Prep delay in accurate result??

[Palmtrees101]

On June 15th, 3 and a half months ago I had sex with another man after having a bit to much to drink. The experience scared me and I wanted to get tested and ordered Prep online.

Exactly 3 weeks later I had sex with someone else and took Prep on demand for the first time (2 1 1 1 1) I took about 6 pills just to be sure.

One week later, 4 weeks after exposure I did a 4th generation test it was negative.

For the following 3 months I took prep on demand ( 4 or 5 pills ) about 4 times.

I did 4 generation tests 12 and 15.5 weeks after that exposure both were negative.

I saw online that Prep can delay antibody response and window periods and they event is really playing on my mind and the anxiety is unbearable.

I know there is limited research on this topic but if anyone who understand how the virus work could shine a light on if there test results may be accurate?

[Jim Allen]

Hiya,

So I get this correct

15th of June you had sex. Condomless intercourse, giving oral?
6th of July you had sex again with on-demand PrEP - Condomless intercourse, giving oral?

You tested four weeks after the first encounter, one week after the 2nd encounter.
Finally, you tested at 15.5 weeks post the first encounter, 12 weeks after the 2nd encounter.

Was this a rapid test or a lab antibodies test?

For the following 3 months I took prep on demand ( 4 or 5 pills ) about 4 times.

Were these encounters also condomless?

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Continue taking PrEP as an additional layer of HIV protection

Keep in mind that some sexual practices described as ‘safe’ in terms of HIV might still pose a risk for transmission of other STI's, so please do get tested regularly and at least yearly for 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.

Kind regards

Jim

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[Palmtrees101]

Hi thanks for getting back to me. Thanks in advance.

The first encounter I was the top and I used a condom. My concern is that I fingered the guy quite vigorously and it was dark. I remember my hands getting very messy. They may have been covered in rectal mucous but I can’t remember as it was dark. I didn’t wash my hands and did finger myself after. And be fingered me too. No oral.

I read online rectal fluid is the most infectious bodily fluid so am very concerned, I infected myself.

On the 6th of July I used on demand Prep, and had protected sex Top, btm and oral.
The same for the other 4 encounter over the following 3 months with 2 weeks or so gap in-between sex where I was not using prep.

No I tested 12 weeks after the first encounter on sept 9th and 15.5 weeks after the first encounter on 1st Oct.

All theses were 4th generation ag/ab laboratory tests.

I’ve been really struggling with anxiety over the encounter on the 15th of June, it’s been hell, he was from Grindr and it was defo out of my comfort zone.

I’ve got really hung up know if these tests are accurate. If I knew they were accurate?? I could move on with my life.

[Jim Allen]

Hiya,

Thanks for the details, ill try to cover all of this.

The first encounter.

Fingering and being fingered regardless of the fluids on your hands is no HIV risk to you.

Several missing conditions for HIV infection to occur and barriers to this, such as that HIV is fragile and sexually only acquired inside the confines of the human body as in never being exposed outside the body, as the receptors needing to infect corrode. In short. It makes sense nobody has acquired HIV from fingering.

Now I know you did not mention any concerns about the intercourse, but ill add HIV can't transmit through an intact latex or polyurethane condom. If a condom fails during the act of intercourse, it's obvious. There is no reason to stress or test outside of the standard routine as long as this obvious issue during intercourse does not happen.

The other encounters.

With protected, I presume you mean condoms. In that case, see above.
That leaves just the oral.

Receiving oral is no HIV risk to you whatsoever. As for giving oral, specifically giving blowjobs, the mouth generally lacks a route for HIV to infect, and saliva also neutralises HIV by damaging the receptors needed to infect human cells. It's such a minute risk that we don't even recommend testing outside of standard routine screening for HIV as every sexually active adult should.

Testing - The first encounter.

There was no reason to test for HIV regarding the first encounter as there was no exposure specifically.  The result you have is also conclusive.

I'll answer the delayed result fear/question, but keep in mind that you had no exposure to test for from that encounter to start with. There would be no delay from the first encounter. You started PrEP weeks afterwards and only on-demand usage, not continued daily.

