Condom broke

[akrissify]

Hello,

Please could I have some advice as I am very worried.

I received anal sex from an anonymous male on Tuesday.  As the receiving partner, I insisted the male use a condom.  The sex lasted for about 3-4 minutes.  After the sex finished and the male left, I checked the condom and was horrified to find a smallish hole in the end.

Judging by the state of the condom - it was clean inside and there were no marks of semen or milky stains - it appears the male did not ejaculate.  Sick with worry, I strained my bowels to try and identify if the male had indeed ejaculated inside me and if any semen or fluid would come out.  Traces of saliva, which he used as lubricant, did come out of my insides, but nothing else.  {I am sorry for posting this detail, but felt it necessary to do so, so you have the full picture}.

The following morning I attended my local GUM clinic and was given a 3-day course of PEP, and I must attend tomorrow and pick up the remaining 28-days.  I have not had any side effects from the PEP, but naturally, I am extremely worried.

I already suffer from obsessive compulsive disorder, which leads to anxiety and stress. 

Given the above information, please could someone knowledgeable tell me how much of a risk I took.

If the male was HIV positive, does this guarantee that I will be infected?  Does the fact that he may not have come at all change anything?  Does it make any difference that I forced any fluid out of my insides?

Thank you for reading this and for your help.

[Andy Velez]

It is unusual for a condom to have the kind of tiny hole you are reporting.

The odds are in your favor that you will come out of this ok. It was a single incident and apparently without ejaculation having taken place anally. And you began the PEP treatment early on. All considered I expect you to come out of this ok.

You will be able to test for a conclusive result at 3 months after you complete the 28 day PEP regimen.

[akrissify]

Dear Andy

Thank you for taking the time to respond to me.

I am almost 2 weeks into the PEP SE treatment, and the side effects are minimal, although I have another problem which I would like to ask you:

I had been taking Garlic Supplements for 1 week whilst on PEP SE (Truvada and Kaletra).  There seems to be some evidence on the internet that Garlic Supplements can make one of the Protease Inhibitors, Sanquinivir, less effective.  I am however not taking Sanquinivir.

I am very alarmed that I have been taking these Garlic Supplements whilst on Truvada and Kaletra.

Does this mean I have unintentionally lowered the effectiveness of the medicines?

I did not see anything in the Patient Information Leaflets for either medicine saying to avoid garlic capsules.

I have been taking quite a lot of the Garlic Capsules (probably more tablets than I should) because I had always heard how good they were for health generally.  Since discovering the info about PIs and garlic tablets, I have stopped.

Just as the anxiety had subsided, I am very worried again. 

Would the Garlic Capsules knock out the effects of all the medicines, ie the two combined medicines within Truvada and the two combined medicines within Kaletra?

Thank you again for your response.

[Tim Horn]

Would the Garlic Capsules knock out the effects of all the medicines, ie the two combined medicines within Truvada and the two combined medicines within Kaletra?

This really isn't anything to worry about.

Though garlic capsules have been found to interact with HIV protease inhibitors, the studies that were done several years ago looked at UNBOOSTED protease inhibitors (protease inhibitors that haven't been boosted in the bloodstream using another drug). You are on Kaletra, which contains two drugs -- one active protease inhibitor (lopinavir) and a second protease inhibitor (ritonavir) designed to boost the levels, and thereby the efficacy, of lopinavir.

As Kaletra contains ritonavir, the potential effect of garlic supplements on lopinavir levels is pretty much voided.  What's needed to ensure efficacy is entirely up to you over the next three-plus weeks: Take your meds exactly as prescribed.

Personally, I really don't think you have anything to worry about here. That said, it's good you're being proactive given your state of mind. You may not need PEP medically, but I hope it benefits you psychologically.

Tim Horn

[akrissify]

Hi Tim,

Thanks so much for your help.  I am really honoured that there are so many wonderful people on here like you who can offer people support.  It really means a lot to me!

Big hug
Aron

[Andy Velez]

You're welcome, Aron. We're glad you found the exchanges to be helpful.

[akrissify]

Hello,

I wanted to write here about my experiences with PEP SE, the post-exposure prophylaxis that was given to me after my risk, almost 3 weeks ago now.

I hope what I write here is helpful for anyone who has to go through the same thing of taking PEP SE.

