and reported to the other towns hospital to seek PEP for the exposure as I remember in PA school we had talked briefly on the subject.  I started PEP within 5 hours of the act, have adhered to the regimen which is Combivir with only one slight 3 hour late dose once.  I have searched the internet high and low, books, etc for answers/statistics/mental relief all with no help.  As my undergraduate work was in psychology I know that I am more then likely working me up more then needed.  However this is large.  I am a circumcised male, with no trauma to the mucosa or penile shaft at time of exposure, however my urethra is slightly open when erect, at withdraw there was no visible blood but with the peroxide obvious fluids were on the penile shaft around the meatus.  The following Monday, the partner agreed to test mine of course was negative his however came back “inconclusive” OraSure Advantage two times so blood was taken and sent out, results are still pending – I am assuming this to be a positive test.  I have read that the Combivir isn’t recommended alone for positive exposure a PE is also warranted, I had already passed my 72hour window at this time. I have read the varied statistics on nPEP, and it is not comforting plus everything is dated to 1997-2002 nothing more recent other then PrPEP. 
I see sites that say insertive is 0.06% with vaginal being 0.05% for insertive, I see that being circumcised reduces risk by atleast 50%, and then the effective rates of PEP is 86% in Occupational but nothing in nPEP.  I am just at loss because one site says this then another is something different.
I have a feeling deep inside that this is not a good situation for myself, and that on the test 6 weeks post exposure, and 3 months at conclusion on PEP I will seroconvert.  The Body site isn’t any help at easing the mind as Dr. Bob isn’t very reassuring with PEP, or the insertive partner.  As you can imagine I am extremely scared.


Offline Ann

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Re: Nieve practicionar
« Reply #1 on: September 24, 2012, 01:22:29 PM »
Just,

I have to admit that I can hardly make heads or tails of what you're written, but I'll take a stab at it.

It would seem you had unprotected, insertive (you were the top) anal intercourse that lasted a few minutes. You put peroxide on your penis afterwards. Right?

You don't know his status but he might be positive.

I can't tell if you're on PEP or not.

Combivir IS a valid, standard and effective PEP regimen, but you need to start it BEFORE 72 hours - by 24-36 is best.

If I'm correct in thinking you were the insertive partner (is that what you meant by "incentive"?) then I would expect you to test negative over this one-off insertive incident, PEP or no PEP. However, you would be prudent to test at the appropriate times.

Can you clarify if I understood you? And what is a PA graduate or PA school? If you mean Physician's Assistant, how did you graduate when you can't write coherently about health matters?

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

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Offline JustNeedHelp

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Re: Nieve practicionar
« Reply #2 on: September 24, 2012, 05:18:28 PM »
Sorry I used an iPad which has its own mind when typing plus my nerves are shot.  You have the basic jest of the situation, I was insertive partner, intercourse lasted a few moments unprotected, yes I used peroxide on penis after intercourse, I am on Combivir BID which was started within 5hours of exposure, His status at the time was unknown but he did agree to test the Monday following the exposure which came back what I assume is positive.  And yes PA as in PA-C, Physician Assistant I wasn't writing as if I were dictating

Offline jkinatl2

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Re: Nieve practicionar
« Reply #3 on: September 24, 2012, 05:27:58 PM »
Sorry I used an iPad which has its own mind when typing plus my nerves are shot.  You have the basic jest of the situation, I was insertive partner, intercourse lasted a few moments unprotected, yes I used peroxide on penis after intercourse, I am on Combivir BID which was started within 5hours of exposure, His status at the time was unknown but he did agree to test the Monday following the exposure which came back what I assume is positive.  And yes PA as in PA-C, Physician Assistant I wasn't writing as if I were dictating

Peroxide on a penis after sex? WTF? Not to be mean, but I sincerely hope you are just now starting PA school. Peroxide, bleach, or a sound pounding with a mallet is not going to do a damned thing to prevent an STD, including HIV, after the fact. The mallet might prevent future issues with STDs, however, so there's that.

As Ann said, you are unlikely to test positive, PEP or not, after this one-off event. Since you are on PEP, however, might as well make use of it.

As far as the statistics you quote, they are useless. They arise from a discredited study that still finds it's way along the internet and the offices of lazy physicians and less-than-dedicated HIV hotlines. There are far too many variables to put your level of risk in anything but a vague ballpark. Yours was on the lower end of high, in the outfield if you will. I'd certainly recommend using a condom in the future, however.

And for your own sake, it might be an idea to look into getting a bluetooth physical keyboard for that iPad. Some models are not that pricey, they sometimes double as cases/protectors, and they REALLY help when typing. Also, autocorrect can be a pain in the dock connector.

"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

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Offline JustNeedHelp

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Re: Nieve practicionar
« Reply #4 on: September 24, 2012, 05:40:25 PM »
I know peroxide isn't effective, it was the first thing in sight remember I was intoxicated. And I have since graduated, and fully practice but in family medicine, not infectious disease.

Offline jkinatl2

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Re: Nieve practicionar
« Reply #5 on: September 24, 2012, 07:29:13 PM »
I know peroxide isn't effective, it was the first thing in sight remember I was intoxicated. And I have since graduated, and fully practice but in family medicine, not infectious disease.

Rest assured, you will need to know accurate and up to date STD prevention, including HIV prevention/care, in family practice.

"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

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