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Author Topic: Doubts, doubts, doubts  (Read 1031 times)

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Offline BrazilianFriend

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Doubts, doubts, doubts
« on: April 13, 2017, 12:39:24 PM »
First of all, hello everyone! I'm a Brazilian 26 yo man and I've been reading your forum for a long time. I would like to congratulate you all on the amazing work you do here by sharing information and helping people. Thanks for being so generous and supportive. :)

Anyway, I have a couple of questions that I would like to address you:

1) I am negative and I have been in an open-relationship with a +man. He is undetectable and the condom broke about 11 days ago while we were having sex (I'm a top btw). As a consequence, about 20 hours later I started PEP and it's been 11 days since I started to take the pills. However, I've found interesting information about the partner study and it seems to me that undetectable people are not able to transmit the virus. In my country our health system does not even advice people to start pep after having unprotected sex with undetectable people because the risk is "very low" but there are countless doctors that still say that there is a risk and that PEP is still necessary in my situation. What do you guys think about it? Should I really consider the existence of a "risk"?

2)As I told you, I'm in an open relationship and today I had sex with a friend of mine who claims to be negative and disease-free. The condom broke (yes, again, even though there was lube) and I was inside of that "friend" for about 2 seconds. I am taking the PEP meds and I would like to know: a) considering the amount of time I was inside of him, should I worry about HIV or other STDs?  b) Should I extent the duration of my PEP due to what happened or should I stick to the 28 days of treatment?

Best regards,
BrazilianFriend
« Last Edit: April 13, 2017, 12:47:56 PM by BrazilianFriend »

Offline JimDublin

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Re: Doubts, doubts, doubts
« Reply #1 on: April 13, 2017, 12:52:54 PM »
Hi

I have moved your post to "someone I care about" section, you can post your questions or thoughts here in this section going forward, however you question to be honest is more of a "am I infected" question.

Most health departments would not give you PEP for this at least I can say that about Ireland and UK and most EU nations as your risk was near nonexistent. Anyhow you have started the course so finish it and if you want to stop first consult your doctor.

Quote
should I worry about HIV or other STDs?

If this was a risk of not well sure, but first have look here I am sure you will find it  very informative: https://www.preventionaccess.org/consensus
 
Truth is however I can not guarantee TaSP (Treatment as Prevention) and none of the other moderators here will either, see TaSP is a great thing and has been studied a number of times now and is very reassuring to both people living with HIV and their HIV negative partners.

I hope that answers you risk question and ill be honest I know some people will go as far as going condom-less based on that reassurance accepting the slight risk and trusting their partners.

This is something people have to decide firstly for themselves and as a couple what level of risk you want to accept/are comfortable with.  As for TaSP (Treatment as prevention), it is not something new, and has been shown to work a few times over and the short version is that if he has confirmed and sustained (>6 months) undetectable viral load than the risks of transmission greatly reduces to negligible. 

That is of course if he is on treatment, remains adherent to his treatment and remains undetectable. (UD)  Hence from a general safer sex point of view and something you will see back in messaging we give in the "Am I infected section" nobody can guarantee TaSP as it requires the individual to remain on the meds and monitored etc and not to experience treatment failure and to remain UD. 

I could personally never in good faith tell a HIV negative and sexually active person not to reduce risks where possible and to protect themselves additionally next to testing regularly.  Safer sex is simple a combination of tools used to reduce risks, TaSP is one thing but its not something within your control and so with keeping all of that in mind we tell people to use condoms and/or PrEP as additional layer of protection against HIV.

Condoms also give some protection against other STIs.  It all depends on what level of risk and trust you are comfortable with and willing to accept. This widely differs from person to person, from what I understand you are currently using condoms, he is using TaSP and you are testing.

Quote
should I worry about HIV or other STDs?


Yeah there are plenty of easier to transmit STI's and as you are sexually active you should (both) be testing regularly.

Jim
« Last Edit: April 13, 2017, 01:05:37 PM by JimDublin »
HIV 101 - Index & everything you need to know
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

Offline BrazilianFriend

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Re: Doubts, doubts, doubts
« Reply #2 on: April 13, 2017, 01:08:37 PM »
Hey Jim, thanks for your answer. Could you (or even other members) also share your thoughts on my other question as well? :)

b) Should I extent the duration of my PEP due to what happened or should I stick to the 28 days of treatment?