See, at most, the HIV meds, in this case, on-demand, could only delay the number of days used directly after exposure at most, no more than that.  oPrEP/nPrEP/PEP studies into the topic of delays go back nearly 25 years now. It's nothing new.

Testing - The other encounters.

There is no reason to run out and test for HIV as the exposure was minute at most with or without PrEP.

Now you probably know PrEP is highly effective against HIV, but not a guarantee, so just out of best practice since you have started to use on-demand PrEP, test more routinely, i.e every three months for HIV and STI's. Not sure if your healthcare provider issued the PrEP? If not, you might want to mention it to them as they may want to run additional labs like a kidney function.

I’ve been really struggling with anxiety over the encounter on the 15th of June, it’s been hell, he was from Grindr and it was defo out of my comfort zone.

Well, I hope the above helps.

Look, Getting out of ones sexual comfort zone is not always a bad thing, it can be good and exploring/trying things is normal, but something about this encounter has triggered some stress. I'm sorry to hear that.

I'm aware that the PrEP, aside from giving the practical benefit of an additional layer of HIV protection when there is a risk, PrEP also provide some people peace of mind, even if there was no real HIV risk.

However, if you can't move past this encounter or feel overwhelmed by an event again/have these fears again, it might also be worth considering having a chat with a qualified therapist. 


P.s

Blood is the most infectious HIV fluid

[Palmtrees101]

Hi Jim thank you so much for getting back to me

This has been really reassuring. I think I’ll throw my phone away now so I can’t google anything more haha.

Just out of interest, where you said…

“See, at most, the HIV meds, in this case, on-demand, could only delay the number of days used directly after exposure at most, no more than that.  oPrEP/nPrEP/PEP and studies into the topic of delays go back nearly 25 years now. It's nothing new”

Really sorry! But I’m not sure I understand.. are u saying prep would only cause a delay if used in the days immediately after  exposure?

[Jim Allen]

You're welcome.

Really sorry! But I’m not sure I understand.. are u saying prep would only cause a delay if used in the days immediately after  exposure?

On-demand PrEP so yes, the PrEP is not continuous use and once HIV has taken hold antibodies will be produced.

Maybe that does not help, let me put it into testing examples.

Situation A: No PrEP

I had condomless sex today, I would test in 6 weeks time with a blood-drawn antibodies test and the result would rarely change. 

Situation B: On-demand PrEP

I had condomless sex today but was using on-demand PrEP, If I wanted to check, I would test 6 weeks after I finished my last on-demand PrEP dose from that encounter, instead of 6 weeks post-encounter.

Situation C: PEP

I had condomless sex today and will start PEP within 72 hours. Instead of testing 6 weeks post-encounter, I'm taking PEP for 28 days and would therefore test 6 weeks post finishing PEP.

I'll add that this would be the cautious approach to testing.

[Palmtrees101]

Hello,

I received a blowjob from another man and I am worried about HIV.

I know that receiving a blowjob is usually little to no risk.

However, the guy had been giving a different man a blowjob a few moments before.

Im concerned if there was cum in his mouth when he gave me the blowjob I could be at risk? 

[Jim Allen]

It's not an HIV risk.

Relax and move on with your life.

[Palmtrees101]

Thanks for getting back to me. Its reassuring that you say this is not a risk for HIV. Would you be able to help me understand why its not a risk? For my own peace of mind. 

[Jim Allen]

Well, where to start, after nearly 40 years of this HIV pandemic/epidemic in terms of BJ's there hasn't been a single documented case of HIV transmission to an insertive partner (the person being "sucked"), and you will not be the world's first.

Receiving a blowjob lacks the conditions required for acquiring HIV and there are too many barriers such as saliva and air etc. So stop stressing about being the worlds first, you are not the first person to get a blowjob from someone who gave someone else a blowjob... Trust me.

Now, if you had told me instead that you have given them a blowjob then my answer would still have been to move on with your life, although, given them a blowjob would have been a minute HIV risk, as in so small, that there is no need to test outside of yearly routine.

[Palmtrees101]

thank you

[Jim Allen]

You're welcome.