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Author Topic: Insertive anal sex , condom broke and now on PEP  (Read 2340 times)

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Offline trevor84

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Insertive anal sex , condom broke and now on PEP
« on: November 05, 2013, 08:53:38 AM »
Hi,

Ann and others, I have read a number of posts that you guys have responded. I know what I am going to write will make you guys respond in a similar way but I still have to tell you what happened, just so I feel at peace.

So, on 5th November 8 pm Indian Standard Time (5:30 h ahead of GMT), I met a guy on an app and he performed oral sex on my for a really long time, about 30 minutes. In the heat of the moment (I avoid anal sex entirely, always), he encouraged me to top him. I wore a condom he gave me. Within a few seconds of thrusting the condom tore on the side and I removed and threw it. He insisted I wear another one and I did so. This too tore. I either wore it wrong or I was too drunk to realise he used oil instead of water-based lube. I asked him if he was tested and he did not give me a convincing answer. I did not ejaculate nor did I see any blood on his body, but all that can be microscopic. I am not sure if my urethra came into contact with his fluids.

I was very anxious and the next day, I went to a hospital and saw a general physician who put me on PEP for 28 days (Viraday by Cipla, also sold as Atripla abroad, I guess). I took the first tablet at 2:30 pm (around 18 hours after the possible exposure). The doctor I saw asked me to take my second dose at night before dinner. So, I took the dose a few minutes before I started to write this letter, and it has been almost 30 hours since my first dose of Viraday.

Now I know, that the possibility of him being HIV positive is not confirmed, but he very well could be, because he mentioned he meets a lot of guys. Second, I know the risks for the insertive partner is lesser and if the condom breaks, it is lesser than not wearing at all. However, it is still riskier than receptive oral sex.

The doctor has asked for an HIV PCR Quantitative Test after 6 weeks (2 weeks post PEP), which costs about $150 where I live and in a developing country like India, it is a bomb. I can't afford so much on a test but I will, if I have to. He has also prescribed B12 supplements.

Here are the questions that you are already used to responding. Honestly, when the answers are written for you, it feels a lot better. So I just have to ask them anyway. I promise I won't bother you with repetitive questions.

1. What are my likelihoods of being HIV positive after this particular incident, considering I started my PEP at the 18th hour and my second dose being 30 hours after my first dose? I am baseline negative and have always had safe sex.

2. My eyes turned red after my first dose of Viraday and I have mouth ulcers as well. The doctor is very expensive as he charges $20 per consultation (Remember, in India, $20 is a lot for a consultation with a general physician). I bought 30 tablets for $100, which again was very expensive for me. I want to continue taking these tablets and not ask for another drug so that I don't have to spend money on drugs again.

3. Someone asked me to do a P24 antigen test instead of the PCR after 3 weeks from the date of exposure, as it is cheaper. Should I do this?

I am worried sick.
« Last Edit: November 05, 2013, 09:05:21 AM by trevor84 »

Offline Ann

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #1 on: November 05, 2013, 09:14:38 AM »
Trevor,

1. What are my likelihoods of being HIV positive after this particular incident? I am baseline negative and have always had safe sex.

I've yet to see the insertive partner end up hiv positive following a condom break - PEP or no PEP - and I do not expect you to be the first.

2. My eyes turned red after my first dose of Viradaya and I have mouth ulcers as well. The doctor is very expensive as he charges $20 per consultation (Remember, in India, $20 is a lot for a consultation with a general physician). I bought 30 tablets for $100, which again was very expensive for me. I want to continue taking these tablets and not ask for another drug so that I don't have to spend money on drugs again.

Red eyes are not a side effect of the meds you are on.

You should take your tablet two hours before or two hours after eating. The side effects of one of the meds in your tablet (efavirenz) can be more noticeable when taken with food. You should also take your tablet just before going to bed at night so you sleep through any efavirenz side effects.

To read more about the drugs that are in the tablet you are taking (it is the same thing as Atripla), see our drug information pages here.

3. Someone asked me to do a P24 antigen test instead of the PCR after 3 weeks from the date of exposure, as it is cheaper. Should I do this?

You do not need PCR testing, and three weeks post-PEP is too early for any testing.

Any PCR test result - positive or negative - must be confirmed with antibody testing. It's a waste of money.

The earliest you should test is at six weeks, and you only need standard hiv antibody testing. Some hiv antibody tests include p24 antigen testing, but this isn't really necessary.

The vast majority of people who have actually been infected will seroconvert and test positive by six weeks (or six weeks post-PEP). A negative result at six weeks (post-PEP) is highly unlikely to change, but must be confirmed at the three month point (post-PEP).

