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Author Topic: Is it possible that I was infected before PEP?  (Read 901 times)

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Offline ajperezmorales

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Is it possible that I was infected before PEP?
« on: July 27, 2019, 07:10:46 pm »
So, this is a long story full of rapid HIV tests. In which I have to point out some things:

-I am Venezuelan inmigrant living in Santiago. Chile, who just had his documents a week ago after an entire year.
-Health public system for undocumented people in Chile is kind of tricky and bureaucratic.
-I didn't have the money to afford private treatment or assistance.
-Chile doesn't have PreP policies nor similar medicaments are easy to get.
-The explanation is long.
-I am very stupid and anxious about my actions.

So, everything began on January 25th, some months ago. Those days I stupidly decided to repeatedly engage in unprotected sex with a guy who claimed he was on PreP(while I wasn't), though I already was aware of the incredibly high rates of HIV transmission that Chile has, I somehow didn't pay too much attention about it and I trusted this person until February 4th. Around two weeks later, after a deep and anxious process of reflection, I decided to take a rapid test from a kind of cheap testing office that claimed they had the best rapid test ever, accurate at two weeks after exposure. So I tested negative and I felt sort of relieved, however, somedays after, an unfortunate situation happened: I engaged with another person from Grindr and the condom broke without me noticing at the moment.

As I wasn't willing to face anxiety again, I managed to find through the collaboration of a foundation, some pills for a whole month treatment of Efavirenz and Kivexa. That resolution didn't help at all to control my anxiety, especially because, a week after that last encounter, I started feeling very ill: fever, headaches, swollen glands in groin and neck. I somehow managed to get money to afford a private infections specialist who didn't give me any relief and told me my regime wasn't effective and that I had to test right after the next week in VDRL, herpes, HIV, and others in order to see if my situation was related to my first unprotected experiences. Then I decided to wait a bit after finishing PEP because I couldn't afford to test twice for all those things. That PEP period was horrible since I was completely destroyed from side effects and other infection-like symptoms, that I thought they were connected to HIV.

The worst stupid thing I've done is that I engaged once again with the first person UNPROTECTED a few days before finishing PEP. You can blame me, I know how stupid I am.

So I tested from the vein after PEP and everything was Ok. And later on, I tested like a thousand times with rapid tests, which were the only ones free. I had the chance to test from the vein two times later: once 4 weeks after PEP and 5 after the last encounter and another time 8 weeks after PEP. Beside those laboratory tests, I had many point-to-care, until 100 hundred days after PEP. All throughout that period, I had many many colds, infections, and stuff so I never stopped feeling I was HIV positive despite the results. Many months after, the glands that originally enlarged still feel round and large, and my original stuffy nose and sore throat symptoms still remain.

Recently, two things happened: I enlisted in a program of an HIV activist movement that provides cheap Truvada bio-equivalents but without the normal evaluation procedures of normal PreP policies. And I also was diagnosed with chronic sinusitis, which somehow explains the throat and nose symptoms.

Some days ago, reading about PEP, I encounter this article in POZ https://www.poz.com/article/taking-prep-contracting-hiv-may-stall-positive-test-result that actually describes the possibility of generating a 100 days remission of HIV if PEP was started some days after the initial exposure. Since I had PEP two weeks after that likely first exposure, I am wondering if this might have happened to me. Even though I am taking Truvada's bioequivalent and that the last test before this was taken 4th months after last unprotected exposure, I haven't tested again from the vein since the 8-weeks-after test. So is it possible that I have experienced a delaying?

I might test from the vein in some weeks, but as the article and other resources say that HIV put under meds during the initial infection may weaken the virus so it might not be detectable to test, I am wondering if facing something similar would be possible in my case.

I know the best option is to consult a specialist, but unfortunately, I still can't afford it and the health public system in Chile is dumb in giving answers to situations like this. For example, I can't approach HIV specialists in Hospitals if I am not actually HIV positive.

I appreciate if you have read everything until this line, I know it is a lot of information, and I'd appreciate you even better if you can provide any insight or helpful opinion about my case.