I did not find much information elsewhere on the internet about PEP SE, and what is on some external pages, can be frightening.   Some sources talk of severe side effects that last for weeks and are debilitating, leaving you unable to get out of bed.

I want to say the following, in an effort to help and comfort other frightened people who may have to take PEP SE:-

When I went to the Hospital and was given PEP SE, I was extremely scared.  I already have OCD (obsessive compulsive disorder) related to health issues, so this was the worst possible nightmare for me.

The lady was nice and calm but the tablets given to me - the size, colour, smell and frequency - were alarming.  Then there was the constellation of side effects on the patient info leaflet inside.

My boyfriend was very supportive of when I started taking the PEP and helped to remind me that it must be taken exactly 12 hours apart.  So if you start taking at 9.45am, you must take it again at 9.45pm. 

There were very minor side effects, such as diarrhoea on days 1-2, feeling somewhat tired on weeks 1-2, very slight headache or fogginess on week 1 and general aches and pains weeks 1-2.

However, now I have been on PEP for almost 3 weeks, all the side effects have gone away.  I am able to run, cycle, walk the dog, and enjoy life again.  It will soon be time when I no longer have to take the PEP.

As for the "horrible side effects" or "aggressive effects on the body" that first horrified me when I was reading about these on certain websites, this never happened to me.  I have been surprised actually as to how easy the PEP SE is to take.  You will notice some differences to your body and sensations, but very minor.

I hope this helps to comfort people who are reading this, whatever your circumstances, and wanting to take PEP, but scared of the side effects.

For anyone starting PEP, try not to get anxious about it, do throw yourself into your favourite hobby to take your mind off it, and do talk to a friend or partner or your doctor or the nice people on here as much as possible.

take care
Aron

[Ann]

If anyone wants to know more about my 3-weeks on PEP so far, please feel free to post here.  I can only tell you my experiences, not medical advice, but I am happy to share them.    I would like to post again once I am off PEP to give you the full story.

AK,

BAD ADVICE.

If you read the Welcome Thread before posting like you're supposed to, you will have read the following posting guideline:

Only those Moderators and members who are authorized to answer questions in the Am I Infected? forum are permitted do so. Unauthorized responses may be deleted without permission of the poster. Repeatedly posting replies of this nature may result in a Time Out or permanent ban, at the discretion of the Moderator Team.

This means that other than authorised persons and yourself, nobody else is permitted to post in your thread, so don't encourage other members to break our rules.

I fully expect you to ultimately test negative.

Ann

[akrissify]

Dear Ann

I am sorry that I did not follow the rules to the exact specification.   I was only trying to help other people as it is incredibly scary taking PEP and there is very little information on the internet about what it is actually like.

I am upset by the way you have chosen to respond to me.  Firstly, my name is Aron not AK.  Secondly, you quote that I did not read the rules, but when one is having such severe anxiety about a situation, it is difficult to follow every single rule that this site lays down.  I posted on my own posting to try and help other people in a similiar situation who would get here by Googling the incident that happened to me and they could know that PEP really isn't that bad to take.  I expected more of a softer approach from a moderator on this site. I won't post again on here since you have made it clear that my comments about my own PEP course are not welcome, and I do not feel welcome now.

Aron

[Andy Velez]

Aron, let's not get off of the track here.

We do have a firm rule about members only writing in their own thread. It's clear that your intention was the best and kindly in offering your comments about your experience. Readers will still be able to benefit from your experience and that is a basic aim of this site.

I just want to remind you that you have to wait 6 weeks past completing PEP for an initial test. If you test negative that will be a good indication you are likely to continue testing negative for a conclusive result at 3 months post-PEP.

Good luck with your post-PEP testing.

[Ann]

Dear Ann

I am sorry that I did not follow the rules to the exact specification.   I was only trying to help other people as it is incredibly scary taking PEP and there is very little information on the internet about what it is actually like.

I am upset by the way you have chosen to respond to me.  Firstly, my name is Aron not AK.  Secondly, you quote that I did not read the rules, but when one is having such severe anxiety about a situation, it is difficult to follow every single rule that this site lays down.  I posted on my own posting to try and help other people in a similiar situation who would get here by Googling the incident that happened to me and they could know that PEP really isn't that bad to take.  I expected more of a softer approach from a moderator on this site. I won't post again on here since you have made it clear that my comments about my own PEP course are not welcome, and I do not feel welcome now.

