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Author Topic: Is it likely that I'm infected?  (Read 1945 times)

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Offline Rwarrior38

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Is it likely that I'm infected?
« on: November 15, 2018, 03:14:16 am »
My main concern: is it likely that I'm infected.

Here are the circumstances:

2 guys.

The guy I'm seeing, from the start was sure of his status, negative..I asked all the questions I ask to feel safe and was satisfied that he was hiv negative given his history. We put going to get tested, on the back burner and continued to have unprotected sex. We have been seeing each other since October 13th.

He has come back this week with a positive test on Sunday the 11th.

I was the receptive bottom.
There was approximately 5-8 encounters where he ejaculated inside me.
I took a rapid test, and a separate blood test on November 11th. Both negative.
Our last sexual encounter was on Saturday Nov 10th.

I'm currently on a 28 day PEP trial and on December 9th I will finish that trial.

My question: is it possible to avoid transmission after this many encounters? I mean, can someone NOT get guy after bottoming this many times for an HIV positive top?

I'm bracing myself for a positive test result when this pep trial is over. Any insight or advice on probabilities and plan of action, would be greatly appreciated.

Thanks.

Btw, This forum has been really helpful in easing some of my fears that I will be ok, if the results do come back positive. So thank you in advance.

Offline JimDublin

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Re: Is it likely that I'm infected?
« Reply #1 on: November 15, 2018, 03:35:43 am »
From what I understand you engaged in unprotected intercourse and post your last unprotected encounter you started PEP.

Well if you started PEP within 72 hours of the last unprotected encounter that instance is covered by PEP and the good news is PEP is highly effective at stopping HIV from taking hold.

Unfortunately from what I understand you also had unprotected intercourse before this so outside the PEP window.

All I can say is test at 6 weeks post finishing PEP and again at 13 weeks post finishing PEP for a conclusive result with an approved antibodies test. Remember to also test for easier to transmit STI's whilst you are at it.

I wish you all the best with testing, until than there is no point stressing about an issue you might not have. Simply finish the PEP and test as per guidelines.

Quote
..I asked all the questions I ask to feel safe and was satisfied that he was hiv negative given his history. We put going to get tested, on the back burner

If your results are negative than going forward, use condoms no exceptions and consider PrEP.

History of someone is irrelevant, HIV does not care and it only takes once for it to be aquired this could be the 1000's time someone takes a risk or the fist time, also plenty of people dismiss risks incorrectly.  Adding to this the issue that when someone test negative all it means is they were negative some 3 months ago, so relatively pointless information.

Also on the idea of testing together at the start of a relationship, well its a nice thought however reality is any unprotected intercourse within the relationship is still accepting the risk of aquiring HIV

Here's what you need to know in order to avoid hiv infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider starting 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 HIV transmission might still pose a risk for transmission of other STI's, so please do get fully tested regularly and at least yearly for all STI's including but not limited to HIV and test more frequently if unprotected 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.

More information on HIV Basics, PEP, TaSP and Transmission can be found through the links in my signature to our POZ pages, this includes information on HIV Testing

Kind regards

Jim

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As a member of the AM I Infected 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 be deleted.
« Last Edit: November 15, 2018, 03:37:52 am by JimDublin »
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Offline Rwarrior38

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Re: Is it likely that I'm infected?
« Reply #2 on: December 06, 2018, 12:33:08 am »
Hi all

Wondering if you can help me.

My ( new ) partner tested positive for HIV Nov 12. I had an exposure to the virus through unprotected sex on Oct 13th, 17th, 24th, Nov 4th and 11th.

I tested HIV negative on Nov 12 ( the day we went in for testing ) and went on PEP the same day. My 28 day PEP regiment finishes Dec 9th.

I'm wondering, how soon I can go in and get tested? Should I wait the 4 weeks after PEP ( Jan 6th ) to get tested? Or can I go in a week to get tested ( once the pep meds have left my system )

I just want to catch an infection as soon as possible, so I can begin treatment right away. Based on the dates of exposure, when would you recommend getting tested again?

