POZ Community Forums
HIV Prevention and Testing => Do I Have HIV? => Topic started by: stupidinser on September 22, 2012, 05:26:14 pm
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Hi all,
First off, thank you for the forum, I've been spending quite a bit of time reading through everyone's posts.
My situation is the following: I met a nice guy whom I started dating. We discussed status before moving forward to having sex, and he told me he was negative. One night, in the heat of the moment, we ended up having sex twice, with me being the insertive partner. We did not use condoms nor lube, which I deeply regret now. We had sex twice on that night. I didn't notice any blood, although there was clearly some white mucus, and washed my penis each time after sex, with water and soap.
As I was quite worried about the incident and was unsure as to whether this guy was indeed negative or not, I asked him to go and get tested. He did so five days later, and the test came back positive. On that same day I had a rapid HIV test which was negative. I was put on PEP (Truvada + Kaletra) and am now on my 5th day of meds.
Obviously, I am in a very dark place right now. I cannot believe how stupid I was in trusting this guy, and really regret my poor decisions. I am fully aware of the statistics, and know that my chances of coming out of this all right, in the full spectrum of HIV transmission rates, are not fantastic - what I did was quite high risk.
I would however like to know about your experience dealing with people at risk for HIV regarding the following:
- do you frequently see in your clinical practice tops seroconverting after episodes like this? I know this seems like a silly question, but stats are not real life and I need some reassurance, if indeed the chances of me becoming positive are not that high.
- how effective would my PEP regime be if started five days after exposure? Again, I am fully aware of the fact that it should have been started within 72 hours, but the doctors still decided to put me on it. I was wondering if PEP failures are frequent, and if you see people taking these meds later than they should end up seroconverting. Needless to say, I have been taking my meds religiously ever since I started them, and know that the nausea is a small price to pay if I come out of this okay.
Thank you for your time. I know there's nothing I can do now but take my meds and wait for the test post-PEP.
Best,
Marc
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Marc,
You started PEP FIVE DAYS after this incident? You may as well stop taking it because you started way too late. Did you tell whoever prescribed you PEP when the unprotected sex took place and that you were the insertive partner?
If you did and they still gave you PEP, they had no business doing so and obviously don't understand how PEP works or the prescribing guidelines.
The window period for PEP initiation is 72 hours (three days) at the very latest - within the first 24-36 is best.
And honestly, as the insertive partner you're unlikely to become positive as the top in only two encounters.
This isn't a clinical practice nor are we doctors. However, I've been answering questions in this forum for over eleven years and I don't recall a top ever ending up poz after two encounters, PEP or no PEP. That doesn't mean you haven't had a risk though - it just means you have a good chance of coming out of this ok.
I just read the bottom half of your post - I was so shocked that you were given PEP a full five days later that I launched right in with my answer.
It's totally up to you if you want to continue with PEP. A friend of mine (a top) was prescribed PEP a day later than you, even though his risk was low and even though it was way too late. I'm fully convinced the clinic only gave him PEP as a punishing reminder to use condoms in future. And yes, he tested conclusively hiv negative at the appropriate time.
Good luck. I expect you'll come out of this ok.
Ann
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Hi Ann,
Many thanks for your reply. I am still taking the medication as I don't want to feel any regrets in case I don't take it as I should and end up testing positive.
Also, today I got a message from the positive guy I had sex with saying that he'd been to the clinic for his first appointment post-diagnosis and was told that the virus in his body was very very low and that there was nearly no chance he could have infected me as a bottom. Obviously, I am not sure whether 'very very low' means undetectable in this case, but how important would a low viral load in this guy be in preventing infection? He's not on meds - would this also affect the viral amounts in his rectal secretions?
Thanks again for your time.
Best,
M.
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M,
The lower the viral load, the less chance of transmission occurring.
This is why people who are very recently infected are probably at the most infectious point they'll ever be - because in the first few weeks/months of infection, the viral load can be in the millions before the body starts to gain some control over the virus. In your friend's case, a "very very low" viral load is probably under 10,000, which is low and does lessen your risk.
You have every chance of coming out of this ok and I fully expect you will. Yes, you did have a risk, but no, you're not likely to end up poz.
Hang in there and test at the appropriate time.
Ann
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M,
Re-reading your thread, I realised I neglected to give you the information on testing at the "appropriate time".
The earliest you should test post-PEP is at six weeks after your last dose. A six week negative is highly unlikely to change, but must be confirmed at the three month (post-PEP) point.
Again, I expect you to come out of this ok - and I hope it's been a lesson to be more careful in future. You can have all the sex you want with as many people as you like, just make sure you're using condoms.
Ann
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Hi Ann,
Sorry to bother you again.
My std checkup came back and I'm negative for chlamydia and gonorrhea.
I finished my pep course a week ago. 5 days later, I started experiencing dry cough, headaches, sore neck and a very annoying post-nasal drip which won't go away and is irritating my throat. I haven't fever so far, I don't have a rash and my lymph nodes are not swollen, but as you can imagine I'm quite terrified I might be seroconverting.
My questions are the following: if my pep regimen had failed, would symptoms appear as soon as 5 days after finishing the meds? How well does not having fever bode for me? And do you think these symptoms justify getting a viral load or p24 test at this point?
Thanks again for your time.
Best,
M.
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I for one cannot answer your question, as in the ten years I have been on this forum I have never seen an instance of properly administered PEP to fail.
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M,
There are plenty of bugs going around the UK right now that produce exactly the same symptoms you're complaining about. I myself am just getting over the very same thing - and it's absolutely nothing to do with hiv. Go see your GP.
I still fully expect you to test hiv negative - when you test at the appropriate time.
Ann