Hugs,
BrazilianFriend

Offline JimDublin

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Re: Doubts, doubts, doubts
« Reply #3 on: April 13, 2017, 01:12:21 PM »
Quote
you have started the course so finish it and if you want to stop first consult your doctor.

So as you have started the course, finish the course, ask you doctor on extending the course. If it was me personally I would not.

Quote
As I told you, I'm in an open relationship and today I had sex with a friend of mine who claims to be negative and disease-free.

Yeah, what he claims means absolutely nothing.

Jim
« Last Edit: April 13, 2017, 01:14:45 PM by JimDublin »
HIV 101 - Index & everything you need to know
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

Offline CaveyUK

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  • Posts: 1,053
Re: Doubts, doubts, doubts
« Reply #4 on: April 17, 2017, 08:09:03 AM »
From an HIV perspective, you had a higher risk with your 'negative' friend, where you cannot be sure of his status than you did with your UD positive friend. We know that UD means the virus won't be transmitted, so as long as he was UD at the time you had sex you should be fine in that regard.

Wider STD risks are a different thing. Unprotected sex, especially with multiple partners, means you need to use condoms at all times and get yourself regularly checked out.

There are many who are ditching condoms for sex with partners who are HIV+ and UD  due to what we know now about transmissibility, however this doesn't apply to you as you have multiple sex partners so it's super important for you to use protection at all times.

As for PEP, just continue for whatever the course is indicated for.
Diagnosed 29th Dec, after Home test 27th Dec 2015
29th Dec 2015 - CD4 160, VL 70,363, CD4% 16
Started Septrin 31st Dec & Tivicay/Truvada 12th Jan 2016
9th February 2016 - CD4 245, VL 96, CD4% 19
8th March 2016 - VL 61 (no CD4 taken)
5th April 2016 - CD4 354, VL  - UD (<40), CD4% 22
5th July 2016 - VL - UD (<40) (no CD4 taken)
13th September 2016 - CD4 432, VL - UD (<40), CD4% 28
13th December 2016 - VL - UD (<40) (no CD4 taken)
18th April 2017 - VL - UD (<40) (no CD4 taken)

Offline BrazilianFriend

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  • Posts: 4
Re: Doubts, doubts, doubts
« Reply #5 on: April 18, 2017, 06:25:23 AM »
From an HIV perspective, you had a higher risk with your 'negative' friend, where you cannot be sure of his status than you did with your UD positive friend. We know that UD means the virus won't be transmitted, so as long as he was UD at the time you had sex you should be fine in that regard.

Wider STD risks are a different thing. Unprotected sex, especially with multiple partners, means you need to use condoms at all times and get yourself regularly checked out.

There are many who are ditching condoms for sex with partners who are HIV+ and UD  due to what we know now about transmissibility, however this doesn't apply to you as you have multiple sex partners so it's super important for you to use protection at all times.

As for PEP, just continue for whatever the course is indicated for.

Thanks, Cavey! Condoms are our best friends. :)

Offline BrazilianFriend

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Re: Doubts, doubts, doubts
« Reply #6 on: May 29, 2017, 06:47:08 PM »
Hi guys, just an update:

I got tested today (21 days after I finished my Pep course) and it was a 4th generation test. The results came negative for HIV, Syphilis and Hepatites. Should i get tested again or the results can be considered conclusive? I've been reading a lot on the internet and many websites say that a 4th generation test after 14 days is very accurate.

Hugs,
Brazilian Friend

Offline JimDublin

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Re: Doubts, doubts, doubts
« Reply #7 on: May 30, 2017, 02:09:38 AM »
Although fourth generation tests shorten the time from exposure to seroconversion a repeat test at 3 months post PEP is still recommended to definitively exclude HIV infection.

In short testing before 3 months can give you a good indication of your HIV status, but test at 3 months after the exposure to be considered HIV negative.
HIV Testing

Now its up to you if you test further over this incident or not and if you happy to move on or not.

Jim
HIV 101 - Index & everything you need to know
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

 


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