Unprotected sex with woman, 48h after starting PEP

[godsaveme]

Hello everybody,

English is not my native langage, so I will do sometimes mistakes sometimes, but I understand it well.

I am currently in a difficult situation that I am experiencing extremely badly.  And I am entirely responsible for it

On the 9th of November, I had an dangerous exposure with woman that I met in a bar. During the night I received an unprotected blowjob from her. I penetrated her for 10 minutes with a condom, then I removed my condom and continued (in her vagina) for 5 minutes to finish.
10 hours after this exposure, I received PEP, and I started the treatment (on the 10th of November, so less than 24 hours before the risk).
And like an idiot, I saw her again the night of the 11th of November. I had exactly the same relation with her on this night.
Bécasse I Was on PeP, and it was the same partner, I didn't evaluate the risk of a 2nd contamination, that can conduce to the failling of my PEP.

1 week after I met her, I had gonorrhea, so I treated this with doxycilin + other antibiotic. It had gone easily.
So I know she had 1 std (gonorrhea).
I don't know her status, I asked her to go for a test but she doesn't answer me, she told me she is safe, but I explained her that she gave me gonorrhea ...

I know that std increase the probability of giving hvi ...
I was top, I didn't do anal, or other stuff. And I am circoncized.

Does I have any chance to be hvi negative ?
1) I don't know her status
2) I took pep in less than 24 hours after my first exposure

I know I screwed up, and my mental health is not good right now.  I would just like to have your opinion if my pep will fail or not.

I took an HIV, Syphilis, Hepatitis test two days ago.  everything was negative (this is normal for HIV because I am on pep).
Now I have to wait 1 month for the next test. And my PEP finish on saturday.
I respected the pep intake, and I took it every day without forgetting

Thank you very much

[Jim Allen]

I asked her to go for a test but she doesn't answer me

This is a pointless request to make of her. Firstly, her HIV status is none of your business, and even if she tested today, the results mean nothing to you.

A non-reactive result would mean she didn't have HIV some months ago but would not reflect her status today or the day you met her. So, your choices and actions with her those times you met would still be a risk to you.

A reactive result would mean she "might" be living with HIV; however, again, it is pointless as you should already presume there was a risk and consider PEP and testing. You have started PEP already, and knowing her HIV status will not change the outcome for you.

std increase the probability of giving hvi

Not in this case. You claim you got the STD from her during those two days that you had sex; if so, it would not have increased your risk for HIV.

[Jim Allen]

Anyhow, prehaps your forum name should be "Pharmasaveme" instead.

You had condomless intercourse, started PEP and then did it again the next day... 

Thankfully, PEP is highly effective,  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.

I fully expect you will be fine.

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

Please Note.
As a member of the "Do I have HIV" 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, which 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 removed

[godsaveme]

Thank you very much for your answer...
I am waiting for get test at the end of the month ...
I don't sleep and I am on big dépression and I full realized what it did ...

[Jim Allen]

You're welcome.

I full realized what it did ...

Yeah you had sex and it's perfectly normal and natural...

Try to get some sleep, you had sex, it's perfectly normal and I fully expect a non-reactive test result when you do test

[godsaveme]

I can't sleep well ...
I read this study

And they say litteraly :
"Nevertheless, 9 (90%) of the 10 treated cases continued to exhibit high-risk behavior following treatment; therefore, only one case can be considered a pure treatment failure (0.04%)."

It's my case ... do you know person, or did you have one case of late seroconversion on this forum, or in tour life ?

I m so so so depressed, I acted like a big big idiot... and maybe I will pay it all my life...

[Jim Allen]

Hiya,

I don't understand why you are stressing.

You have read a single report looking into 3547 PEP consults, and you focus on these 10 cases.

Anyhow, it essentially outlines what plenty of studies and clinical data have shown over the last 30 years from both nPEP and oPEP. 

1) PEP is less effective if you don't take drugs correctly. No surprise there.

2) If you continue to have condomless sex after PEP, then that's not PEP's fault if you get HIV. Also, no surprise.

3) PEP is highly effective; I would go so far as to consider it extremely effective, but it's not a guarantee. Hence, you should test at the appropriate time to confirm your HIV status after finishing PEP.  We would not have bothered telling you to test if it were guaranteed to work.

4) Next time, use condoms! Also, consider PrEP as an additional layer of prevention.

late seroconversion

It's not a concern or real issue. Just test at the correct time. 

In short, PEP is highly effective, 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.

I fully expect you will be fine.

P.S.: Nothing you read will change the outcome, and it's obviously causing you unnecessary stress at the moment, so stop focusing on HIV, take your meds correctly for now, live your life and focus on better things and test at the correct time.

