HIV tranmission while on PEP

[thichtructhaiminh]

Hi Jim and everybody

Sorry for my bad English if any as I'm not native English speaker.

Below is my question:

I had a real RISK (broken condom why Have sex with a girl with unknown HIV status, I didn't realized that until finish). So I went to meet doctor, get test which come back Negative and then I start PEP (Acriptega) for 28 days around 16 hours from exposure. I finished full 28 days (not miss any dose) and then at day 29 I went to test and I got Negative result, 4 months later I tested and also got Negative.

But while I was on 28 days PEP course. I have few times unprotected sex with my wife, last time was 27th day (I cum outside all times)...

My question is: since I got Negative result after 4 months after PEP, is my wife at risk getting HIV from me (from few times unprotected sex) while I'm on 28 days PEP course?


Could you help to give me answer? thank you very much

[Jim Allen]

I had a real RISK (broken condom why Have sex with a girl with unknown HIV status, I didn't realized that until finish). So I went to meet doctor, get test which come back Negative and then I start PEP (Acriptega) for 28 days around 16 hours from exposure. I finished full 28 days (not miss any dose) and then at day 29 I went to test and I got Negative result, 4 months later I tested and also got Negative.

You took PEP and had a non-reactive test 4 months later, so you did not get HIV from this incident.

My question is: since I got Negative result after 4 months after PEP, is my wife at risk getting HIV from me (from few times unprotected sex) while I'm on 28 days PEP course?

Thankfully you did not get HIV from the incident with the broken condom. So you did not have HIV to pass on to your wife at the time.

Of course, I can't give your wife a full risk assessment without talking to her, so send her my way.

my wife

I'll mention the same thing I always do when someone says they are in a relationship;

If you engage in condomless sex with your partner, you are obviously at risk of acquiring HIV. In relationships, condomless sex is often based on trust or past test results; however, this does not prevent HIV, so if condomless sex does occur, you should consider testing more frequently.

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 and get vaccinated against HPV, Hepatitis A & B.

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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[thichtructhaiminh]

Dear Jim

Thank you for your quick reply. Just to be sure. You mean:

1. I took PEP and had a non-reactive test 4 months later, so I didn't get HIV from broken condom incident. Because I didn't get HIV, of course I can't I pass it to my wife although we have few times unprotected sex while I was in 28 days PEP course.

2. If me and my wife DON'T have any others HIV RISK except the incident which we are discussing in this topic (Me: broken condom, my wife: few times unprotected sex with me while I'm on 28 days PEP course and haven't tested Negative yet). We both don't have HIV.

Are my understandings correct?

[Jim Allen]

1) Asked and answered. You didn't get HIV from the broken condom incident, hence you didn't pass HIV on from that incident to anyone else.

2) I don't know what risks your wife has had or will have, I don't know her current HIV status or future HIV status and neither do you. HIV is thankfully difficult to pass on even when exposure does happen, you recent result doesn't mean her HIV status is also negative.

Hence I said "Of course, I can't give your wife a full risk assessment without talking to her, so send her my way."

End of the day, any condomless sex with your partner, is obviously accepting the risk of acquiring HIV. In relationships, condomless sex is often based on trust or past test results; however, this does not prevent HIV, so if condomless sex does occur, you should consider testing more frequently

[thichtructhaiminh]

Dear Jim

Thank you for quick reply as always. I understand fully now. Much appreciated for great job you are doing here...

By the way, in past couple of day I spent my time to read many topics in our forum try to find same topics with my question, and also to educate myself how HIV is transmitted.

And below are what I got:

I got two comments from you and your colleague as below.

In brief, your adult HIV risks are:

* Sex; Condomless intercourse & a minute (theoretical) HIV risk if you give a blowjob.
* Sharing drugs rigs (Syringes)
* Blood products/ transfusions (Rare nowadays in most nations thanks to screening)

Please do not post again unless you have been having sex without a condom or have been sharing syringes to inject drugs.

You have been warned and this is the last time.

Before asking about any other situation ask yourself two easy questions:
Did I have UNPROTECTED anal or vaginal sex with anyone?
Was I shooting up drugs and sharing an injection needle with someone?

If you can say NO to those two questions, you did NOT have a risk for HIV.

They are very clear and helpful for me.

So I assume that: If in my life, if I DON'T have any UNPROTECTED anal or vaginal sex, or giving blowJob or Sharing drugs rigs (Syringes). I DON'T have risk for HIV.