I seriously do not expect you to end up hiv positive due to this situation.

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 trevor84

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #2 on: November 05, 2013, 09:19:21 AM »
Thank you very much Ann, for responding. I edited my first question to include this: that I took my first dose 18 hours after my possible exposure and the second dose, 30 hours after the first dose (48 hours after exposure). Will the 30 hours gap make any difference? The doctor I consulted said it will not and I just followed his instructions.

Also Ann, the doctor told me to take the tablet 30 minutes before food (dinner).

Offline Jeff G

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #3 on: November 05, 2013, 09:22:35 AM »
The window period for pep is within 72 hours of exposure so you will be OK . Best of luck .

Offline Ann

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #4 on: November 05, 2013, 09:23:58 AM »
Trevor,

No, the one-off time gap won't make a difference. From now on just try to take it as close to 24 hours apart as you can.

Your doctor was mistaken. It's a well-known fact that the efavirenz component of Viraday should be taken on an empty stomach, and that means two hours before or two hours after a meal.

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 trevor84

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #5 on: November 05, 2013, 05:36:33 PM »
After taking my second dose I got a serious high and I couldn't move for about 2 hours. I shouldn't have eaten scrambled eggs I guess. I'll remember to wait for two hours before eating. I have been worried about two things that Atripla could probably do. I was diagnosed with insulin resistance last year and when I mentioned this to the doctor he just shrugged and said it wouldn't matter as it is only for 28 days. But I have read online that Atripla can cause diabetes. Can taking this for 28 days trigger diabetes in its full blown form? I'm 29 with a normal HBA1C (4.6) but impaired fasting glucose (105). Second I am a bit vain and I am worried if this tablet is known to exacerbate hair fall. I read forum pots on this websites about both the conditions and someone who posted that their condom broke, got HIV and hairfall increased on Atripla was banned and in one of the posts Jeff says he got diabetes cos of Atripla. I mean no offense but I just can't stop searching on Google about diabetes Atripla and Hairfall atripla.

Offline Jeff G

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #6 on: November 05, 2013, 07:56:41 PM »
A month of Atripla may raise your lipids temporarily but that's about it . Your hair wont fall out and you wont get diabetes .

I think the long term use of Atripla contributed to my diabetes , not caused it . The side effect profiles of these drugs only applies to you guys on PEP in a general way for the short term . Many of the the more serious metabolic problems that plague people living with HIV took years to develop . My lipids after long term use has greatly improved off the Atripla so a month isn't going to hurt you . 

Offline trevor84

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #7 on: November 08, 2013, 06:06:03 AM »
Hi.. Here is an update. I made the guy go get tested for HIV. The lab did a CMIA/P24 test and the results came back non-reactive with his index value being 0.17. Though he is negative, he has had unprotected sex prior to meeting me. He probably could be in the window period? The PEP is really tough and my hair has gone dry and brittle and it has started to fall. Today I have to take my 5th dose. I want to make him get tested on the PCR test but he won't agree. He isn't answering my telephone calls and cancels it when I call up. So, there is no way I will know if he is in window period or actually negative. I haven't been able to do/think anything but this, since Sunday (November 3, when the exposure happened).

Offline Jeff G

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #8 on: November 08, 2013, 06:15:19 AM »
You are on PEP and you are going to be OK . Stop harassing some guy to go test , the only test that matters is yours that you must take at the appropriate time . 

Think about it . Whats done is done and your test is what matters now .

Offline trevor84

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #9 on: November 08, 2013, 06:21:19 AM »
According to the protocol here, if the source tests negative, they ask you to stop PEP. So, my confusion is whether to continue PEP with all its side effects or just stop it. Or should I ask my doctor for a different drug combo other than Atripla, which probably is kinder to my body? I don't mean to harass him or anyone here by posting, but I am just confused what I must do, with regard to the remaining 24 days of PEP. Should I take his P24 test as a true negative and stop the PEP?

Offline Ann

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #10 on: November 08, 2013, 06:38:31 AM »
Trevor,

This other guy could very well be in the window period - and yes, a window period exists for the p24 antigen as well. See this post for an explanation - but DO NOT post in that thread.

Even if what's going on with your hair has anything to do with the meds you're on, it will stop and reverse once you stop taking it at the end of the 28 days.

What would you rather have, a short-lived hair problem, or hiv for the rest of your life?

Given that you've been complaining about the financial aspect of having to go on PEP, do you really want to shell out more money for a different set of drugs, ones that might well have the same or other side-effects? Either quit taking PEP all together or stick with what you already have.

