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Condom break with HIV+ person, started PEP

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Scared2bits:
Hey,

I just need to share with somebody who will not judge me as the most unserious stupid human being there ever was .

Sunday morning this week I had penetrative vaginal sex with a CSW; initially used a condom but it broke. I must have gone more than a minute with it broken.

The CSW assured me she was HIV negative although she agreed to an HIV test. We did an oralquick test ourselves which came out positive for her.

I was overcome by the shock. I panicked. An old medic friend directed me to a health centre where I was started on PEP (TDF/3TC/DTG) six hours after exposure.

The PEP medz have been largely tolerable so far. But I now cannot stop reading about stories of PEP failure. I have seen articles online report that PEPís efficacy has never been proven in humans but only in macaque monkeys. That made my heart sink.

Two days later, I developed two tiny blisters on my penis; this worried me as hell. I had a cold the day before my exposure and it had now escalated; i feel mild discomfort in the lymphnode area as well.

The long and short of it is that I am scared that the PEP will not work. It is my only line of defense now. I am overwhelmed to be honest.
 

Jim Allen:
Hiya,

Until the condom broke, it was protecting you, and as the insertive partner, the odds are in your favour. Also, understand you started PEP within 6 hours, and PEP is highly effective, so finish the course as prescribed and then test to confirm your HIV status.

Test at six weeks post finishing PEP with a blood-drawn (Lab) HIV antibodies test, a non-reactive result at that time would rarely ever change and retesting at three months post completing PEP is generally not needed.


--- Quote ---The CSW assured me she was HIV negative although she agreed to an HIV test. We did an oralquick test ourselves which came out positive for her.
--- End quote ---

Next time just focus on yourself.

That test result isn't a diagnosis for her, and even if it had been non-reactive, it would have been meaningless to you due to the window period.


--- Quote ---The PEP medz have been largely tolerable so far. But I now cannot stop reading about stories of PEP failure. I have seen articles online report that PEPís efficacy has never been proven in humans but only in macaque monkeys. That made my heart sink.
--- End quote ---

 ;D
Stop reading crap online, it's not helping you.


--- Quote ---Two days later, I developed two tiny blisters on my penis; this worried me as hell. I had a cold the day before my exposure and it had now escalated; i feel mild discomfort in the lymphnode area as well.
--- End quote ---

Nothing to do with HIV from this encounter. See your doctor and have them check and treat the blisters and nodes.

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse correctly and consistently, with no exceptions. Consider talking to your healthcare provider about PrEP as an additional layer of protection against HIV

Keep in mind that some sexual practices described as safe in terms of acquiring HIV still pose a risk for other easier acquired STIs. So please do get tested at least yearly for STIs, including but not limited to HIV, and more frequently if condomless 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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Scared2bits:
Hi,

The anxiety is killing me right now and I do not have many people I can openly share with.

Today is day 16. I woke up with a night sweat. My lymph nodes today increased sensitivity in the groin, abdomen and neck. I also developed diarrhea this morning. I have had an upset stomach and I wonder whether it is connected to the anxiety or, more likely, the GIT response to the virus. I have lost appetite for food. Then later in the morning i got mild body aches in the shoulders. I have also had a mild on and off headache; while I initially thiught that this was a PEP side effect, now i suspect ARS.

This has all been awful for me. I do not think I will ever forgive myself. I have read (and I cannot stop my self from reading) that the chances of PEP failing rise if you either start it late, or the virus was a resistant one or there has been a lack of adherence to the regimen. I have been very disciplined with the medicine, taking it within the same 10-minute window every day. I started at 6 hours after thr act, which should be early. I suspect that it must be a resistant virus. I also suspect that the CSW was not virally suppressed as i do not think she was on medication.

I am confused, mentally drained, scared. I have been working from home but moved to the office today because i felt the world narrowing around me and I wanted to be near a community of human beings.

Jim Allen:
Hiya,

See your doctor and treat the issues experienced, I hope you feel better soon.

You had a relatively low HIV risk and started PEP that's highly effective early.  Stressing about this will not do you any good and just make you sick.

From an HIV point of view, I suspect you will be fine if this was your only exposure, just test as mentioned above to confirm that.


--- Quote ---I suspect that it must be a resistant virus.
--- End quote ---

--- Quote ---The anxiety is killing me right now
--- End quote ---

--- Quote ---I am confused, mentally drained, scared. I have been working from home but moved to the office today because i felt the world narrowing around me and I wanted to be near a community of human beings.
--- End quote ---

You have no logical reason to believe there is resistance, to start with odds are you didn't acquire HIV and that's even if you didn't take PEP and on top of that, the drugs you are taking are from three different classes including one with a high resistance profile.

This kind of thinking isn't helping you and stressing about things isn't healthy or helping you. Stop focusing on HIV, it's not going to change the outcome, focus on living your life, and what is within your control instead of stressing about things that are not an issue or aren't within your direct control, if you can't cope then consider seeing your doctor and asking for a referral to a qualified therapist.


--- Quote ---I also suspect that the CSW was not virally suppressed as i do not think she was on medication.
--- End quote ---

Well we already presumed the other person is HIV positive without treatment. If we presumed otherwise, there would be no need for PEP or testing.


--- Quote ---This has all been awful for me. I do not think I will ever forgive myself.
--- End quote ---

Forgive yourself for what? You had sex, it's a pretty common human activity.

Scared2bits:
Hi there again,

I did not want to use up my third reply until the conclusive test but now I am having to share my predicament more.

It is now day 36. Yesterday i had an anti body test come back negative but i am not at peace at all.

The diarrhea lasted only two days. On day 24, I developed a dry cough. It was not severe, but whenever it came, it sent an unpleasant sensation through my chest. Two days later, that sensation became throat irritation whenever I coughed. After two more days, I developed throat congestion. By day 30, when I finished the dose, the cough was subsiding but the swollen lymph nodes, headache and muscle aches remained. I then also developed a white spot at the back of my throat.

I visited the hospital on day 31, had a test which came back negative. The counselor told me to return after 3 months. However, on day 32, the muscle aches, lymph node swelling and headaches became much worse in intensity. They subsided on day 34. I however also then realised i had significant loss of body weight, (about 2.3kgs) in a space of about a month. My waist circumference has reduced from 33 to 31 inches in a month. I have had dehydration and my lips are dry and cracking most of the time.

I read on the internet that the only respiratory symptom for ARS is a dry cough. I have not had a fever but the dry cough is very telling. My biggest worry now is that i cannot start ARVs quickly to stop the infection in its early days. The weight loss is the most perturbing. The hospital cannot give me ARVs until i test positive yet if i started early, I could prevent a worse outcome. I even contemplated buying the ARV meds accross the counter and doing self medication so that i can prevent more weight loss.

How long would ARS last after PEP fails? Today i have had just mild headache, a little sensation in the neck lymphnodes. The rise in intensity of the symptoms that i experienced last week, coming a day after stopping PEP, proves that the PEP failed and was only mitigating the symptoms, and that when I finished the PEP the virus spread throughout the body and caused the symptoms to get worse.

This has been very difficult on me. It has affected my work and my relationships.


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