Am I correct?

[Jim Allen]

In brief, your adult HIV risks are:

* Sex; Condomless intercourse & a minute (theoretical) HIV risk if you give a blowjob.
* Sharing drugs rigs (Syringes)
* Blood products/ transfusions (Rare nowadays in most nations thanks to screening)

So I assume that: If in my life, if I DON'T have any UNPROTECTED anal or vaginal sex, or giving blowJob or Sharing drugs rigs (Syringes). I DON'T have risk for HIV.

Am I correct?

Basically correct but you do have some of these risks.

To reduce your HIV risk 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

[thichtructhaiminh]

Dear Jim

Back to my first question. I got your answers, It's very helpful for me. But to be honest, I still have a little concern about I can transmit HIV to my wife from that incident... Without any offend, before know our forum, I read on Internet, some said No Risk, some said low Risk, some said extremely low Risk...

So could you please explain why I can't transmit HIV to my wife from this incident ? Let say the Girl have HIV and some amount of virus actually enter my body...PEP kill the virus so It can't be available in my blood or semen to transmit to my wife in few times unprotected vaginal sex while I'm on 28 day PEP course (me and my wife never do anal sex) or other reasons...?

1) Asked and answered. You didn't get HIV from the broken condom incident, hence you didn't pass HIV on from that incident to anyone else.

Few more thing to be added to my cases

1. I have vaginal sex with the girl when condom broken. We didn't have anal sex at all.

2. After this incident, I'm 100% sure that I didn't have any unprotected vaginal/anal sex with anyone else except with my wife (Only vaginal, not anal sex) and never Sharing drugs rigs (Syringes) .

3. I also start do yearly screening test for HIV after this incident. Last time I tested is last month (3rd July 2024) by Combo Ag/Ab, and I got non-reactive.

Your comments would be very appreciated... I'm OK if I get infected because it's my fault to have a risk but I really can't forgive myself if my wife got it from me from that incident 

[Jim Allen]

PEP kill the virus so It can't be available in my blood or semen to transmit to my wife in few times unprotected vaginal sex while I'm on 28 day PEP course (me and my wife never do anal sex) or other reasons...?

So firstly PEP does not kill HIV. 

In Brief: When HIV enters the body it will hijack cells and use them as factories to produce new virus. This happens over seven stages, PEP is taken within 72 hours post-exposure and the drugs in PEP attempt to block or interfere with these stages, thus stopping HIV from taking hold (stopping you from getting HIV).

Presuming HIV had entered your body, then PEP blocked the process successfully, hence the non-reactive (negative) test result and this also means there never was a sufficient viral load to pass it on. If the viral load had been at a sufficient level to pass HIV on through your semen/pre-ejaculate fluid then PEP would have failed and you would now be living with HIV.

So as explained previously, thankfully you did not get HIV from the incident with the broken condom. So you did not have HIV to pass on to your wife at the time.

1. I have vaginal sex with the girl when condom broken. We didn't have anal sex at all.

2. After this incident, I'm 100% sure that I didn't have any unprotected vaginal/anal sex with anyone else except with my wife (Only vaginal, not anal sex) and never Sharing drugs rigs (Syringes) .

3. I also start do yearly screening test for HIV after this incident. Last time I tested is last month (3rd July 2024) by Combo Ag/Ab, and I got non-reactive.

1) You are not telling me anything new. 
2) Rather irrelevant
3) Excellent also get a yearly STI screening as HIV isn't the only risk, there are far easier to transmit STIs


To wrap this up:

Condomless intercourse, even with your wife is accepting a risk and your adult HIV risks are:

* Sex; Condomless intercourse & a minute (theoretical) HIV risk if you give a blowjob.
* Sharing drugs rigs (Syringes)
* Blood products/ transfusions (Rare nowadays in most nations thanks to screening)

To reduce your HIV risk 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

[thichtructhaiminh]

Dear Jim

Thank you for your quick and clear reply as always 

I have one more curious question before I can try to let this incident behind and move on with my life. Could you help to answer?

As you said, PEP doesn't kill the virus. So if PEP successfully prevent virus taking hold and produce new virus, what happen with virus have already entered my body from unprotected sex? With the help of PEP my immune system can manage to eliminate...them all?

[Jim Allen]

As you said, PEP doesn't kill the virus. So if PEP successfully prevent virus taking hold and produce new virus, what happen with virus have already entered my body from unprotected sex?

