High Risk encounter / Condom broke / PEP

[roaming99]

Hi,

I had a sexual encounter with a guy I met at a bathhouse two months ago.  I was the insertive partner and I felt the condom break literally 3 seconds before my ejaculation and of course I did not care to stop for such short moment. 

After I finished, I expressed my concern to this guy and he told me that in fact he was HIV+ but that I should not worry because "it was undetectable". 

I panicked and ran to the hospital where I was put on Truvada + Isentress for 20 days.  I started the treatment 8 hours after the exposure. The treatment went perfect exept for 2 missed doses (one that I took two hours late and one that I took one hour early).

It's been almost a month since I finished the treatment and I am complitely panicked to get tested and come back positive. 

My questions are:

1.  Given my case, what are my chances or having contracted HIV.  I've read endless threads on this page and I can conclude it is very low, but I wanna hear it anyway. (sorry).

2.  Is OraQuick effective in detecting HIV infections?  If I do that today, will it be able to detect it if I had it? or should I wait a little longer?

3.  two days ago (60 days after exposure aprox) I develop a very mild cold.  Do you think that's a bad sign?  Its symptoms are very mild.  No fever, no lymph nodes, just sore throat and nasal congestion.  Should I worry?

4.  Why is it less likely to contract HIV by being insertive than receptive?  (I'm just curious).

Thanks, thanks and thanks!

[Jeff G]

Hi Roaming , you are correct that part of the equation that makes for a low risk situation if the brief insertion time that the condom was broke and the fact you were the insertive partner . What's done is done but it could have been argued that would have been OK without PEP . 

To answer your questions ...

1 . We don't give percentages but its been established that you had a low risk encounter but low risk doesn't mean no risk .

2 . Oraquick is a good reliable HIV screening tool and the window period post PEP would be 6 weeks post PEP and again at 3 months to confirm the results . It would be highly unlikely to test positive from the low risk encounter followed by PEP , expect a negative result .

3 . Symptoms are not HIV specific so we don't discuss symptoms that could be caused by many other things than HIV , if you are sick see you doctor but it doesn't sound like HIV .

4 . Was addressed at the top of the page .

[jkinatl2]

1.  Given my case, what are my chances or having contracted HIV.  I've read endless threads on this page and I can conclude it is very low, but I wanna hear it anyway. (sorry).

2.  Is OraQuick effective in detecting HIV infections?  If I do that today, will it be able to detect it if I had it? or should I wait a little longer?

3.  two days ago (60 days after exposure aprox) I develop a very mild cold.  Do you think that's a bad sign?  Its symptoms are very mild.  No fever, no lymph nodes, just sore throat and nasal congestion.  Should I worry?

4.  Why is it less likely to contract HIV by being insertive than receptive?  (I'm just curious).

OK, right to your questions first.

1. Given your case, your likelihood of contracting HIV from insertive anal sex with a partner of unknown status (we always assume that) is quite low. The vulnerable part
on a man's penis is the urethra, the hole at the tip. THAT, and possibly some dendritic cells underneath the foreskin in an uncircumsized male, are the ONLY areas of the genitals that are vulnerable to HIV. In the receptive partner, the entire inside of the anus is a semi-porous membrane, and is essentially entirely vulnerable to HIV. In addition, semen of an infected partner hasd a far higher concentration of active HIV particles than anal mucousa.

(I just answered question 4 as well)

2. Otaquick is very effective, but you need to wait SIX WEEKS after finishing PEP in order to get a preliminary result. Three months past PEP is still the "gld standard."

3. Symptoms are immaterial in diagnosing HIV, with the exception of acute ARS which often leads to hospitalization. We don't discuss symptoms here much because they are vague, and mimic everything from allergies to the flu.

4. (answered).


NOW

If the guy WAS Undetectable, and had no other STDs (which can cause a spike in viral load even in people consistent in taking meds) then your sex with him without a condom was essentially as safe as sex with a condom.

In the ten years I have been answering questions on this forum, I have never seen an insertive partner test positive after a condom break, whether it was during vaginal or anal sex. This is without PEP involved. As you took PEP, you are almost assuredly negative over this incident. As a matter of fact, I would not have recommended PEP over this relatively low-risk incident.

So if you can wait two more weeks, you will be able to test with almost complete assurance. Three months is still the standard, however. I do not in any way predict an unfortunate outcome here.

IN addition, you used up one of your free posts to goute your first post without additional commentary. I will remove that post and hopefully that will allow you to post twice more. I certainly hope you use one of those posts to reveal your almost certain negative result.

Cheers.