EMERGENCY PEP

[Johnnyhdublin]

Hi Jim,

I have a couple of questions if you don't mind?

If I bottom for a guy, using brand new unopened condoms, plenty of lube, pulling out before any ejeculation, would you deem this extremely safe?  I get that oral is a negligible risk so I will stop worrying about this.

With Oral, would you class the risk with and without cum in the mouth as the same neglible risk?

Couple of questions on PREP

1. Does this need to be prescribed by my local GP or can it be prescribed by a sexual health clinic? I would. Prefer not to use my local GP

2. Do you have any idea how much this costs monthly in Ireland?

3. How long does it take to be effective?

I would still be planning to use condoms without ejeculation even when I take prep

[Jim Allen]

Hiya,

I get that oral is a negligible risk so I will stop worrying about this.

With Oral, would you class the risk with and without cum in the mouth as the same neglible risk?

I really have answered this already, anyhow, both would be a near negligible risk.

1. Does this need to be prescribed by my local GP or can it be prescribed by a sexual health clinic? I would. Prefer not to use my local GP

PrEP is prescribed by the clinic.

2. Do you have any idea how much this costs monthly in Ireland?

The legal route, PrEP is available free of charge to those who meet HSE clinical eligibility criteria.

If the HSE will not provide you with free PrEP you can still get an prescription from the clinic and buy PrEP through the participating pharmacies. You can find the pharmacy listings here: https://www.hivireland.ie/hiv/prevention/prep-2/prep-map/

The Brand-name Truvada costs around €400 for 30 pills, but generic versions from Teva and Mylan are available for less than €100 for 30 pills last time i checked. 

3. How long does it take to be effective?

Daily PrEP after 7 days would provide protection for receptive anal sex.

There is also on-demand PrEP.  Now On-Demand dosing is different, it's considered as effective as daily PrEP for anal sex.

On-Demand dosing is would be:
- Take 2 pills 2 – 24 hours before sex
- Take 1 pill 24 hours later
- Take 1 more pill 24 hours after that

I would still be planning to use condoms without ejeculation even when I take prep

Yeah. Look PrEP is highly effective in HIV prevention, it's not perfect though, nothing is. PrEP also offers no addtional protection against acquiring other STI's.

Again, HIV can't transmit through an intact latex or polyurethane condom, however, there is no such thing as safe sex just safer sex. Condoms can break, also, some sexual acts described as safe in regards to HIV still pose risks for other STI's.

Condoms can reduce the risks of STI's, however, the levels of protection for various STIs, depends greatly on differences in how the diseases or infections are transmitted.  Some infections (Not HIV) are transmitted primarily by skin-to-skin contact, which may infect areas not covered by a condom, such as genital herpes, human papillomavirus [HPV], etc.

End of the day, sex comes with risks, no need to stress though, just try to reduce the risks by using condoms, consider PrEP in regards to HIV and test routinely for HIV & STI's.

Best, Jim

Info about, On-Demand PrEP
https://www.poz.com/article/ondemand-prep-regimen-works-us-study
https://i-base.info/guides/prep/on-demand
https://www.aidsmap.com/news/jul-2018/demand-dosing-effective-daily-dosing-first-year-french-prep-study

PrEP information for Ireland:
https://www.hivireland.ie/hiv/prevention/prep-2/
https://man2man.ie/getting-prep-online/
https://www.sexualwellbeing.ie/sexual-health/prep/where-to-get-prep/

[Johnnyhdublin]

Your a gent and a scholar Jim.

I'll try leave you alone now.

Stay safe and well

[Johnnyhdublin]

Sorry one last question on condom usage and hiv. When people state that condoms are not 100 effective against protection from HIV.

Is that due to possible breakage? As in I would assume so long as the condom is not visably damaged then that does mean I would be 100% sure of protection against HIV. Not other STIs

[Jim Allen]

Hiya,

HIV can't transmit through an intact latex or polyurethane condom. When they break during intercourse it's obvious, as long as this obvious issue doesn't happen there is no need to stress about it.

The problem with condoms like most things in life is incorrect usage and/or inconsistent usage.

http://ec.europa.eu/research/press/2003/pr2010-hiv-en.html

During the last 15 years, the European Commission has financed several research projects aimed at studying, (directly or indirectly), the use of condoms as a preventive measure against sexually transmitted diseases, including HIV/AIDS. These projects were carried out not only in Europe, but also in Asia and sub-Saharan Africa, where the burden of the HIV epidemic is at its highest. All the studies concluded that the male condom was an effective way of preventing the transmission of HIV, with an efficacy close to 100% when the condom is used appropriately.

