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Author Topic: PEP - Are Two Drugs Enough? What's my risk?  (Read 1261 times)

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Offline Jeff03301

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PEP - Are Two Drugs Enough? What's my risk?
« on: July 15, 2016, 09:56:18 PM »
Today I was the receptive partner in anal sex with a stranger who insisted he was HIV negative (and no other STIs). I noticed before he put the condom on that he had a lot of "precum". I insisted that he pull out before ejaculating (he ejaculated outside of my body). After we parted ways, I checked the condom and noticed a hole in it up near where the head of his penis would be. I called my doctor and was prescribed a PEP combination of Truvada and Tivicay. (Doctor was previously unfamiliar with PEP and had to look it up). The doctor said to take them together at the same time every day for 28 days. I took the first dose within about 4 hours of possible exposure. A couple of questions: Reading up on PEP, some sites say "a combination of three drugs". Should I ask my doctor to prescribe one more drug for the treatment? Also, a couple of sites say you shouldn't take both drugs at the same time, rather you should take one in the morning and one at night (if taking a combination of two drugs). Is this true? How bad is my risk, and am I on the right drugs? Thank you very much.

Offline JimDublin

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Re: PEP - Are Two Drugs Enough? What's my risk?
« Reply #1 on: July 15, 2016, 10:09:14 PM »
Hi

Quote
After we parted ways, I checked the condom
How did you check the condom?

As for the PEP, the combination you have contains 3 drugs. Truvada = emtricitabine and tenofovir and the Tivicay = Dolutegravir.  Take them as prescribed by the Doctor, I personally always took them at the same time.

Jim

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HIV 101 - Index & everything you need to know
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
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HIV TasP
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HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

Offline Jeff03301

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Re: PEP - Are Two Drugs Enough? What's my risk?
« Reply #2 on: July 15, 2016, 10:39:53 PM »
I checked the condom by picking it up and looking at it. There was a small round hole about the width of the round top of a pencil eraser when you look down on the eraser from above. So, I guess like a centimeter. The condom was slimy inside from his precum. I think the hole would have been located about where the ridge of the penis head would be. I hope this isn't too offensive, but there was a bit of fecal matter on the outside of the condom (I had thought that I had cleaned myself better, but I guess not). Before I checked the condom,. I noticed that there was some of my fecal matter on the head of his penis. I asked if the condom had broken, but he said it didn't. He said it got there when he removed the condom. I thought that weird because condoms usually turn inside out when you take them off. Again, I apologize for the graphic nature of this reply.

PS The woman at my pharmacy said Tivicay is "experimental". Should I be worried about this, and ask my doctor to switch me to a drug that has a more established record?
« Last Edit: July 15, 2016, 10:44:29 PM by Jeff03301 »

Offline JimDublin

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Re: PEP - Are Two Drugs Enough? What's my risk?
« Reply #3 on: July 16, 2016, 03:19:05 AM »
Quote
PS The woman at my pharmacy said Tivicay is "experimental". Should I be worried about this, and ask my doctor to switch me to a drug that has a more established record?

Tivicay is excellent and was approved in 2013, not sure what she means by "experimental" nothing "experimental" about it. http://www.medscape.com/viewarticle/846532

To be honest it sounds like the condom was damaged after being discarded, you have now started PEP and PEP is excellent in terms of preventing HIV infections from taking hold. Finish the course and test at 6 & 13 weeks post completing PEP.
I suspect that you are going to be fine when you do test.

Jim
HIV 101 - Index & everything you need to know
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

Offline Jeff03301

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Re: PEP - Are Two Drugs Enough? What's my risk?
« Reply #4 on: August 21, 2016, 02:39:14 PM »
This is just an update to share my experience with PEP, now that I have completed the 28-days course on the drugs. The first few days I felt a little nausea, but it subsided. I took the pills faithfully every day between 5 and 6pm for 28 days. I had no side effects while on PEP, other than one odd thing that I'm unsure if it's related or not: I have the sensation of a sunburn on my left shin, even though I don't have a sunburn there. Again, I don't know if it's related or not, but it started about 3/4 of the way through PEP and has not yet subsided even though I finished PEP a week ago. Now I have 5 more weeks to wait until I can get tested (and again at 12 weeks). I'm scared, but hopeful. I am writing this to encourage those going on PEP to stay on track with taking the drugs every day at the same time, and go all 28 days. Keep busy and try not to worry -- that's what I'm trying to do. Best wishes.

Offline JimDublin

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Re: PEP - Are Two Drugs Enough? What's my risk?
« Reply #5 on: August 21, 2016, 07:09:36 PM »
Hi

Glad to hear you finished the course. The sunburn feeling if it remains or you are concerned talk to you doctor as is not something associated with Tivicay.

I suspect you had no risk to start with, but do test to give peace of mind if it helps you move on.

