Extrapolarice:
Hello! I have a bit of a unique situation I'd like some guidance on.
I (male) had unprotected vaginal sex with a female of unknown status on 5/1/24. She later told me she does not wear condoms and currently has 5 other partners she is sleeping with. 6 days after the incident I began taking Truvada as PrEP for future exposures and I continued to take it daily for ~3 months. As a quick note, I was not on PrEP when the exposure occured on 5/1/24.
6 weeks after the exposure I took an HIV Oraquick test (using saliva) and it was negative. I did this again 12 weeks after the exposure and it was negative as well. I was told by a doctor that I can't trust these test results because I was on Truvada. So I stopped taking Truvada and 38 days after stopping Truvada I did another HIV Oraquick test (using saliva) and it was negative.
Are my test results conclusive? Or should I get tested again using a 4th generation test? Thank you so much for your help by the way! How can I donate to this forum? Or is there a way I can compensate you for your time?
Jim Allen:
Hiya,
Having to guess here but it sounds like your doctor was concerned about a blunted HIV infection, trying to keep this somewhat short, so ths point is that this can cause delayed detection and can happen with PEP & PrEP usage. Now this is always part of the risk when using PrEP, but ideally, you should have waited for the window period to end post-exposure and then confirmed your HIV status before starting PrEP, once on PrEP you should be getting an HIV screening every three months so if you do acquire HIV at some stage whilst using PrEP even a blunted infection would be detected within the first or second screening dates post-infection.
Anyhow, this is what I would recommend you do now: See your healthcare provider or clinic and get an STI screening, that includes HIV and Hepatitis B testing. This is to confirm you do not have Hepatitis B as undiagnosed Hepatitis B whilst using PrEP can be a problem and a blood test to check your kidney function. While getting this done, talk to your healthcare provider about getting vaccinated against HPV, Hepatitis A & B.
If you do decide to start using PrEP again after these tests, make sure to get a regular HIV screening, ideally every three months, not the Oraquick test but a laboratory antibody test from a blood draw and routinely check for STIs and your kidney function.
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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