[Jim Allen]

Your a gent and a scholar Jim.

I'll try leave you alone now.

Stay safe and well

You're welcome.

[Johnnyhdublin]

Sorry Jim back with a hypotethtical question.

If I was bottoming for a guy and he had precum on his fingers or hand when putting on a condom, am I at risk of HIV if it gets on his condom just as he's about to insert

[Jim Allen]

Hiya,

No the fluids on his hands when putting on the condom isn't going to result in you acquiring HIV. HIV is sexually transmitted inside the confins of the body as in never being exposured outside the body.

Best, Jim

 

[Johnnyhdublin]

Thanks Jim. Sorry what I meant was if he had for precum from his hand onto the condom and then put his penis inside me immediately could that potential have a HIV risk.

Really another possibly dumb question. I orginiay thought it was durex condoms but have since realised it was boots brand. I read some reports that they are poor quality. I'm sure they have to be CE marked and a decent quality. The condom looked fully intact and there was no ejeculation. I just now a bit concerned when reading some horror stories about boots condom quality and tears/rips

[Jim Allen]

Hiya

Whatever fluids were on his hands it's not an HIV risk.

Regarding boots, HIV can't transmit through an intact latex or polyurethane condom. When they break during intercourse it's obvious, as long as this obvious issue doesn't happen there is no need to stress about it.

[Jim Allen]

Boots is walgreens pharmacy for anyone not from the UK/Ireland reading this.

[Johnnyhdublin]

Appreciate it Jim.

Thanks for the reassurances. Goes a long way for idiots like me!

[Jim Allen]

You're grand.

[Johnnyhdublin]

I have a very abnormal fear of HIV but not to the point I don't worry in the heat of the moment as I know I'm sensible and generally don't take risks. But then I panic afterwards and common sense goes out the window. I sure be more worries about covid from meeting this guy than I should be about HIV as I took no real HIV risk.

I lack sense at the best of times 

[Jim Allen]

Johnny, Ill give you my two cents on this.

After reading all your post, taking a guess, and it being Ireland I would suspect, your fears in part are triggered by some deep routed yet misguided guilt about sex and sexuality. Prehaps as accepting sexuality particularity, anything other than heterosexuality is still a taboo despite some limited progress in recent years.

However, what do I know? I am not a therapist, just a guy living with HIV who volunteers to tell people to use condoms and to test regularly. 

If you keep having these fears, the PrEP might aid in giving you peace of mind but, beyond that, you prehaps should consider talking to a therapist at some stage.

[Johnnyhdublin]

You know a lot more than me that's for sure Jim.

As for you living with HIV yourself, I can only say I have massive respect for you and the work you do here with the other mods to support, guide and reassure people like me.

I really struggle with basic common sense when I let my mind overthink situations and regardless how much I can see I'm paranoid I still fall I to that trap.

Wishing you safety during covid and best wishes my friend

[Jim Allen]

You're welcome

[Johnnyhdublin]

Hi Everyone. I am looking for some advice on a recent potential exposure. I will start by apologising in advance if this post is a little graphic but I don't know how to post it without showing context.

Exactly 18 days ago I hooked up with a guy I meet regularly. I agreed to bottom for him.

We started by me giving him unprotected oral and he was a little rough with me. Once he got properly hard he put on a condom and use water based lube on both my ass and his condom. I was very tight and so he decided to force himself hard into me and was rough. I pulled away and told him it was too sore but he quickly forced himself into me again with me being ready and again was very rough for a few seconds. At that point I pulled away and told him to stop.

I looked around and it appeared to me at least that the condom was fully intact when he was taking it off.

I was a bit shocked to be honest so wasn't quite sure what  to do but he decide to climb ontonme and rub his cock against my ass without a condom.

At this point I was just frozen but eventually got him to stop and i got dressed and left.

For the past few days I have had a really sore throat, runny nose, ache and pains all over and have what feels like a swollen lymph node in my arm pit. On top of this my anus has been very sore over the past 2 days.

I'm really concerned so hoping you can offer some advice or opinion.