Aron

Aron,

I apologise for using the abbreviation "AK" to address you by. It was simply a shortening of your screen name (I often do that) and I absolutely meant no harm or disrespect. While I read the important points of your post, I missed the name you signed with. My mistake.

I wasn't concerned about you relating your experiences on PEP - that is most welcome. However, you invited people to come into your thread to ask you questions and that was essentially inviting people to break our forum rules. That's where I had a problem with what you posted.

The heights of anxiety we deal with in this section of these forums are exactly why we have the rules in place that we do. This section has been running for over twelve years and we have learned through experience that letting non-authorised people respond or ask questions where they want to only leads to confusion and misinformation being bandied about. Confusion and chaos rules in that environment.

It creates more work for us when we have to correct all the (well-meaning) wrong information - and the misinformation and misconceptions only add to the overall anxiety in this forum. So please, make sure you read - and abide by - our posting rules. They're in place for your benefit as much as - if not more than - ours.

This forum used to be a free-for-all and trust me, it runs much better for everyone since the rules have been in place. If you would rather post in an hiv prevention and testing forum where there are no rules, maybe you'd feel more at home elsewhere. I'd rather you'd post here where you're only going to get the scientific facts rather than hysterical and just plain wrong replies, but it's your call.   

Your concerns over the lack of information for people on PEP have been noted. Perhaps in future we will include a comprehensive lesson on PEP. We're currently working on other lessons that will be pertinent to our members in this forum - I'll see about a PEP lesson being added to that list.

At the end of the day, given your description of what happened coupled with the fact that you started PEP in a very timely fashion, I fully expect you to come out of this hiv negative. You do need to test at three months following your last dose of PEP to be certain, but try to relax and expect a negative result like we are. Good luck and keep us posted.

Ann

[akrissify]

Dear Andy and Ann

I just want to say I am truly sorry for my posting above; I was just very upset that is all.  I now understand what you have told me about not encouraging others to post in my thread, and I will adhere to this. 

Thank you both for your kind and supportive responses to me.  This means an enormous amount to me.

I have had strong feelings of wanting to commit suicide since the incident with the broken condom.  I do not know if I will ever get to the 4 month test period.  I also have Borderline Personality Disorder.   

I have so much self-hatred, guilt and shame for what I did (sex with a stranger) that has ultimately lead to this. 

I know now that if I'd been honest with my psychiatrist about my impulsivity, I would not have put myself in that situation or behaved in such a way in the first place and would not be going through this.

thank you again
Aron

[Andy Velez]

You're welcome, Aron.

It's good that you have some awareness of your impulsivity. If you have an impulse to act upon your suicidal ideas you need to get yourself to the nearest emergency room and tell them what is going on. Life at its longest is all too short so personally I don't think you should hurry to that premature ending, but that's just my outlook.

It's also good that you are speaking up about your feelings of shame, guilt and self-hatred. I suggest you put away the whips and chains for now. I've never found that beating up on yourself is very productive. And being isolated with those kinds of feelings is not good either. Sounds to me like you need some practice in treating yourself with the gentleness that you would likely offer to any stranger in need of help. And talking with others about what is going on with you is a good way of stepping out of isolation.

There is only a limited amount we can do in this setting with emotional problems. As far as HIV is concerned I expect you to come out of this ok.

Good luck with talking with a professional and getting some support with the personal devils that are bothering you. 

[Ann]

Aron,

I agree with Andy - stop beating yourself up over this. You had sex with a stranger - it happens and I'd wager that most of us have done exactly that at some point in our lives. It's what people do.

Regarding hiv - I also agree with Andy that you're going to come out of this OK. As I stated previously, this was a brief incident, no cum was involved, and you started PEP in a timely fashion. You are going to be OK - provided you stop beating yourself up. You're human like the rest of us and we humans make mistakes. I know I have.

You're going to be OK. Believe it.

Ann

[akrissify]

Thanks Ann and Andy for both your replies.

You both take care too
Aron xx

[Andy Velez]

You're welcome, Aron.

Best regards.

[akrissify]

Hello

It is almost three weeks since I finished PEP.  I took it religiously and took every pill.

However, I've been feeling run down recently - not been sleeping, got caught out in the rain a few times, anxiety spiralling out of control - and my glands in my neck, armpits and groin have swollen up.

