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Author Topic: Conclusive testing after PEP  (Read 1669 times)

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Offline pep_user

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Conclusive testing after PEP
« on: January 20, 2022, 04:01:55 pm »
Hello forum,

I hope everyone is well. I wanted to seek guidance on the conclusiveness of testing following a course of PEP. I had an encounter with woman where she forced me to have sexual relations with her. I insisted on condom use but it broken during penetration leaving me unprotected for like 1-2 minutes. This person says they are negative for all STDs but for obvious reasons, I donít trust anything she says. She later on went to block me and I canít communicate with her.

Long story short, I was pretty traumatized and I sought PEP 30 hours after exposure. I took my pep religiously and never skipped a dose.

I have done the following testing:
Week 4 after exposure: PCR RNA - non detected; AgAb: non-reactive; Chlamidya/Gonorrhea/Hep C Ab: negative; Hep B: immune
Week 8 after exposure: AgAb lab: non-reactive; Syphillis: negative

* at this point, my doctor told me I was negative and that I should move on with my life; though searching the web and the CDC guidelines told me otherwise *

So,
15.5 weeks after exposure: Finger prick AgAb: non-reactive at planned parenthood
17.5 weeks after exposure: lab AgAb: non-reactive

For obvious reasons, this has been a very traumatic time for me. My girlfriend broke up with me because I have not been myself for quite a long time and I couldnít open up about my assault to anyone.

All I want is to know if I should test again for hiv or this is sufficient to exclude infection? Iím very worried despite my own doctor, a second infectious disease expert, Dr. Hook, Dr. Handsfield, and multiple sources telling me Iím conclusively negative.

What should I do? Is it safe for me to go back in the dating world? Im really scared if I end up infecting other people. I also did not have any other sexual interaction or exposure whatsoever since the event prompting PEP.

Your advice will be very helpful in this tumultuous time.

Offline Jim Allen

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Re: Conclusive testing after PEP
« Reply #1 on: January 20, 2022, 04:20:54 pm »
Hiya,

Your last test was 13 weeks post finishing PEP. This non-reactive result is conclusive over the concerning incident.

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider starting PrEP going forward as an additional layer of protection against HIV

Keep in mind that some sexual practices which may be described as safe in terms of HIV transmission might still pose a risk for transmission of other easier to transmit STI's, so please do get fully tested regularly and at least yearly for all STI's including but not limited to HIV and test more frequently if unprotected 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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As a member of the AM I Infected Forum you are required to only post in this one thread no matter how long between visits or the subject matter. You can find this thread by going to your profile and selecting show own post and it will take you here . It helps us to help you when you keep all your thoughts or questions in one thread and it helps other readers to follow the discussion. Any additional threads will be deleted.
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Offline pep_user

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Re: Conclusive testing after PEP
« Reply #2 on: January 21, 2022, 09:23:08 am »
Hello Jim,

Thank you for your response. I appreciate your reassurance.
In your opinion, what do you think about testing at 6 months after exposure, after PEP? Are these simply outdated information and there is no chance of an infection being missed when testing 13 weeks after PEP?

Iím worried about an infection being missed and me not getting on treatment early enough to prevent worse HIV complications.

Offline Jim Allen

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Re: Conclusive testing after PEP
« Reply #3 on: January 21, 2022, 09:41:45 am »
At six weeks post finishing PEP a non-reactive result from blood (lab) antibodies test will rarely ever change and retesting at three months is generally not needed.

However, you did a test three months post finishing PEP and as would be expected it was a non-reactive result and this is conclusive over the concerning incident. Testing at six months over a possible sexual exposure would be decades out of date.
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Offline pep_user

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Re: Conclusive testing after PEP
« Reply #4 on: March 06, 2022, 04:27:16 pm »
Hi forum,

Iím curious. It has now been 6 months since I finished my PEP treatment. Iím thinking of going into Planned Parenthood and get an Alere Rapid Ag/Ab. I havenít had any exposures in the meantime. Is there a chance this will come back positive?
Should I be worried about a false positive result?

I have been working on anxiety with my social worker and things have been a lot better but sometimes it comes back and I feel like maybe testing again will help.

Offline Jim Allen

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Re: Conclusive testing after PEP
« Reply #5 on: March 06, 2022, 09:20:55 pm »
Hiya,

You have conclusively tested negative over the concerned encounter, this non-reactive result isn't going to change unless you have had other more recent exposures.

Quote
Should I be worried about a false positive result?

That's never a real concern, false reactive results on screening tests can and do happen, it's not a diagnosis though and any reactive results simply means more specific follow-up testing is required.

Jim.
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Offline pep_user

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Re: Conclusive testing after PEP
« Reply #6 on: May 08, 2022, 12:39:09 am »
Hi Jim,

Hope you are well. I'm back with another brief round of questions to see if you can help me assess. I wasn't sure if starting another thread was okay so I figured I keep it all in the same thread.

a) I did another round of testing at around 7.5months after the exposure warranting PEP. One Ag/Ab blood draw that has returned non-reactive and one PCR RNA that has returned non-detected. Is it fair to say this only confirms the negative results we discussed from earlier tests and that it is fair to move on from the August incident?

b) in the meantime, I have had 2 protected encounters (vaginal, used condoms that didn't break) with two people from my university. the first was about 32 days prior to my AgAb/PCR rna tests and the second was 18 days prior to that round of testing. Would you recommend to further test for HIV regarding those two exposures as well? My understanding was that if the condom does not break there is 0 chance of contracting HIV but the internet is giving me mixed signals and don't have the expertise to know what to do next.

c) I have decided to abstain from sexual practice due to the severe anxiety I have around HIV. I want, however, to be sure of my status with regards to hiv. Would you recommend doing tests at any timeline or were the tests mentioned in b) sufficient given what I have described?

