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Author Topic: PEP for insertive anal sex  (Read 1618 times)

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Offline Lisbon4848

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PEP for insertive anal sex
« on: April 10, 2014, 05:01:13 PM »
Ola from Portugal.

I'm a foreigner currently studying in Lisbon. I have been diagnosed by my doctor at home with OCD and hypochondria. I'm on an SSRI (anti-depressant/anxti-anxiety) to help cope with this.

I've been cutting down on my drinking recently because when I drink my memory gets foggy as a result of my SSRI. However, last Thursday night I had an encounter after a night out. You see, I am very scared of HIV infection. When I learned about PEP a few years ago, it seemed to play into my OCD and now I always ask myself if I need to take it within the 72 hour period. Even for oral sex and handjobs. I never resort to getting it though.

Last Thursday night I went to a sauna in Lisbon. I had had a few drinks and ended up chatting with a local Portuguese guy. We went into a cabin and I topped him. I am very nervous so I vaguely recall discussing HIV status with him, telling him of my last test. I also vaguely remember using a condom and even keeping the condom wrapper afterward to prove to myself we used protection. (Though I'm not sure if that wrapper was from the encounter because earlier in the evening, a man tried to penetrate me, but I said no. He was wearing a condom, so I dont know if I kept the wrapper from that and got mixed up.)

I was nervous because this guy had a friend who came into the cabin with us who he mentioned was high on cocaine, and this man tried to enter the other man without protection. I don't think he did, because the guy turned around and made him use a condom (I think). Even sober, I get scared of condom usage (like it may break, etc.) He didn't sit on me for long and I rimmed him and finished and left, but felt very ashamed.

I went to an A&E in Lisbon on Friday and had to wait hours to discuss the issue with a doctor. They gave me a starter pack and sent me to another hospital to discuss with an Infectious Disease specialist a few days later. This man was around when HIV-2 was discovered and was jovial with me, mentioning all of the probabilities were on my side.

I started PEP at 14-15 hours. Viread and Combivir. Today marks end of Day 7.

 The Combivir is making me quite sick. I am taking some anti-nausea meds to help, but it's mostly in the morning and I have been lying in bed all day. During this week, I have vomited twice in the morning, about 15-25 minutes after my Combivir dose. I didn't see any pills in the toilet but maybe some water and fizzy stuff? I did not repeat the dose. Will this affect the PEP?

I am on the PEP because I am nervous maybe I did not use a condom after all. This is the first time I have had sex in a sauna. I am feeling shamed and want to learn healthier and safer ways to express my sexuality.

Thank you for your help and time.

Offline Jeff G

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Re: PEP for insertive anal sex
« Reply #1 on: April 10, 2014, 05:15:58 PM »
HIV is not your problem . You used a condom and do not need PEP for a no risk encounter .

There is nothing we can do you to ease your anxiety . This is something you should be discussing with your therapist or doctor, we cant help you with your OCD or hypochondria condition . You did not have a risk for HIV so that is as far as we can go in the way of assistance .

Here's what you need to know in order to avoid hiv infection:

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence.

Although you did not have a risk and do not need to test for this specific incident , anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

Offline Joe K

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Re: PEP for insertive anal sex
« Reply #2 on: April 10, 2014, 05:36:49 PM »

I want to caution you about getting too drunk or whatever, to remember what you did sexually with someone.  Mixing alcohol and SSRIs is always a bad idea and if you wish to remain negative, you should avoid abusing before engaging in sex.


Offline Lisbon4848

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Re: PEP for insertive anal sex
« Reply #3 on: April 11, 2014, 08:51:04 AM »
Thanks for your replies.

I am staying on the PEP in the scenario I didn't wear a condom- I can't say for 100 percent I did or not. What would the risk be for a top with a partner bottom of unknown status in that scenario with no exchange of fluids? Coupled with the PEP I started at 14-15 hours? (Despite the two Combivir doses I may have partially vomited up)

Do you have any suggestions on how to tolerate the side effects of Combivir? It seems if I eat frequently and take dimenhydrinate, I'm not as ill.

I do agree that people on medication need to remember they are on meds before they drink. The mixture could be very troublesome in more ways than one.

Thank you for all of your help.

Offline Jeff G

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Re: PEP for insertive anal sex
« Reply #4 on: April 11, 2014, 09:03:32 AM »
You didn't need pep to begin with and its very effective at preventing infections so you need not worry about HIV at this point . Continue with proper nutrition if you want to mitigate some of the side effects .   

Offline Lisbon4848

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Re: PEP for insertive anal sex
« Reply #5 on: April 12, 2014, 08:25:04 AM »
Thanks Jeff.

I guess this is my final post.

The nausea from the Combivir has gone, but I noticed a rash on my torso today. Mostly to one side, but very faint colored spots, not raised, and they don't look like ARS rash photos I've found online. Would it be possible to undergo ARS 9 days after an encounter while on PEP?

My skin is quite sensitive and very fair. I am guessing it could be any number of things, but I read on the British HIV Association's PEPSE guidelines that those with a rash should get tested again to make sure it's not seroconversion. I haven't missed any PEP doses, besides perhaps vomiting up two partially (not totally sure), and taking one an hour late.

Doing my best to mitigate the anxiety and making some better choices. I appreciate the help and apologize for coming across as naive or ridiculous when people must deal with these issues every day.

Offline Ann

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Re: PEP for insertive anal sex
« Reply #6 on: April 12, 2014, 08:32:42 AM »

The rash is most likely from the meds you're on, not hiv. You don't need to be on PEP and I cannot understand why you're putting yourself through all this. Your hypochondria and OCD are way out of control - they're controlling you instead of you controlling them.

If you want to continue putting up with side effects from meds that you don't even need, crack on. It's your life.

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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 Jeff G

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Re: PEP for insertive anal sex
« Reply #7 on: April 12, 2014, 08:44:09 AM »
Its not ARS ... you must remember that you are only on pep for anxiety caused by your mental illness and not because you had an actual risk . Lets be honest here ... you remember the details of that night pretty well and even brought home a condom wrapper as a reminder that you did the right thing and used protection, you would have remembered if you had unsafe sex . You have acknowledged that you always had to fight the urge to seek out pep in the past but this time your fears escalated and you followed through .   

PEP is not recommended in situations like yours because you were the insertive partner with a person of unknown status ... so the best advice I can offer at this point is you need to go see your doctor and find out whats causing the rash ... it could be the meds but its something you should address with your doctor and not us .

Please continue to work with your doctors and therapist concerning your HIV phobia . Please do not buy a subscription to continue asking questions about this, we cant help you with your phobia . I'm wishing you the very best .     


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