[Jim Allen]

Hiya,

Look, it sounds like this encounter was not what you expected or fully consented to and I hope you are doing alright.

Regarding HIV, I read your post three times, nothing you mentioned would warrant HIV testing outside of the standard yearly routine, there was only a minute HIV risk from giving a bj.

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse correctly and consistently, every time, 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 which may be described as safe in terms of acquiring HIV might still pose a risk for other easier acquired STI's. So please do get tested at least yearly for STI's 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, and the only way of knowing is by testing.

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, 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 removed.

[Johnnyhdublin]

Thanks for your quick response and comments Jim. Not not exactly consensual  but not as scary as I may have sounded. More angry and upset.

Can I ask, since he rubbed his bare penis head against the opening of my anus would this not be a risk if there was precum? Incase he pushed it in with his finger?

Im pretty sure the condom stayed in tact so less freaked over that.

I know symptoms aren't a way to diagnose but mind is the mind.

I know rapid tests are useless in this time frame so pointless taking one?

[Jim Allen]

Hiya,

Rubbing against your anus regardless of whether fluids were present or not isn't an HIV risk, fingering isn't an HIV risk.

For the past few days I have had a really sore throat, runny nose, ache and pains all over and have what feels like a swollen lymph node in my arm pit. On top of this my anus has been very sore over the past 2 days.

Nothing to do with HIV from this encounter.

I know rapid tests are useless in this time frame so pointless taking one?

You don't need an HIV test over this encounter.

You should contact your GP to treat whatever is making you feel unwell instead of focusing on HIV. I also suspect the sore anus and the other symptoms are unrelated to each other. Now a GP in Ireland will most likely ask you to test for COVID first before being seen. 

[Johnnyhdublin]

Thanks for all the answers Jim I won't waste my time either the test over this then.

Last question if that's OK.

When you mention in some replies that things aren't HIV specific, do you mean there are symptoms that are HIV specific?

[Jim Allen]

Last question if that's OK.

When you mention in some replies that things aren't HIV specific, do you mean there are symptoms that are HIV specific?

...

Despite shit people are reading online, initial HIV infection rarely causes any noticeable symptoms. I wish it did because we would then not have up to 50% late or very late detected HIV cases (AIDS) within the EU.

Anyhow, most of the stuff people post here and other online forums falls under never related to initial HIV infection or so vague that it could be just about nothing or any number of more common infections/bugs.

I stubbed my toe this morning, I did not stress about the possibility of an incurable rare brain tumour or about a burger I ate years ago when vising the UK.   

[Johnnyhdublin]

Understood Jim and thanks for the answer.

Thanks for the info and help I will try relax.

go raibh maith agat

[Johnnyhdublin]

Hi All,

I am looking for some urgent advice. I have been having a very casual hook up with a gay guy for 3/4 years. I have bottomed for him and perfom oral sex on him.

Today I had a hook up with him where I bottomed, condom changed twice and he did not ejeculate before we stopped. However, what's really shook me is by pure coincidence he left his HIVmedication in his kitchen and it was the first time I found out he is HIV positive.

Before anyone judges me I know it's his business but we have had conversations multiple times over those years about testing and him saying he had no infections/ all clear from the testing. He never once told me he had HIV.

I'm terrified now and even though he wore 2 condoms and both stayed intact from what i could see, he did rub the head of his penis against my asshole without condoms and fingered me a bit. I am now panicking that I may have been at significant risk. He has assured me he is undetectable as he's taking something called Odefsey and says he's undetectable for over 3 years. The fact he lied about his HIV status, the more I don't trust he is undetectable.

I can't help but panic that I should go amd get Emergency PEP. Please help me with some advice e

[leatherman]

HIV is transmitted through unprotected anal or vaginal sex, or sharing injection needles.

People who are living HIV who are taking meds and undetectable for 6 months can't transmit HIV.

According to your situation you were NOT at risk for HIV and you do NOT need PEP.

Have a great day,
Michael
Reducing Your HIV risks:
With no exceptions, use condoms correctly and consistently for anal or vaginal intercourse
Talk to a healthcare provider about PrEP as another layer of protection

Get tested yearly for HIV and other STIs.
If you don’t use condoms and/or PrEP, test more frequently

Some sexual practices described as safe in terms of acquiring HIV still pose a risk for other more easily acquired STIs. It is possible to show no signs or symptoms from an STI so testing is the only way to know.