Thanks

Offline JimDublin

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Re: Is it likely that I'm infected?
« Reply #3 on: December 06, 2018, 01:45:35 am »
Hiya

I merged your posts, please only post in this one thread going forward.
Thank You.

Try to relax and just test between 4-6 weeks post finishing PEP for an initial result, this result will rarely change but test again at 13 weeks post finishing PEP for a conclusive result with an approved antibodies test. Remember to also test for easier to transmit STI's whilst you are at it.

Jim

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Offline Rwarrior38

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Re: Is it likely that I'm infected?
« Reply #4 on: December 11, 2018, 10:18:25 pm »
Hi Jim thanks for your response.

I had a question regarding antibodies.

You mentioned in a previous post that ARV treatment, including PEP would not suppress antibody production. ( You wrote: "yea you still produce antibodies while on PEP, he'll you still produce them on full treatment" )

Can you confirm this?

I'm going in for an antibody test today, for an exposure I had on October 13th.. ( I had another exposure on November 11th, for which I took PEP for 28 days )

My main focus is to get an antibody test for the October 13th exposure. I'm just concerned that the PEP medication that I took in between then and now, would have suppressed any antibody production to an undetectable level as well.



I will continue to get tested until a confirmed result is produced..I ask just hoping to rule out these exposures in early October.


Any insight?

Offline JimDublin

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Re: Is it likely that I'm infected?
« Reply #5 on: December 12, 2018, 04:15:19 am »
Quote
My main focus is to get an antibody test for the October 13th exposure. I'm just concerned that the PEP medication that I took in between then and now, would have suppressed any antibody production to an undetectable level as well.

Once you are infected with HIV and start to produce HIV antibodies the body will do so for life. Average person will have levels detectable within 22-28 days, with an outlier taking longer hence the 3 months conclusive guideline. Once your body produces antibodies to HIV no amount of PEP or HIV treatment will ever change that.

Regarding the 11th of November incident, there are two trains of thought regarding PEP within 72 hours of an exposure. One of them is that if the PEP failed to stop the infection from the 11th of November incident it might still delay the infection / seroconversion process hence the more conservative guidelines for PEP users, to test out to three months past the last dose of PEP instead of three months post exposure.

Jim

« Last Edit: December 13, 2018, 03:42:45 am by JimDublin »
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Offline Rwarrior38

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Re: Is it likely that I'm infected?
« Reply #6 on: December 28, 2018, 12:37:13 am »
Hello,

I have had several exposures to a partner who was ( unknowingly ) HIV positive.

I had an exposure to HIV on:
Oct 10th 2018, Oct 15th, Oct 23rd, Oct 28, Nov 3rd and Nov 11th 2018.

My partner found out he was HIV positive November 12th 2018.

 I had a baseline test on November 12th 2018, and it was negative. I was prescribed a 28 day treatment of PEP.

The PEP treatment ended on Dec 9th 2018.

I had a dual antibody/ Antigen HIV test done on Dec 12th, which was negative.

I had a PCR/ RNA test done, recently, on Dec 26th 2018 ( 6 weeks post exposure, 17 days post PEP ).

The PCR test was negative/ undetectable.

Can you tell me the if this is somewhat of a confirmation of being HIV negative? I see so many conflicting conservative responses online, ( and on this forum ) regarding the window period and frankly I'm sick of the mis-information.

Does a negative PCR/RNA, 17 days post PEP/ 46 days post exposure, give any likely indication of a negative result: yes or no?

 I know you are all supposed to say "test out to 12 weeks post pep, post exposure" or something to that affect. But I am sick of waiting and don't want these conservative, outdated window period responses for "outliers" or whatever you call them...I just want the most up to date, current, solid, direct, educated answer on the most likely outcome drawn from the information I have given, regarding the tests I have received. OR a reason why this most recent test, would not provide a conclusive result.  Surely someone knows the efficacy and reliability of this test in 2019

I'm not in a place of hysteria. I am completely at peace at this point, if i have HIV.. i just want an indication as to whether or not this latest PCR/ RNA is an indication of a negative result.