This is within the timeframe for seroconversion after coming off PEP.  I have no other symptoms, just the swollen glands.  They've been there for 3 or 4 days and are now on their way out as I've been taking paracetamol.

Does this sound like seroconversion, please?

[Andy Velez]

Swollen glands happen for all sorts of reasons and are not in any way an HIV specific occurence. I suggest you discuss the matter with your doctor and feeling run down as well. No, it doesn't sound like ARS to me.

And I still expect you to test negative. You can do a test initially at 6 weeks after having completed PEP. A negative at that point will mean that very likely you will continue to test negative at 3 months. 

[akrissify]

Thanks, Andy.  I thought that was the case, having read other postings on here.

thanks for taking the time to respond to me.

aron

[Andy Velez]

You're welcome, Aron. As I said, I expect you to come out of this ok.

[akrissify]

Hello

On Sunday 27 May, it will be 6 weeks after I finished PEP.  I have read that it is possible to take an HIV test at 6 weeks post PEP, however when I rang the HIV trust in Helsinki, they said I should wait for 3 months, ie don't test until 15 July 2012, 3 months after stopping PEP.

I saw my psychiatrist and she said I had developed a "severe health anxiety" after this and she gave me a prescription for Sertraline (Zoloft).  I am terrified about going for the HIV test, waiting in the doctor's room, giving the blood, and going back for the result.  I have had swollen glands in my neck and groin and muscle aches.  I take sleeping tablets every night just to get to sleep but usually wake at 4am.  I cannot stop thinking about what I did, and this whole thing has drawn out like a nightmare, thinking about it all the time, every hour, every day, waking in the middle of the night and thinking about it.

What would your advice be - should I test at 6 weeks or wait until 3 months have passed?

Thank you
Aron

[Matty the Damned]

Hello

On Sunday 27 May, it will be 6 weeks after I finished PEP.  I have read that it is possible to take an HIV test at 6 weeks post PEP, however when I rang the HIV trust in Helsinki, they said I should wait for 3 months, ie don't test until 15 July 2012, 3 months after stopping PEP.

I saw my psychiatrist and she said I had developed a "severe health anxiety" after this and she gave me a prescription for Sertraline (Zoloft).  I am terrified about going for the HIV test, waiting in the doctor's room, giving the blood, and going back for the result.  I have had swollen glands in my neck and groin and muscle aches.  I take sleeping tablets every night just to get to sleep but usually wake at 4am.  I cannot stop thinking about what I did, and this whole thing has drawn out like a nightmare, thinking about it all the time, every hour, every day, waking in the middle of the night and thinking about it.

What would your advice be - should I test at 6 weeks or wait until 3 months have passed?

Thank you
Aron

Why not do both? A negative 6 week test (even after a period of PEP) is an excellent indicator of what will happen at 12 weeks.

But you must test at 12 weeks to be certain.

MtD

[akrissify]

Hello,

After 4 months of waiting - and a lot of anxiety - I finally went for my final confirmatory HIV test.  The health advisor offered me the finger-prick test.  I cannot describe how terrified I was.  Over the past 4 months, the fear of the 'accident' with the broken condom and becoming HIV positive has seeped into every element of my life.  It has been a very difficult time.

I went to a clinic in London's Soho area and they were very nice there.  The health advisor explained that with the finger-prick test they can give me my HIV status in just 60 seconds.

As it has now been 4 months since the broken condom, today was finally the day I would find out.

Time seemed to stop for those 60 seconds.

The health advisor then said the result came back negative, that I had not contracted HIV.  I was overwhelmed with relief.

I would like to say thank you to everyone on this forum who has helped me.  Sometimes it had been very hard dealing with emotions and the enormity of having to wait 4 months over such an incident, as well as feelings of guilt and self-hatred. 

I also chatted to lots of people online and learnt over the past 4 months that people who do unfortunately get diagnosed HIV positive can live very long and enjoyable lives.  I am pleased to now be able to get on with the rest of my life.  My heart goes out to anyone reading this who is in the situation that I was, or who gets a positive diagnosis.  But you will be okay, whatever the outcome. 

Thank you Andy, Ann, Tim and Matt for answering my questions and supporting me, and all the wonderful help you have given to others.

Aron