Get tested at least yearly for STIs, including but not limited to HIV, and more frequently if condomless intercourse occurs.

What’s the ONLY way to know if you’ve been infected by HIV or an STI?
Get tested.


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

[Johnnyhdublin]

Thanks for your reply. I appreciate that if he's undetectable he can't pass it on and indo understand its my responsibility to make sure i am safe. I guess the concern is that we have discussed our testing for years and at no point had he told me that he actually had HIV, just that his routine tests were all negative.

Ita now a trust thing, how can I trust hea actually U=U if he lied about being HIV positive. I feel like i am probably missing the opportunity to take emergency pep unless i act today/tomorrow as it will br 72hrs on Tuesday evening.

I don't even know how i would get Emergency PEP with discretion as I am attached (non physical relationship)

[Jim Allen]

Today I had a hook up with him where I bottomed, condom changed twice and he did not ejeculate before we stopped

You had no HIV exposure regardless of his HIV status.

he did rub the head of his penis against my asshole without condoms and fingered me a bit.

Not an HIV risk

Ita now a trust thing

No it's not.

It's an emotional issue. You didn't engage in activities that were an HIV risk regardless of his HIV status or treatment adherence.

However you found out he is living with HIV and despite not having a risk,  you are having an emotional wobble and reaction.

No PEP is needed, move on with your life

[Johnnyhdublin]

Hi Jim,

I agree its an emotional response. I do understand he doesn't need to disclose hia status and ita my job make sure I use protection however its rhe fact we openly discussed our testing ans my fear of HIV for over 3 years and he never once disclosed his status, just said he teats regular and his screenings are clear. Now it appears why he was saying is clear was undetectable.

If I'd have know I could have at least made rhe choice of whether I had a physical relationship regardless of the risks.

I know you say PEP is not necessary but I almost feel I need it for my peace of mind. Is there anywhere I Dublin incan go tomorrow to get it without it being a big deal where my GP will.be aware?

As I said, condoms were used over the past years and all tests i took where negative and common sense tells me I'm still negative but know I know his status my head can't get past the fear

[Jim Allen]

🙄

I could have at least made rhe choice

Nobody took your choices away from you. No matter what someone claims, you are responsible for your sexual health.

The right choice is for you to practice safer sex, you did that, congratulations 🎉 and and from the activities mentioned had no HIV exposure, no HIV risk and no drama or PEP is needed.

Enough drama, I'm not going to entertain this nonsense any further

[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.

[Johnnyhdublin]

Jim, it wasn't my intention to annoy or waste anyones time. I fully understand my questions could be stupid or annoying to you but I'm not asking them to be disruptive. I'm clearly very shaken by yesterday and can't help felw that way. What is common sense for you might be clouded as he'll for me right now. Sorry if I've wasted anyone's time. I just wanted to react inside a window period that's all.

I take your advice on board and will move on with a no risk outcome. Thanks for your support

[Jim Allen]

I want to be very clear on this, it has nothing to do with being annoying or asking questions.

We provide safer sex information and HIV risk assessments. You had no HIV risk, no exposure from the activities mentioned here, and no PEP is needed. What you need to understand is the guy's HIV status, treatment status, viral load and ultimately your feelings don't change that and we are not going to pretend otherwise or go on about it as that would be a disservice to you and the wider community.

In short, someone you had safer sex with, not in a relationship, who owes you absolutely nothing, kept their private medical information, which has zero impact on you, private...

we openly discussed our testing ans my fear of HIV

It's overall a pointless item to discuss with someone. No honry guy has ever or will ever declare: Suck this, oh wait, now you ask, I have untreated HIV, a dose of Syphilis or some Herpes for you. It doesn't happen...

Also, the next person you sleep with could claim to test regularly, which means absolutely nothing to you because even if true and that's a big "if", it just means they didn't have HIV a few months before their last test ... no good to you on the day whatsoever.

As for your irrational HIV fears, consider talking to a therapist instead.

common sense

Safer sex!

Just presume they are living with untreated HIV & STIs and if you decide to have sex then focus on what you can do to reduce your risks and at the moment that's mainly Condoms & PrEP. Keep in mind that sexual activities that are not an HIV risk remain a risk for easier to pass on STIs, so get an STI screening yearly and talk to the clinic again about getting vaccinated against HPV & Hepatitis B.

I consider this topic now closed!