Your help needed please

[Worried Dave]

I have just got back from a weekend in Prague. I had vaginal intercourse with a female sex worker and used a condom so am hoping that essentially eliminates any risk.

However, the following night, I essentially blacked out for unknown reasons (drank too much? drink spiked?) but know that I returned to the same club with my friends and paid for time with a sex worker. Other than a flash memory of being in the bath together with her, I cannot recall anything and so am obviously fearing the worst........

Aside from the obvious that I need to get myself tested - should I try to get post exposure prophylaxis (it is a little over 24 hours since the potential encounter)?? It is entirely possible that there was no sexual intercourse (I may not have been capable) but wanted to get your opinion on whether I should be ultra cautious. I keep thinking...what if we had sex without a condom (I know this is unlikely and the place where we were at seemed very strict about condom use)?

Thanks in advance for your opinions.....

[jkinatl2]

I certainly would not be keen on taking drugs that can have some serious side effects on a hunch.

Were I you, I would wait six weeks, get tested, then test again at three months to be sure.

[Worried Dave]

4 weeks of therapy to minimise the risk? Are there any non-reversible side effects with anti-retrovirals that would warrant not taking?

[jkinatl2]

4 weeks of therapy to minimise the risk? Are there any non-reversible side effects with anti-retrovirals that would warrant not taking?

Oh no, by all means do it if you feel you must. You appear to live in a country where cotst is not an option. And the risk of long term unwanted effects is very low.

I just think it's not needed.

Also, it adds a month to your testing window. But it's absolutely up to you.

[Worried Dave]

What makes you think it is not needed? If I had vaginal intercourse with an HiV positive sex worker, what would my risk of infection be? I understand female to male transmission rates are low?

I live in UK - where can I get post exposure prophylaxis? How bad are the side effects?

[jkinatl2]

What makes you think it is not needed? If I had vaginal intercourse with an HiV positive sex worker, what would my risk of infection be? I understand female to male transmission rates are low?

I live in UK - where can I get post exposure prophylaxis? How bad are the side effects?

Except that you don't know what you did. You were blacked out, remember?

If you are still obsessing over this, head to your nearest hospital. Maybe - MAYBE - a doctor will still prescribe PEP for you. BTW, instead of having this conversation while the PEP clock ticked (PEP's efficacy after the first 24 hours drops off sharply) you could easily have Googled the information yourself. This is not a chat room, rather it is a message board. It may be hours, even a day or more before your questions are answered.

You asked for my opinion, and I gave it. You can wait until someone else chimes in, sooner or later, or you can go to your nearest hospital or GUM clinic and see how that goes. I would be a little surprised if you were given PEP, considering you have no idea whether or not you even had sex. But this back and forth conversation tells me that you might indeed be so inclined.

[Ann]

Dave,

I really doubt you'd be able to get PEP - you don't need it. Sex workers use condoms to protect themselves - they're not going to throw their livelihood away on some sex tourist from the UK.

Even if you did by some chance get her to go bare (and this would have involved extra Euros - lots of them), your chance of being infected from a one-off insertive vaginal encounter is vanishingly small.

I really hope you don't waste precious NHS resources on this. While any sexually active adult should be availing themselves of GUM testing services on a regular basis, PEP is a whole 'nuther kettle of fish. A kettle you don't need to climb into.

Ann