Please advise.

Thnx

ps. I'm a Canadian in Vietnam, and the language barrier hasn't always been the easiest so I rely on this forum for the most up to date info..thnx

Offline JimDublin

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Re: Is it likely that I'm infected?
« Reply #7 on: December 28, 2018, 02:28:16 am »
I merged your threads for you.

As a member of the AM I Infected Forum you are required to only post in this one thread no matter how long between visits or the subject matter. Thank you.

Quote
Does a negative PCR/RNA, 17 days post PEP/ 46 days post exposure, give any likely indication of a negative result: yes or no?

Lets see PCR can have have false results, also as a PEP user the drugs could have been suppressing the HIV viral load (PCR RNA) to undetectable levels and its not part of screening testing generally speaking for a reason, anyhow any negative result is a good indicator.

Now relax, PEP is highly effective and if you took it as directed I would fully expect a negative outcome, just follow-up with standard follow-up testing as per guidelines given to confirm that.

If you don't like or accept the assessment BTW that is fully up to you, shouting about it in caps and stomping your feet is not going to help you.

Jim
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HIV prevention
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PEP and PrEP

Offline Rwarrior38

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Re: Is it likely that I'm infected?
« Reply #8 on: December 28, 2018, 02:44:08 am »
No tantrums or feet stomping Jim.. Just a question ;)

I.do appreciate you taking the time to reply and my potentially aggressive tone was just frustration directed at the universe and having to wait in general..not you, or the moderators on this forum. ** gives him a friendly punch on the shoulder**

You mentioned that viral load can be suppressed to undetectable levels whilst on PEP..But even after 17 days off the medication? The RNA PCR I took detected 20 copies p/ ml ( I would think that after 17 days off of antiretroviral meds, some replication would occur, no? )

I do plan on taking the antigen/ antibody test at 4 weeks.. But we wondering about the viral load test being a possibility of a conclusive negative.

Given my exposure to my partner, I am/ was fully expecting to be diagnosed as HIV positive with this PCR.


Offline Rwarrior38

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Re: Is it likely that I'm infected?
« Reply #9 on: December 28, 2018, 02:54:19 am »
You also mentioned that "there is a reason PCR testing is not used for diagnosis..

But from what I've been reading... It is used for diagnosis..it is referred to as" the early detection test"... It generally only has a history of false positives ( not false negatives ) and is being considered in some cities as a means of early diagnosis testing.


Offline JimDublin

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Re: Is it likely that I'm infected?
« Reply #10 on: December 28, 2018, 03:01:04 am »
Quote
Given my exposure to my partner, I am/ was fully expecting to be diagnosed as HIV positive with this PCR.

Given your exposure and the PEP I was and, still am fully expecting a negative outcome. HIV is very difficult to transmit and you took PEP for the later exposures.

Quote
You mentioned that viral load can be suppressed to undetectable levels whilst on PEP..But even after 17 days off the medication? The RNA PCR I took detected 20 copies p/ ml ( I would think that after 17 days off of antiretroviral meds, some replication would occur, no? )

You have asked about the PCR already and I've given an assessment.

Low level VL post PEP is possible, and rebound can take time. Also regardless of this PCR method relies on amplifying copies, its less accurate even without PEP involvement and can have both false negative and false positives. The RNA version is used for routine Viral Load monitoring in confirmed cases, however its not used for routine screening in adults, there are cheaper and more accurate methods.  I know as example some commercial companies offer this test, but its simply not part of the initial screening algorithm

Quote
and is being considered in some cities as a means of early diagnosis testing.

It can in many cases pick up on a early infection, same as P24 Antigen, however the later is not offered as standalone due to issue of its own and the PCR would still need confirmation testing on any positive result due to the higher false positive rates and would not be conclusive on any negative results.

