question about PEP

[rayrayray]

Hi,

i had two exposures 1 month apart and took PEP right after the second one. Since, I took PEP during the 'window period' of the first exposure, I am not sure if I should test 3 months after it or 4 months after it (with an extra month to take into account the time I was taking PEP). I understand PEP delays seroconversion.


I was negative from when tested at the beginning of my PEP regime (so 1 month after the first exposure).

Also, if possible, please back up your recommendation with something scientific

[Andy Velez]

Don't make this more complicated than it actually it. Keep it simple. Having begun PEP during the window period related to the first incident is irrelevant in terms of when to test for a reliable result.

You should test at 3 months after the completion of PEP for a conclusive and hopefully negative result. 

There was no indication as to the nature of your risk. Unprotected vaginal and anal intercourse are the only confirmed risks for the sexual transmission of HIV. If you have been having unprotected intercourse, cut it out and use condoms everytime. Protecting your health is really that simple.

[rayrayray]

Thanks Andy, for your response, and to all the volunteers on the forum.

I used condoms for vaginal and anal sex but I performed cunnilingus on a woman in a high risk category (a pro). I know that this is a very unlikely route for HIV transmission, but I bite my cheeks a lot (bad habit) and my gums bleed when I brush my teeth (gingivitis).

I know that the general consensus on this forum is that cunnilingus is not a risk and I've read Ann's posts. However, the fact is, according to the CDC, there are both biological factors and documented cases that make this type of sexual behaviour a low risk but real risk.

Viral load and dental hygene are 2 factors that increase the risks so from Ann's posts, the reason she could have not infected her partner despite him performing oral sex on her is because she has a low viral load because of her medication regimen.

I'm not overreacting and know my chance of exposure is low, but I still want to rule it out with a real HIV test. I'll also screen for syphilis etc.

I will definitely test 3 months after PEP but I was just wondering when the soonest time is that I can rule out infection from the first exposure.

[RapidRod]

You can test anytime you want, you don't have a window period you've never had an exposure.

[Ann]

so from Ann's posts, the reason she could have not infected her partner despite him performing oral sex on her is because she has a low viral load because of her medication regimen.

WRONG!!!

I was NOT on meds during my relationship with an hiv negative man and I always had a detectable viral load during that time. The reason he didn't become infected was because giving a woman oral is NOT a risk for hiv infection. He remained hiv negative throughout or relationship and is hiv negative to this day.

The only thing we did to protect his negative status - the only thing we NEEDED to do - was to use condoms for anal or vaginal intercourse. Condoms have been proven to prevent hiv infection.

There have been three long-term studies of couples where one is positive and one is negative. In the couples who used condoms for anal or vaginal intercourse, but no barrier for oral activities, not one of the negative partners became infected with hiv. Not one.

Here's what you need to know in order to avoid hiv infection:

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence.

ALTHOUGH YOU DO NOT NEED TO TEST FOR HIV SPECIFICALLY OVER PROTECTED INTERCOURSE OR CUNNILINGUS, anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

Ann

[rayrayray]

Thanks guys!

[jkinatl2]

Thanks Andy, for your response, and to all the volunteers on the forum.

I used condoms for vaginal and anal sex but I performed cunnilingus on a woman in a high risk category (a pro). I know that this is a very unlikely route for HIV transmission, but I bite my cheeks a lot (bad habit) and my gums bleed when I brush my teeth (gingivitis).

I know that the general consensus on this forum is that cunnilingus is not a risk and I've read Ann's posts. However, the fact is, according to the CDC, there are both biological factors and documented cases that make this type of sexual behaviour a low risk but real risk.

Viral load and dental hygene are 2 factors that increase the risks so from Ann's posts, the reason she could have not infected her partner despite him performing oral sex on her is because she has a low viral load because of her medication regimen.

I'm not overreacting and know my chance of exposure is low, but I still want to rule it out with a real HIV test. I'll also screen for syphilis etc.

I will definitely test 3 months after PEP but I was just wondering when the soonest time is that I can rule out infection from the first exposure.

None of the reported cases of HIV infection through cunnilingus have withstood any real examination. Ans now we have moved beyond patient report after the fact, a manner of information gathering that, to put it mildly, is considered "soft" science.

We now have no fewer than three long term serdicordant couple studies that show that the ONLY risk for HIV infection is penetrative anal and vaginal sex.

Trust me, if we thought for a microsecond that cunnilingus presented ANY risk for HIV we would say as much.

The science geek in me wants to engage you in a debate over this, the CDC and it's sometimes shady STD/HIV transmission theory, and the status of science v. governmental agency issues that have, IMHO, diminished the CDC's cresibility for accurate HIV information. But those discussions are for another forum, as they never, ever, ever turn out well in this one.

Suffice it to say that we do not come by our transmission assessments lightly.