Scared + PEP question

[Mikemikee]

Dear all,

I would like to ask for my chances with PEP. I do huge mistake and had a protected sex with risky prostitute and my condom breaks...:/ I was unprotected in her vagina not for long time because during whole intercourse I continually check if my condom is OK. When I saw condom is broken I stop. She wasnt worried about that and if I ask if she is regulary tested she said NO what makes me really stressed. Than I found information about PEP and visit my doctor and he provide to me PEP (emtricitabine/tenofovir) which I take in 33h after sex but than I found on internet that for PEP is 3rd drug needed. I immediately call to doctor and he provide to me also Isentress as a 3rd drug which I take in 53hours after sex. Today is my last day on PEP and I am still very nervous.. I dont have any other symptoms like gonorhea etc...and all entry test before medication was negative. Now I am waiting for my final test at the end of January and it is really hard for me.

Questions:
1) Can you help to me evaluate my chances for transsmision of HIV if my condom breaks?

2) What are my chances that PEP will be effective with emtricitabine/tenofovir in 33hours and add Isentress in 53hours. Is this delay big problem?

3) Your colleague mention in many threads on this forum that she never see any case of seroconversion if condom breaks. Is it true?

4) What if she has high viral load? without treatment? I cant believe to public information that chance for transmission is only 0,04% for vaginal sex.

Appreciate your help and your point of view and I am very sorry I  bother you with my question during Xmass... Wish you all the best and hope everything will be good.

[Jim Allen]

1 & 2

The condom broke; it meets all the biological and environmental conditions needed for you to acquire HIV and has led to people acquiring HIV.

Now, as the insertive partner, it is less risky than it would be for the receptive partner, but it's still a real-world risk that at least warrants testing. Now, you started PEP in a timely manner, and PEP is highly effective so you should fully expect a non-reactive result when you do the test.

So relax and test to confirm your HIV status six weeks after finishing PEP with a blood draw (lab) HIV antibody test. A non-reactive result at that time would rarely change, and retesting at three months is generally unnecessary.

3 & 4:

I normally ignore these questions but the ill answer just for the hell of it.  Don't ask any follow-up questions about this.

So 0.04% is old, not based on the region you are from either, but yeah, it's statistically low; HIV is not very infectious, most of the population you have sex with will not even have HIV to start with, and you are the insertive partner, so less route, exposure and surface area to acquire HIV.

From a risk assessment point of view, we will presume they are living with untreated HIV, but even with that, your odds could be as low as 1% or as much as 25%+ with the right conditions.  However, you took PEP, so you should expect to be fine.

As for what someone else claims to have seen or not seen, I can't comment on that, but I will say that I've never seen a dolphin, whale or shark in the wild but if I believe the discovery channel, the sea is apparently full of life.

Here's what you need to know to reduce your HIV risks:
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; testing is the only way to know.

Kind regards

Jim

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[Mikemikee]

Thank you for you answer Jime. But I would like to ask also the PEP scheme... does it mean it is not problem that I added Isentress little bit later ( Emtricabine 33h and Isentress in 53h)? Also a was little bit cold during the threatment and in last two days of PEP i catch covid-19 :/ This is my last question and once again thank you for your effort and help a really aprreciate.

[Jim Allen]

Asked and answered already. You started a full PEP regimen before the 72 hour mark hence I said:

you started PEP in a timely manner, and PEP is highly effective so you should fully expect a non-reactive result when you do the test.

So relax and test to confirm your HIV status six weeks after finishing PEP with a blood draw (lab) HIV antibody test. A non-reactive result at that time would rarely change, and retesting at three months is generally unnecessary

As for having a cold it happens, changes nothing