Ill repeat myself that any negative result is a good indicator, and that PEP is highly effective and if you took it as directed I would fully expect a negative outcome, just follow-up with standard follow-up testing as per guidelines given to confirm that.

This answer is not going to change, like it or lump it to be blunt at this stage.

Jim
« Last Edit: December 28, 2018, 03:05:44 am by JimDublin »
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HIV Transmission and Risks
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HIV Testing
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HIV TasP
You can read about HIV prevention here:
HIV prevention
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PEP and PrEP

Offline Rwarrior38

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Re: Is it likely that I'm infected?
« Reply #11 on: December 28, 2018, 11:50:38 pm »
So, after a million ways of asking the same question about the PCR test, I've come to the conclusion that either nobody knows anything about it on this forum ( or elsewhere ) or nobody wants to talk about it as a legitimate tool for early diagnosis.

Not even you Jim, have specifically referenced why it is not able to provide me with a definitive/ conclusive result.

Everyone I ask has vague, contradictory responses..and some Drs won't even answer questions about it..

Are we in the Twilight zone?

How is it that a test that measures for the virus itself can't be validated and verified as a useful option for early diagnosis...and why can't anyone give me a straight answer as to why it's not valid.

I'm so confused....it's comical actually. How conservative everyone is regarding the PCR.. As if it's a taboo to consider it as an actual means for testing.. Everyone says" dual antigen/ antibody test at 4 weeks"... What a load of bollocks..there is no reason why they pcr can't also be the first line test ( combined with the follow up dual 4th generation ).. It's just so weird to me that nobody talks about it.

 I paid 15 bucks to come in this forum and nobody replies to my messages..and Jim, no offence, but you don't seem to be very informed as far as the PCR test goes.

Ugh so frustrating.

Offline JimDublin

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Re: Is it likely that I'm infected?
« Reply #12 on: December 29, 2018, 03:38:32 am »
Hi

Quote
some Drs won't even answer questions about it..
Quote
How conservative everyone is regarding the PCR.. As if it's a taboo to consider it as an actual means for testing..

Asked and answered, and if I am reading this correctly so has apparently have other people you have been asking. Its simply not a conclusive test.

Now i'm sorry that you are frustrated about that but there is no point taking that out on me.  You're questions have been answered and I stand by the assessment provided.

Quote
nobody replies to my messages

WTH  ???

I have replied to all of your posts, I have answered your questions, you just don't like the answer as its not what you want to hear.

Move on. Test as per guidelines given or don't totally up to you.

Jim

« Last Edit: December 29, 2018, 03:41:55 am by JimDublin »
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Offline Rwarrior38

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Re: Is it likely that I'm infected?
« Reply #13 on: December 30, 2018, 03:47:32 am »
You're right Jim. I don't like the answers..

I guess I'm pissed that I'm stuck in Vietnam ( and not in Canada ) where I have zero access to specialists to answer my questions.. In Canada, I can't help but think there would be a Dr there that would give me a reassuring smack and say your fine..which is what I need. Or too just be told I'm positive and move the F on...

But this forum is not what I expected..You seem to be the only one responding to me or my concerns..I guess I was expecting to hear from other people too..their different perspectives.

I don't mean to be a Dick, I'm just annoyed..because I had made up my mind that I was HIV positive and became at peace with that...and now I'm testing negative and I'm just sick of the waiting and confusion.

 I imagine, from your perspective, all you ever have to deal with is mass hysteria and fear fear fear..so I apologize in advance if I'm adding to that..I can't imagine it's easy dealing with everyone's panic all the time

On that note,  I'll go over my testing history one last time and see if I can get you to flex your reassurance muscles on me:

I am a Canadian citizen. I am currently working abroad, in Vietnam.
Nobody speaks f#@king English so I'm hooped...

Here are the circumstances in chronological order:

I have had several exposures to HIV, from a partner who did not know his status. The last exposure was on Nov 11, 2018.