Offline Jim Allen

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Re: Conclusive testing after PEP
« Reply #7 on: May 08, 2022, 02:14:07 am »
Quote
a) I did another round of testing at around 7.5months after the exposure warranting PEP.

The first time you posted, you had already had a conclusive result. No further testing was or is needed. You did not acquire HIV from the concerned encounter, end of story!

I wish you well, but please don't post about that encounter again or about testing over that encounter.

Quote
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.
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Offline Jim Allen

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Re: Conclusive testing after PEP
« Reply #8 on: May 08, 2022, 02:14:23 am »
Quote
b) in the meantime, I have had 2 protected encounters (vaginal, used condoms that didn't break) with two people from my university. Would you recommend to further test for HIV regarding those two exposures as well?

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 of the standard yearly routine.

So no HIV testing is needed over these encounters, just move on with your life and test out of standard routine yearly.

Condoms also reduce the risks of other STIs. However, the protection levels for various STIs depend significantly on how these infections infect. Some STIs (Not HIV) can also be acquired through skin-to-skin contact or viral shedding during sex on areas not covered by a condom, such as genital herpes, human papillomavirus [HPV], etc.

No need to panic or test every time you have sex though over STIs. Just test out of routine yearly.

Quote
c) I have decided to abstain from sexual practice due to the severe anxiety around HIV.

If your fears impact how you live your life, and in this case, your sex life,  your sexual life, I would recommend you consider talking to a qualified therapist. In addition, you could also consider using PrEP to provide you with an additional layer of HIV prevention and peace of mind.

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Offline pep_user

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Re: Conclusive testing after PEP
« Reply #9 on: June 30, 2022, 06:49:18 pm »
And back at it again, with another inquiry. I would appreciate the timely response given that I'm still in the PEP window (47 hours so far) and have to decide soon.

Long story short, I have messed up again and despite my determination to abstain, I was engaged in a massage therapy session with a up-scale CSW (appointment only + very high fee). The only genital contacts I had was me kissing her body (I understand to be risk free), and using my fingers to to stimulate her clitoris area. Granted my fingers never entered her vagina, and I was under the feeling that this is safe sex, but I noticed a small cut on my index finger (<1 cm long), the kind you get from peeled skin around the nail area. I do recall having some vaginal fluid over my cut, but all of the exposure was in open air, as I didn't have any insertion.

No other penetrative or oral sexual events took place. Upon inquiring from the lady, she laughed and said she is very healthy and well and is particular about the people she sees with no penetrative actions ever taking place.

The big question is, is there any risk associated with getting HIV from vaginal secretions over this minor cut? Should I pursue PEP again? It has been about 48 hours since the incident and I'm very confused and ashamed. I had a call with the San Francisco Clinic and they didn't recommend PEP nor testing. An in-person appointment with a nurse practitioner today saw the cut and told me I should be fine, Happy to attach a picture of my finger or send privately if helpful.

Is this really a no-risk event no matter the cut? Why do people say cuts are access to the bloodstream and consider this to be risk? Also how do I distinguish an open cut from a non-open cut and does that even make a difference?
« Last Edit: June 30, 2022, 07:06:18 pm by pep_user »

Offline Jim Allen

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Re: Conclusive testing after PEP
« Reply #10 on: June 30, 2022, 07:27:03 pm »
The vaginal fluids you are concerned about aren't an HIV risk to start with and the cut isn't an HIV route.

Now in theory if you had a cut that required urgent medical care and stitches, like cutting your finger off and instead of going to hospital, you instead stuck the bloody stump into her vagina, well, then in theory my concern would be with her, not you.

Quote
I had a call with the San Francisco Clinic and they didn't recommend PEP nor testing.

Makes sense, considering what you posted isn't an HIV risk to you.

Relax, Move on with your life!
« Last Edit: June 30, 2022, 07:31:19 pm by Jim Allen »
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Offline pep_user

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Re: Conclusive testing after PEP
« Reply #11 on: June 30, 2022, 07:40:18 pm »
Jim,

Your messages bring me a lot of peace. I truly appreciate it. Your sense of humor is also very appreciated! You are truly a blessing.

Yes, the cut wasn't substantial and if I recall correctly, there has not been any active bleeding.

So, you basically recommend no testing at all regarding this encounter? Would there be a case when a cut like you describe would result in HIV transmission or is the vaginal secretion not infectious as soon as it hit open air? Curious about how this is different than vaginal exposure, given that I continue to read there have been 0 documented cases through fingering.

Thank you again once more.

Offline Jim Allen

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Re: Conclusive testing after PEP
« Reply #12 on: June 30, 2022, 07:44:53 pm »
Hiya,

As said, move on with your life. So no testing iover what you posted is needed as you didn't have an exposure.

Quote
Would there be a case when a cut like you describe would result in HIV transmission or is the vaginal secretion not infectious as soon as it hit open air? Curious about how this is different than vaginal exposure, given that I continue to read there have been 0 documented cases through fingering.

Not sure what the question is. The fluids you came into contact with didn't have viable HIV to start with and as for fingering there are zero cases as it lacks route for HIV to infect.

Day to day cuts, scrapes or wounds aren't routes for HIV.
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PEP and PrEP

 


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