Extremely worried- Potential PEP side effects or ARS.

[Recklesstemptation]

Hello everyone,

I would be very grateful for some advice as I feel I am trapped in a position and I am having some really dark thoughts.

So basically I had a potential exposure in Thailand. I was very drunk and I can't really remember much but what I do remember is that I received Oral off a transgender/ladyboy CSW who I had met on the street ( I didn't know she was TG or a CSW at this point). I then remember finding out that she was and for some absurd reason in my drunk state I remember trying to give her Anal. I remember pushing hard but I don't think I inserted but I cannot be sure. In the morning, there was a condom packet on the floor and I think she put it on me before I tried to insert her but again I can't be sure. I really can't remember. I think maximum from what I remember I rubbed her anus and maybe possibly dipped. I think I would remember having full blow anal sex surely- I do remember giving up initially but I am worried I may have taken condom off and tried again or something. The next morning my penis had no abrasions and didn't really feel how it would have if I had given her anal/ has sex.

I then started to panic and after 60 hours post exposure I went to a clinic and was prescribed PEP- Teevir (Tenofovir Disproxyl fumarate, emetricibane and efavirenz) due to the potential high risk nature of my exposure. I was also given an injection for Gonorrhoea and given deoxycycline tablets to take twice a day for 7 days post exposure.

I started taking the PEP and initially I had a few stomach cramps e.g. first week 10 days. I stupidly went out and drunk a lot 4 days after exposure whilst on PEP and smoked a lot whilst on holiday still. After this, I developed a dry cough (come down from smoking). When I got home a week after exposure I started to get a mild sore throat that was like I kept needing to swallow flem this lasted for around Day 9 post exposure to day 19 and went from swallowing flem to itchy/scratchy with the occasional need to cough. From around, day 10 post exposure I felt like I had a fever but I monitored this whilst at work and my temperature ranged from 36.8- 37.4 taken from the ear (highest recorded just after eating). However, I did feel hot/ like I had a temperature at times which may have been a hot flush. This lasted from day 10-day 17 with only a couple of hot flushes. Day 12 in the morning I had a possible swollen lymph node in my neck, but it felt like it subsided quickly and later on that morning the nurse at my work could not feel anything. The evening of Day 12 post exposure, I developed very itchy feet and on the morning of Day 13 I noticed I had a erythematous macropapular itchy rash on my feet and on my elbows. My back itched slightly but no visible rash and also the palms of my hands with possible rash but hard to tell. By Day 16 the rash had totally disappeared.
Day 20, I developed mouth ulcers (2  on inside lip, one on tongue and one on gum) but this followed a weekend of heavy drinking and smoking as well as for the previous week I had been drinking a lot of fizzy pop more so than I normally would (like 2 cans of diet cola a day at least). I also have had slight/mild muscle pains and hungover feelings in the morning.

Throughout all of this, I have been very stressed and worried and I have had suicidal thoughts. I finshed PEP 30 days post exposure and 3 days after I developed 2 more ulcers again after a night of heavy drinking and smoking.  After 5 days post PEP ending, I sat outside drinking and smoking and it was very cold and the next day I developed a heavy cold, with fever, night sweats, swollen glands (which were much pronounced, tender and sore than before) this lasted a couple of days and subsided.

I am terrified to get tested as I am worried that these symptoms I have had are not Side effects of the PEP and are the result of ARS.

I want to get an ORA saliva self test but I just need some advice on whether you think I will be positive or not based on your experience.

Any help/advice would be greatly appreciated.

[Ptrk3]

I gleaned the salient facts in your post related to potential exposure to the HIV.

I didn't note an activity that exposed you to the HIV, at least as you present the facts and recall them.

If you completed your PEP regimen, despite drinking and the like, you should understand that PEP, when commenced within the 72-hour guideline (which you have done), is highly effective. It appears to me that it is highly unlikely that you have contracted the HIV as a result of the activities you have described in your post.

Attempting to analyze symptoms as they may relate to acute HIV-infection is fruitless since such symptoms, if they occur at all, vary widely.

If you are ill, see your healthcare provider for proper examination and treatment, if applicable and appropriate.

Also, take care of your mental health: you appear to be fretting over nothing that presents a viable risk.

Assuming that you are working with the healthcare-provider who prescribed you PEP,
continue to work with him or her to test for an HIV-antibody test that conclusively indicates your "negative" status. 

[Recklesstemptation]

Thank you for your prompt reply, I have been under a lot of stress and worry and I have been having really dark thoughts.

I understand that PEP is effective but the constant symptoms have had me really worried. The rash in particularly. I forgot to mention on top of deoxycycline I took Azithromycin while taking deoxycycline as an extra precaution. That was around day 7 after acquiring it over the counter.

My issue is I live in a country where I will be deported if I am found to have it and I an struggling to get tested as the doctors are required to tell the government. Therefore, I need to get an ora saliva self test or just risk going for the antibody. I just wanted to know how likely is it that the symptoms are caused by the drugs I have taken as well as poor lifestyle/stress.

Thank you again.

I really appreciate it.

[Jim Allen]

Hi

The symptoms are not specific and you spent all night outside drinking and smoking and felt like bad the next day ... Well yeah that would be the case regardless of your HIV status.

If you are not working with a doctor on this than keep in mind PEP is highly effective and to test at 6 weeks and 13 weeks post finishing PEP for a conclusive result

Here's what you need to know in order to avoid hiv infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions.

Keep in mind that some sexual practices which may be described as ‘safe’ in terms of HIV transmission might still pose a risk for transmission of other STI's, so please do get fully tested regularly and at least yearly for all STI's including but not limited to HIV and test more frequently if unprotected intercourse occurs

Also note that it is possible to have an STI and show no signs or symptoms and the only way of knowing is by testing.

More information on HIV Basics, PEP, TaSP and Transmission can be found through the links in my signature to our POZ pages, this includes information on HIV Testing

Kind regards

Jim

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[Recklesstemptation]

Hi again,

I managed to muster the courage to do a ORA quick test today and it was negative. Thats about 3 weeks since I finished PEP.

Do you think that is pretty conclusive?
Would you expect it to change?

Thank you for your help.

[Jim Allen]

Hi

Its a rapid test post PEP. Look I would not expect your status to change because you used PEP but test 3 months post PEP for a conclusive result and going forward test for easier to transmit STIs and HIV at least yearly as a normal routine and use condoms for any intercourse

Jim