On Nov 12th I took a baseline 4th generation ( atg/ant ) HIV test ( negative)

On Dec 12th I started 28 days of PEP. (12 hours post exposure )

On Dec 9th 2018, the PEP treatment ended.

On Dec 12th, I had a 4th generation ( atg/ant ) HIV test ( Negative, 3days post PEP, 1month post exposure )

On Dec 26th, I had a PCR/ RNA HIV test.
( Negative, 45 days/ 6 weeks post exposure, 17 days post PEP)

Today, On Dec 29th, I had a 4th generation ( atg/ant ) HIV test
 ( Negative, 21 days post PEP, 7 weeks post exposure )

I will test again next week at 4 weeks post PEP ( 8 weeks post exposure, and again at 12 weeks post exposure )

But I would like to know, Would these test results be considered somewhat conclusive? Or would the PEP medication have delayed replication of detectable RNA, P24 protein as well as antibodies?

Any insight or advice would be much appreciated. I'm teetering on the edge here because nobody seems to be qualified to do anything other than administer the tests.

Thank you so much him. I owe you virtual beers 🍺



Offline JimDublin

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Re: Is it likely that I'm infected?
« Reply #14 on: December 30, 2018, 05:46:13 am »
I appreciate that you are anxious about the results and the waiting, truly I am and I've been there not only in regards to HIV but also far more important & inpactful things in life.

Stop stressing, stop focusing on this, test as per guidelines given and in the meantime focus on far more important things like living your life!

Maybe the lesson here is learning to cope in a positive way with uncertainty in life, and having patience because life is filled to the brim with waiting & uncertainties along the journey.  Being able to cope with a situation without freaking out is going to be a useful life skill. Prehaps whenever you are back home you could look into this uptoyou.

Quote
You're right Jim. I don't like the answers..

I guess I'm pissed that I'm stuck in Vietnam ( and not in Canada ) where I have zero access to specialists to answer my questions.. In Canada, I can't help but think there would be a Dr there that would give me a reassuring smack and say your fine..which is what I need. Or too just be told I'm positive and move the F on...

But this forum is not what I expected
..You seem to be the only one responding to me or my concerns..I guess I was expecting to hear from other people too..their different perspectives.

I don't mean to be a Dick, I'm just annoyed..because I had made up my mind that I was HIV positive and became at peace with that...and now I'm testing negative and I'm just sick of the waiting and confusion.

Only those Moderators and members who are authorized to answer questions in the Am I Infected? forum are permitted do so.

Currently there are 4 active members who are authorized and if any of them had anything to add to what I've told you they would not hesitate to do so.

I actually understand why so few volunteer to answer the questions from people here, and I totally understand why, given the paranoid, stigmatized, judgmental types of posting from people. Also bare in mind the primary focus here is being a community forum, a safe place for people living with HIV to provide each other public forum and private message support, not answering questions from the public.

So long story short very few of us living with HIV volunteer to provide risk assessments and safer sex information. I'm sorry if that is not what you were expecting.

Quote
I don't mean to be a Dick, I'm just annoyed..because I had made up my mind that I was HIV positive and became at peace with that...and now I'm testing negative and I'm just sick of the waiting and confusion

Quote
Today, On Dec 29th, I had a 4th generation ( atg/ant ) HIV test
 ( Negative, 21 days post PEP, 7 weeks post exposure )

You keep asking the same question about PCR and PEP, for the last time and to be clear even without PEP I would not recommend relying on PCR testing and certainly won't consider it conculsive in initial screening situations.

I do fully expect you to remain negative following the events posted here, PEP is highly effective and HIV is limited & highly difficult to transmit and thus I expect you to also contuine to test negative, the testing post PEP & Exposure is merely to confirm that.

Relax already stop focusing and stressing about this, focus on better things like living your life and, just test as per the guidelines given to confirm your negative earlier results

So go have a beer, go to work, read a book, go hiking, go laugh, go watch a movie whatever but simply move on.
Test as per guidelines given

Jim
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