Exposure, then PEP, now scared

[Unktious]

Dear Poz Forum,

I am so scared.

In the last week of December, I had unprotected sex with a woman I had just met.

5.40a.m. - Exposure starts with unprotected sex.
6.00a.m. - Exposure ends.
6.30a.m. - We do HIV test.
7.00a.m. - Doctor says that she is HIV+.
7.27a.m. - I am started on PEP (Dolutegravir, lamivudine, tenofovir disoproxil fumarate.) at 1 hour and 47 minutes post exposure.

23 hours after exposure (21 hours after first PEP dose): I take second PEP dose (I panicked and did not want to wait until 24 hours are done, incase the drug concentrations in the body are dropping).

41 hours after exposure (21 hours after second dose:) I took third PEP dose, again, scared about waiting the full 24 hours.

65 hours after exposure (20 hours after third dose): I took fourth PEP dose. (By the 72 hours mark by which PEP should stop working, I had taken at least four PEP doses.

I took each of the doses from the fifth to 28th at exactly 10.p.m.

I had minimal side effects, which faded even more after I stopped drinking coffee.

But now on day 7 after I finished PEP, I started small headaches, sensation in  armpits, neck and groin. Today is 10 days after PEP. Today headache was not big problem but sensation in the neck was very strong. 

I am scared. I hope I was early for PEP but very scared that something did not work.

[Jim Allen]

5.40a.m. - Exposure starts with unprotected sex.
6.00a.m. - Exposure ends.
6.30a.m. - We do HIV test.
7.00a.m. - Doctor says that she is HIV+

This is nuts. I mean it, and I say that after even being asked about HIV from having sex with moo, moo cows, but this, if true, is messed up, and the doctor needs a good few verbal slaps for several reasons.  Please feel free to pass that on, and they can contact me and ill adminster the verbal slaps.

[Jim Allen]

You had condomless intercourse and started PEP; I fully expect you will be fine. Nothing you mentioned is HIV specific, and you should see your regular healthcare provider and get whatever is making you sick treated. 

Anyhow, the PEP is highly effective, so to confirm your HIV status test 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.

In the meantime, stop messing about with the PEP timing; take it every 24 hours and next time you have sex, use condoms!

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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[Unktious]

Thank you Allen,

I have worried that I messed up with the PEP in the first few days and made it less effective. I am waiting to test.

Do you think the doctor delayed to give me the PEP? It was nearly 30 minutes from the time our results came out when i was able to start the medicine. The doctor however was also counseling the woman during that time, as she had taken the news hard. I think she did not know her status and I have not talked to her since.

[Jim Allen]

Thank you Allen,

I have worried that I messed up with the PEP in the first few days and made it less effective. I am waiting to test.

Do you think the doctor delayed to give me the PEP? It was nearly 30 minutes from the time our results came out when i was able to start the medicine. The doctor however was also counseling the woman during that time, as she had taken the news hard. I think she did not know her status and I have not talked to her since.

Hiya,

You have not messed up the PEP or made it less effective. Just take it correctly from now on. PEP is highly effective when started within 72 hours post-exposure, and you started within 2 hours.

As said, I fully expect you will be fine; test when due after finishing PEP to confirm your HIV-negative status.