Any viral particles would degrade and damaged cells would die off, this material that's left would be taken care of by the normal cleanup process during which some of the material will be discarded or used by other cells. 

With the help of PEP my immune system can manage to eliminate...them all?

There is no HIV left.

[thichtructhaiminh]

Thank you again Jim, I think I got enough information now. I will try to let this incident behind me and move on.

You are doing great job here. Keep going...and Take care 

[Jim Allen]

Thank you again Jim, I think I got enough information now. I will try to let this incident behind me and move on.

You are doing great job here. Keep going...and Take care 

You're welcome.

You had a risk, took PEP and tested. Time to move on with your life

[thichtructhaiminh]

Dear Jim

Sorry it’s me…again.

1. You may think that it’s irrelevant but I forgot to tell you that my condom broken but  it was broken along it’s length (follow only a straight line from middle to near top) and didn’t expose whole of my Penis Head during sex, only a part of my Penis Head exposed other parts still covered (I saw it when I finsihed and took condom out). Does it make any sense? In this situation, I assumed I have Real risk and take PEP but from your asssement do I really need PEP in this situation?

2. To be sure I understood correctly your comments to explain “why I can't transmit HIV to my wife from few times unproteced sex while I’m on 28 day PEP course?”. I summarized my understanding as below:

“Assume that HIV had entered my body, I took PEP, PEP was successful, I got Negative test result, this mean I have never had sufficent viral load to pass to my wife while on PEP course because if I have had suffient viral load to pass, it mean PEP have failed and I will get Positive test result”

Am I correct?

Thank you for your comment…

[thichtructhaiminh]

Could you help to answer my previous post?

[Jim Allen]

1) irrelevant
2) Sure, that's good enough.

Time to move on with your life, you didn't aquire HIV from the broken condom incident. Use condoms for any intercourse no exceptions and get tested yearly for HIV & STIs.

[Jim Allen]

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.

[thichtructhaiminh]

OK Jim. Thank you for remind me. Have a good day 

[Jim Allen]

👍

[thichtructhaiminh]

Dear Jim

After installled application from the Hospital which I used to test HIV here (I don’t think they will save whole of data like this), I got extact date of my testing history. And I have some more details to add to my cases. Let me summary one more time… in the best way what happend to me from beginning (including date) as below (that’s all of my cases, no more):

-1st exposure: Around 2-3/11/2021, I had first real risk (broken condom with the girl (not my wife) who have unknown HIV Status) and then I came to doctor, tested Negative, got PEP on time (within 24h) and I completed 28 days PEP, didn’t miss any dose. Then 27/12/2021 (~ 8 weeks after exposue) I got Negative result by Combo Ag/ab. But in 27th day PEP course I had 1 time unproted sex with my wife. 

-2nd exposure is what I described from beginning of this topic (only one more thing to be added is my condom broken around 10-11/1/2022).

Sorry when opened this topic I thought that 1st exposure is not needed (And I didn’t have exact date, as quite long time) so I didn’t tell you…

My last test for HIV was 3/7/2024 and it was Negative (almost 2.5 years since 2nd Exposure).

So my question is: With new detail added. Can I transmit HIV to my wife from few times unprotected sex while I was on PEP course (both 1st exposure and 2nd exposure)?

Can I assume that your advices for me will be as below?

“ Thankfully you didn’t get HIV from the incident with broken comdom (both 1st exposure and 2nd exposure). So You did not have HIV to pass on to your wife at the time”.

That will be my last questions relates to this topic…Thank you for your help.

[Jim Allen]

Asked and answered already.

You didn't get HIV from the concerned exposure. If you post about this again it will result in a ban.

[thichtructhaiminh]

Dear Jim

I understand the rule and trust me, I definitely don’t want to break it for sure… I just want to be sure I didn’t miss anything in my case and I didn’t give HIV for my wife from 2 times exposure (described in this topic)…. Hope you understand…

So could you please help me to answer my final question relates to this topic as below:

I assume that: “I didn’t get HIV from my 2 times exposures (described in this topic) so I didn’t have HIV to transmit to my wife from few times unprotected sex during my 1st and 2nd 28 days PEP course”. Am I correct?


Your anwer in simple way: Yes or No is so much appreciated…

It will help me move on and there will be no more post about these ones again from me, I promise. If I do that again, you can ban me 28 days… And please don’t ban me afer this post… I still want to be here to read more and educate myself.

