Please help me !

[Member1303]

Thank you for actived my account and let me have a chance to write my case,
First of all , iam sorry about my english.
Iam male and had vaginal sex with prostitute 2 times, both times I used condom and also using Prep daily (already 15 day and 17 day ), but iam still worried and can't sleep because  :
at the first sex , I had a skin damaged on foreskin middle ( uncircumcised) by hard mastubated 2 hours before sex , when i put condom the foreskin pull down so i worried it's not covered by condom and maybe infected.  in the second sex after 2 day , the skin still peeling not healing yet.
I used daily Prep , My heath provider say it maximum protection after 7 days for male and 21 days for female , but after i research from CDC , or Brishtish health, it's a data for receptive not for me ( the insertive). I also search and got information that Prep protect Tops, straight male as well as bots but don't have Time for maximum effective. So I used Daily Prep already in 15 days , does it already enough effective protect me from HIV ?
thank you and waiting your reply , god bless

[Jim Allen]

Hiya,

Read your post three times; with or without PrEP, I don't see a concern for HIV.

Regarding PrEP, after 15 days, the levels of the drugs in your tissue are sufficient to provide an additional layer of protection against HIV, even if you are the insertive partner.

Another option for you could be on-demand PrEP (2-1-1 PrEP) instead of daily PrEP. On-demand PrEP it's not used for receptive vaginal sex but can be used for insertive sex or receptive anal sex. https://i-base.info/guides/prep/on-demand

Anyhow, move on with your life and, as a PrEP user, get an STI & HIV screening every three months if possible.

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. Keep using 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. As a PrEP user, it's recommended to get an HIV & STI screening every three months.

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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[Member1303]

Dear Mr Jimmy,
thank you for your information ,
yes i had thinking about Prep 211 but i was thinking daily prep had more effective if i can hold it longer like 21 days.
1. Sorry to ask you again , but if my damaged foreskin is not covered by condom , you still think that not a risk ? I thinking about it so much , In case it not covered but at base penis  , when i thrust in and out , it exposed to air so will damage hiv and can't infected me right ?
2. Why some source say Condom only protect 70% hiv even you use correctly ? ( i used 1 for oral then i change for vaginal sex , iam sure i used at begin and correctly)
3. And I intend to test hiv after 1 month , but i used prep , does it effect to result ?
4. How many case fail prep for insertive people MR Jim ? i search and see result major about the LGBT male but don't know about there are tops or bots.
I used condom and prep but iam coward overthinking now , i ask so much , sorry for your time but i don't know what to do .

[Jim Allen]

1) Asked and answered already.
2) When used correctly and consistently, the male condom efficacy is close to 100% concerning HIV prevention. For some STIs, condoms have lower effectiveness, such as STIs that, unlike HIV, can be acquired through skin contact in areas not covered by the condom, and condoms can also break during intercourse.

So take away regarding HIV and condoms is HIV can't transmit through an intact latex or polyurethane condom, unless a condom obviously fails during intercourse, there is no reason to be stressing or testing for HIV outside the standard routine.

3) You don't need to test over this encounter. I'm not going to pretend you do, and yes, PrEP can extend the testing period should you ever have a real HIV risk. However, no need to worry; As a PrEP user just keep getting screened for HIV every three months.

4) Some claimed cases but it's not relevant.

Move on with your life. If you keep having these fears and irrational fears about HIV prehaps consider talking to a therapist.

[Member1303]

thank you for your patient to answer all of my question , i read it carefully and feel peace and confident my mind , i also did some research about how hiv infected , and saw it not easily to infect , it need some requiment like amount , temperature , enviroment to active , and i had 2 layer : condom and Prep. I think i had to worried about STIs like herpes, hpv and syphilis.
Thank again MR Jim

[Jim Allen]

You're welcome.

[Member1303]

hi , i already Pay-For-Participation to ask more detail about my case, sry but when i had free time i still searching how Prep effectiveness to me .
1. Could MR.Jim please tell me why 15 days is already enough drug level to protect me from hiv ? I mean i believe to your answer but all informations Prep just talking about Receptive not Insertive.
2. Iam very confuse about receptive male have studied 7days for maximum drug level but insertive male don't have any data , they are both "male" . Are Tissues in anal is different from penile tissues ?
3. Also they said ( also Mr. Jim) advice Prep 2-1-1 is suitable for Insertive male , mean it studied for prove to advice , so why Daily Prep is lacking data for insertive male ? Daily Prep Take a long time than Prep 2-1-1 , i Thought it's more effectiveness
 if could please answer detaily like 15 day prep support around 0-90% .
Thank you so much .

[Jim Allen]

Your doctor, who prescribed PrEP, has already explained it's effective.

Anyhow, in short, the CDC does not support PrEP for the insertive partner, whilst other organizations do; One of the reasons why the CDC does not is the lack of tissue samples from the penis, but feel free to contact them if this keeps you up at night.

The reason others recommend PrEP is based on several things, including but not limited to multiple studies showing a real-world reduction in the number of people acquiring HIV, including some insertive partners; PrEP should have similar levels in the tissues found elsewhere in the body that has been tested, regardless blood level concentrations are sufficient when taken correctly, same can be said with (n)PEP results and sometimes it just gives peace of mind to people. However, besides PrEP giving peace of mind, I would also urge therapy if you are dealing with HIV phobia or anxiety.

At the end of the day, as the insertive partner, your HIV risk is already lower than the receptive partner and PrEP or 2-1-1 PrEP is just an additional level.

However, you used condoms and had no HIV risk with or without PrEP. You are only taking PrEP for peace of mind, yet, it's clearly not giving you peace of mind, and I can't help you with irrational concerns in this setting.

I recommend that if you keep having these largely irrational fears about HIV and can't move on with your life, then you should at least consider talking to a qualified therapist about your fears and return to your healthcare provider who prescribed you PrEP, so they are also aware it's not giving you peace of mind as intended.

I wish you well, but please don't post about this again. You had no HIV risk from the events posted here.

Anyone who continues to post excessively, questioning a conclusive negative result or no-risk situation, will be subject to a four week Time Out (a temporary ban from the Forums). If you continue to post excessively after one Time Out, you may be given a second Time Out which will last eight weeks. There is no third Time Out - it is a permanent ban. The purpose of a Time Out is to encourage you to seek the face-to-face help we cannot provide on this forum.