[godsaveme]

Thank you for your answer and professionalism.
I just want to try to understand and analyze what can happen to me.  given that I took a risk again at the beginning of my pep, I wanted to see if it would cause my treatment to fail.  I went through your forum because you have a lot of testimonials and experiences, and I wanted to get your opinion... since this accident I haven't had any new exposition, and I don't plan to have any sex for a long time.  As long as my serological status is not fixed I do not want to risk infecting someone and they find themselves in my situation which is extremely anxiety-provoking...

I know I have to fous on other thing, but I m very alone and I dont find I formation and support easily.
This may seem ridiculous or easily surmountable to you, but I have a very, very bad experience with it and I feel really guilty.

[Jim Allen]

I just want to try to understand and analyze what can happen to me.  given that I took a risk again at the beginning of my pep, I wanted to see if it would cause my treatment to fail.

This was asked already in the initial posts, and this was taken into account when I answered you. You had condomless intercourse, started PEP and then did it again the next day.

I fully expect you will be fine, take the PEP and test when due, and expect a non-reactive result. No drama is needed, try to relax.

since this accident I haven't had any new exposition

It wasn't an accident; you were not walking down the road all innocently when you tripped and landed penis-first against your will inside a woman who happened to be lying in the street naked... That would be an accident, a very unique one.

You made a choice, you had sex, took the condom off and engaged in condomless intercourse by choice, not by accident.

As long as my serological status is not fixed I do not want to risk infecting someone and they find themselves in my situation which is extremely anxiety-provoking...

Okay but start using condoms regardless of the outcome of your HIV test, this is how you start protecting yourself and your partners, as well as considering PrEP in the future to reduce the HIV risk.

I feel really guilty.

Why?  Is there a relationship at home? Or is there some sort of moral, religious or upbringing issue that has you feeling guilty about sex?

You had sex it's perfectly normal. You didn't use a condom, okay, that happened, probably happened a few million times whilst I was typing this message and you can't change the choices you made in the past, but you took appropriate measures afterwards, PEP, and soon testing to confirm your HIV-negative status.

[godsaveme]

My PEP is finish til last saturday. So now I'm waiting to get tested after Christmas, and my last test will be end of January.
I know it's not an accident, but I fully regret it and on the moment I didn't realized what I was doing.
I know that HIV exists, and STD, but before this, I never had problem with this, and I didn't care ...

I will do condom all the time (even if i hate condom...), and if I have a serious relationship I will ask to the girl to get tested now.
I don't want to have Prep because I don't have many partner, it's better to have one partner ( girlfriend) and get both tested before going without condom... I don't want to have one night sex like I did , now I'm in a big big trouble

I feel guilty because if I have HIV, I lost my job (army), my family, my parents would be ashamed of me (they are from a less tolerant generation than mine).
there are people who are well supported to deal with an illness, and can face it with serenity.  I will find myself alone and very isolated (financially and socially) if that happens.

[Jim Allen]

I don't want to have Prep because I don't have many partner, it's better to have one partner ( girlfriend) and get both tested before going without condom...

Well, even testing together and going condomless is accepting an HIV risk as I hope you are not planning to keep her locked up 24/7 to ensure she remains HIV-negative.

I feel guilty because if I have HIV, I lost my job (army), my family, my parents would be ashamed of me (they are from a less tolerant generation than mine).
there are people who are well supported to deal with an illness, and can face it with serenity.  I will find myself alone and very isolated (financially and socially) if that happens.

It's HIV and very manageable medically; pop a pill a day and get on with your life. There is also no need to tell everyone, certainly not your family members and parents if you don't want to; I am sure they have medical issues they don't announce to the world and you don't know about.

As for the job, if positive, you might lose your job depending on what nation you are serving with. However, it's just a job; there are other jobs, so you might finish this job sooner than expected if positive, that's all.

Anyhow, these are all issues you currently don't have and are extremely unlikely to have as you took PEP. So stop stressing about problems you don't have and focus on problems you do have and can change.

[godsaveme]

Hello Jim,
I had a first test (28 of December) 19 days after  i finished PEP.
I am negative.
I have to do an other test on the end of January (around the 27th of JAN).
The 20th of January, it will be 6 weeks after finishing my PEP.


Are these results encouraging, or is there absolutely no point in doing a test this early? The doctor prescribed this date for me to take my first test.

I try to not stress like you told me and focus on other thing but it's very hard.

What is the average delay for a late seroconversion with a PEP failures (you deal with many people with PEP and maybe you have observed some experience with your internet forum user ?)

Thank you very much

[Jim Allen]

Any non-reactive result is a good sign but just retest 6 weeks after PEP to confirm your HIV status.

[Jim Allen]

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.

Just test when due to know your HIV status; that's all that matters and focus on living your life.

[godsaveme]

Thank you Jim, I will write you my next HIV test ...

and Happy new year

[Jim Allen]

You're welcome and happy new year

Thank you Jim, I will write you my next HIV test ...

Zero need to update us when it's a non-reactive result. When we don't hear from you we will know.