I've yet to see the insertive partner end up hiv positive following a condom break - PEP or no PEP - and I do not expect you to be the first.

What you decide is totally up to you.

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 trevor84

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #11 on: November 08, 2013, 11:16:36 AM »
Hi Ann and Jeff,

I have decided to continue the PEP as long as my body allows. I am sorry I am asking this question again but the doctor I went to doesn't seem to meet a lot of HIV patients and has no clue what to say, except that PEP lasts for 28 days. I have no place to turn to, which is why I am coming back here to post.  I have read that hyperglycaemia is a side-effect of Atripla and as I am already diagnosed with insulin resistance, will I become completely diabetic in the near future? Is there something I could do to reduce toxicity? Can I take biotin tablets along with Viraday or will it interact?

Trevor

Offline Jeff G

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #12 on: November 08, 2013, 11:38:15 AM »
Trevor , you are not going to become a diabetic from 28 days of PEP so you can put that aside . Don't load up on supplements or change things up too much . Just take your meds at least two hours after a meal at bedtime .

You can do this . Go find something you enjoy and do it . Its going to be a long 28 days if spend it fixated on all the negatives . You are going to be just fine , so go have fun .   

Offline trevor84

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #13 on: November 08, 2013, 11:52:12 AM »
OK Jeff. I will remember what you just said each time I worry (which is like 24/7). I will try to stay away from the forums for a while and come back and let you guys know how the PEP goes. Thank you very much for your kindness.

Offline Jeff G

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #14 on: November 08, 2013, 12:02:28 PM »
You are welcome ... I have lived with HIV for 30 years and it seems to be much harder for you guys to live with the thought of it for 28 days LOL . I'm just kidding of course but be mindful that you are on pep and you are going to be ok and come out of this fine .

Offline trevor84

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #15 on: November 08, 2013, 12:04:59 PM »
I know Jeff.. A lot of us without a particular problem sound insensitive and self-centred, though that may not actually be the truth. Such is human nature. And I know you are kidding too.

I can't express how consoled I feel reading yours and Ann's replies again and again.  :)

Offline trevor84

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #16 on: November 10, 2013, 02:05:00 PM »
I have been taking domperidone to beat the nausea. I take it along with Viraday at night. Is this going to interact and render the medicine ineffective? Noticed sore throat, very low grade fever and nasal congestion today.. I take the tablet about 2 and half hours to 3 hours after my dinner. I do not get the scary 'highs' anymore..

Offline Jeff G

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #17 on: November 10, 2013, 02:09:29 PM »
I have been taking domperidone to beat the nausea. I take it along with Viraday at night. Is this going to interact and render the medicine ineffective? Noticed sore throat, very low grade fever and nasal congestion today.. I take the tablet about 2 and half hours to 3 hours after my dinner. I do not get the scary 'highs' anymore..

It will not effect your medication so you can relax .

Offline trevor84

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #18 on: November 11, 2013, 08:28:48 AM »
Jeff/Ann, I am sorry I am posting again but I have to get this out of my mind. When I took my first dose of Viraday, it was 18 hours (2:30 pm, Nov 4th) post exposure (8:30 pm November 3rd). The second dose was after 29 hours the next day (November 5th, 7:30 pm, 47 hours from exposure) and the third dose was again 29 hours later on the third day (November 6th, 12:30 am, 76 hours post exposure). I pushed the dose timing on the third day because Ann mentioned there has to be 2-3 hours gap after eating and taking it before bedtime reduces side effects (which has so far been true). My doctor had wrongly told me to take the tablet 30 minutes before food and I used to get scary highs.

Anyway, my new worry is that these lengthy gaps during those initial 3 days might somehow have compromised my treatment. Since the 4th day, I have been taking it around 12:30 am, before I sleep.

Offline Jeff G

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #19 on: November 11, 2013, 08:45:15 AM »
Trevor , that particular med is very potent and stays in your system a very long time . You will be more than OK if you take your one pill a day , the time of day isn't that important , just be careful to not take it with as fatty meal like we discussed before .

Offline trevor84

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Re: Insertive anal sex , condom broke and now on PEP
« Reply #20 on: November 11, 2013, 09:03:33 AM »
Ok Jeff. That's a relief. I shall continue to take domperidone in the morning and at night (2 tablets) to beat the nausea. I think I will take domperidone throughout my PEP regimen, as it has also helped me beat dizziness along with nausea. Thank you so very much. Will go out and try to distract my mind. You guys are awesome.

 


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