Jim
HIV 101 - Index & everything you need to know
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

Offline Jeff03301

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Re: PEP - Are Two Drugs Enough? What's my risk?
« Reply #6 on: September 01, 2016, 11:19:23 AM »
Thank you so much for your reply and reassurance. There's something I've been too ashamed to admit ... The morning after my sex with the stranger (and one PEP dose) I had sex with my partner. (My possible infection happened at 2pm on Friday and my partner and I had sex at 10 Saturday morning.) I hadn't slept much all night so I was pretty exhausted. My partner took advantage of my "morning wood" and put it inside himself. In my dreamlike state, it took me a bit to realize what was happening and I pulled out. I didn't cum inside his body, but I was still freaked out. I probably was inside no more than a minute. I almost never have any precum, so I'm hoping that helps.  Then a few days later (6 days into PEP), we were fooling around and he entered me. I don't know why I let him. I haven't been able to find a definitive answer online about how soon after being infected that a person can pass the virus on to someone else.

I know what I did was dumb. I feel like such an idiot, possibly putting him at risk. We haven't had sex since - I've been using the excuse that I've been a little depressed and not horny, trying to buy time until I can get tested.  We have been together over 10 years and I've never cheated on him before. I've been having a midlife crisis this year and the thing with the stranger was a result of it.  I really tried to have the safest "safer" sex possible with the stranger, short of abstinence, to protect myself from HIV and STIs. No oral, kissing, or anything else. I just wanted to bottom because my partner rarely ever tops me. I wanted to get it out of my system and have an exciting experience and that would be that.

Coming to this forum eased my fears quite a bit, and I was worrying a lot less until this week. My partner told me that on Monday, he had a headache, diarrhea, and a fever that lasted about 24 hours. I know we don't talk about symptoms here, but the timing has me very scared. It was almost exactly 6 weeks since we had sex. I'm worried that might have been a seroconversion illness. I'm hating myself right now. I really hope thgat him being sick like that is just a cruel coincidence that the universe is playing on me to teach me a lesson.

Can you give me your thoughts about this situation? Thank you.

Offline JimDublin

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Re: PEP - Are Two Drugs Enough? What's my risk?
« Reply #7 on: September 01, 2016, 11:41:17 AM »
Hi

We do risk assessments here and provide HIV information.
 
Look go get tested for STI's first of all and than do your follow-up for HIV testing.
If you do have an STI I think you should tell your partner.

Jim

EDIT:

Look I should not and normally don't comment but I will.

My relationship ended as the person I loved lied, cheated and discarded the life we had. Grass was greener on the other side, so I have a sore spot when it comes to this.

Anyhow I think you feel bad because you betrayed 10 years of trust given to you by your partner. Well its not a nice thing to do and nobody here can forgive you as it does not effect us. It up to you but maybe you should start owning up to yourself to what you have done no excuses.

You did something, you took a decision to do something, nobody forced you to cheat, its that simple. The circumstances etc do not make it the right thing or excuse you. That's my view.

If I was you I would decide if you want to save the relationship or not ? If yes start working with your partner on resolving whatever is bothering you now, today do not wait because if you wait whatever the problem will grow and it will ruin it.

I wish you all the best.

Jim

HIV 101 - Index & everything you need to know
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

Offline Jeff03301

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Re: PEP - Are Two Drugs Enough? What's my risk?
« Reply #8 on: September 01, 2016, 12:23:14 PM »
Jim,
I know I was wrong and there are no excuses. My relationship hasn't been perfect but we've always had pretty good communication. I did reveal my midlife crisis issues as soon as they started and we discussed it at length, along with the occasional check-in. I'm going to confide in him what I've done, I just need to figure out when and how, some time when I'm less depressed and can think straight. This is the lowest I've ever felt. I'm hoping that I can get a negative HIV test in a few weeks so I can clear my mind a little and not go into the talk feeling shitty AND worried. I don't know what it will do to the relationship but it's the right thing to do.

I'm human and I made a mistake. I wish I had resisted the temptation. Yes I had a choice and I chose wrong. Yes I do feel completely disgusted with myself and there's nothing I can do to change it. I'm also so very sorry that I reawakened your bad memories of your relationship ending! You really made your point, though nothing you've said I haven't already told myself. I won't blame you if you are disgusted with me and won't respond to this. I thank you from the bottom of my heart for all that you're done for me and everyone else who posts their concerns here.

(PS I have been tested for all STIs except HIV because it's too soon. I don't have any STIs and haven't passed any on to my partner)

Offline JimDublin

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Re: PEP - Are Two Drugs Enough? What's my risk?
« Reply #9 on: September 01, 2016, 06:18:57 PM »
Hi

Look I would not worry too much about what I think, what you need to do is decide for yourself what you are going to do and whatever that is, I wish you all the best and hope things work out for both of you.  I mean that.

Jim

HIV 101 - Index & everything you need to know
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

 


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