[Jim Allen]

Asked and answered - 28-day ban.

It doesn't matter how you frame the question; the answer remains the same, which has been explained several times. You had a risk, took PEP and tested negative afterwards outside of the window period, you did not acquire HIV and hence did not pass it on to your wife from those incidents.

You are at risk of acquiring HIV from your ongoing exposures (condomless sex with your wife) so make sure to test regularly and if you want to reduce this risk use condoms & consider PrEP.

[thichtructhaiminh]

Hi Jim

I’m coming back after 28 days banned. Firstly, I want to say thank you for your support in last questions relate to PEP which I couldn’t say last time.

Secondly, I have two questions which happend during my banned time and would like to ask…for support.

1st question:

At 7/8/2024, I went to massage place, The girl gave me the massage by her hand with oil mixed with something which I don’t know (I’m nude whole time). Then she took bath for me. Then she gave me Handjob. Then she took bath for me again and finish. I only touch her breasts, her hand, her butt during massage.

The thing made me concern are.

1. When she gave me massage. I feel pain one time at my back neck, something like her fingernail hit me (I asked her she said no bleeding, but let say her fingernail made me a cut (first cut) and bleeding). If her fingernail have fresh blood, am I at risk?


2. When I finished, go out to the main gate of massage place. I checked and detected an other small cut (second cut) at my back near my neck (different place where I feel Pain at my back neck which I described above). It looked fresh, I surprised and I don’t know why/how I have it and when it happen, maybe during massage which I’m not sure…(I think at this time it didn’t bleeding but let say it’s still bleeding). This cut made me worry.

If her hand have fresh blood when she gave me massage (with, without oil) /hand job and touch my cut (first and second cut) during massage. Am I at risk?

Maybe crazy thinking but is there any chance my cut (both) made by needles/syringes but I don’t know…    if it the case? What is my risk?


2nd question

Around 18/8 when I finish my work at company and prepare to leave.

1. I collisioned with my cabinet door key at my office and I had a wound with blood at my head. I used my hand to touch the wound on my head to check immediately , then I took a tissue paper from my colleague's desk to touch the wound twice (each time about 5 to 10 seconds) about 1 minute gap between two times. Then I used another tissue paper (taken from my pocket, I don't remember when I put it here) to touch the wound on my head. Let say my tissue paper and my colleague tissue paper, my hand have fresh blood. Am I at risk?

2. About few minutes later. I took my motorbike, put my helmet on my head (with cut uncovered) and leave my office. If there are some fresh blood from anybody in my helmet touch my cut. Am I at risk?

Sorry, I tried to put as much detail as I can including all what if…

Thank your for your support…and could you give as detail answer as…possible so I don’t need to ask again…

Your comment are much appreciated…

[leatherman]

In brief, your adult HIV risks are:

* Sex; Condomless intercourse & a minute (theoretical) HIV risk if you give a blowjob.
* Sharing drugs rigs (Syringes)
* Blood products/ transfusions (Rare nowadays in most nations thanks to screening)

You should have re-read this thread while you were out on that ban. Unless you were having condom-less anal/vaginal sex or sharing injection needles, you did NOT have a risk for HIV.

If you need to ask about any further situations, please don't include "more" details, just ask yourself first, "did I have sex without a condom? Or was I shooting up drugs with someone?" if your answer to both is NO, then we're aready given you the answer about your next situation.

In brief, your adult HIV risks are:

* Sex; Condomless intercourse & a minute (theoretical) HIV risk if you give a blowjob.
* Sharing drugs rigs (Syringes)
* Blood products/ transfusions (Rare nowadays in most nations thanks to screening)

Have a good day,
Michael

[thichtructhaiminh]

Hi Leatherman

I’ve read many times what you and Jim told me before I decided to asked again my 2 new cases (2 new questions above) because I think my new 2 cases are little…complicated and need your team’s expert evaluation/assessment…(I know the rule and don’t want 2nd banned so I tried not asking too much..)

So from your answer, I’m NOT at HIV risk from my 2 new cases based on what I provided including all what if right?


Could you please help to answer? This will be last questions from me for these 2 new cases.

[Jim Allen]

Micheal has already provided a clear answer, so if you post about this again it will result in an eight-week ban from the forums.

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.

[thichtructhaiminh]

Hi Jim

I got your point. I will keep this simple HIV adult risk which I got from here, move on and try to apply in my next incident…if any.

Thank you and your team for support.