Offline Jim Allen

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Re: Is it possible that I was infected before PEP?
« Reply #1 on: July 27, 2019, 07:50:14 pm »
Hiya,

The article is about PrEP not PEP, don't confuse the two also, it's not news, it was not even newsworthy in 2017 if you ask me. 

Anyhow, I gather you had risks before and, during PEP. The last risk event was a few days before finishing PEP?

Test over the date you finished PEP, it will cover the exposures from before that as well. See the conservative answer is the testing guidelines are applied post-finishing PEP instead of post-exposure to cover any possible delay.

So test at 6 weeks post finishing PEP for a result, this result will rarely ever change, test again at 3 months post finishing PEP if you want a conclusive result with an approved antibodies test.

It's unclear to me if in the meantime you have started PrEP though?

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.

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

Please Note.
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: July 27, 2019, 08:04:54 pm by Jim Allen »
HIV 101 - Everything you need to know
HIV 101
Transmission and Risks:
HIV Transmission and Risks
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline ajperezmorales

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Re: Is it possible that I was infected before PEP?
« Reply #2 on: July 28, 2019, 05:09:07 pm »
I started PreP a few weeks ago, through somehow of a trial policy of an institution that only required a base 4th generation rapid test. My most recent test was a rapid 4th generation one last week at 128 days after finishing the first PEP treatment. Knowing so, should I feel relief about the topic or do you think it is better to test with a more precise test such as 4th generation lab ELISA or any other?

I am really sorry if the situation feels confusing, Chile is not great at all in terms of health support regarding this kind of situations, and it's even worst for people in my financial and migratory status. So I've all the time felt kind of confused about days, window periods, the likelihood of a seroconversion delay and ways of transmission. I remember that the infection specialists even told me to stop any form of oral sex because that's one of the main ways of transmission. Later on, I learned the opposite from different sources.

Thank you very much for your incredible fast replay, by the way.

Offline Jim Allen

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Re: Is it possible that I was infected before PEP?
« Reply #3 on: July 28, 2019, 05:43:29 pm »
How many days/weeks did you test post finishing PEP and, before starting PrEP? You mentioned 128 days post PEP and that is way past confirmed I'm just not sure when you started PrEP.

Let me word it like this if you tested  at 6 weeks post finishing PEP and before starting PrEP it's highly unlikely to change.

To avoid HIV start using condoms and, as you are on PrEP test for STI's & HiV out of routine every 3 months if possible
« Last Edit: July 28, 2019, 05:57:31 pm by Jim Allen »
HIV 101 - Everything you need to know
HIV 101
Transmission and Risks:
HIV Transmission and Risks
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline ajperezmorales

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Re: Is it possible that I was infected before PEP?
« Reply #4 on: November 15, 2019, 06:56:44 am »
After 4 days of restarting PreP, I engaged in an unprotected receptive encounter with a few seconds of penetration with no ejaculation. I've read that you need at least 7 days for full protection as a bottom and I wanted to know what's my real risk/level of protection and if I should be doing something beyond taking my meds normally.

Offline Jim Allen

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Re: Is it possible that I was infected before PEP?
« Reply #5 on: November 15, 2019, 07:29:28 am »
Hiya

Look PrEP is highly effective but it's not a guarantee, and using it incorrectly will just further increase your risks.  You had a risk although as a PrEP user you should be testing every 3 months anyway so keep testing as per schedule.

If you keep struggling to adhere to Daily PrEP you might want to talk to your doctor to see if PrEP on demand would be more suitable.

In short, this dosing option is only suitable for anal sex.

take 2 pills 2 – 24 hours before sex
take 1 pill 24 hours later
take 1 more pill 24 hours after that

If you’re having sex for an extended period of time, perhaps over a few days or a weekend, continue to take a pill every 24 hours until you have 2 sex-free days.

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. Continue to use 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 easier to transmit 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

Kind regards

Jim

Please Note.
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.
 

HIV 101 - Everything you need to know
HIV 101
Transmission and Risks:
HIV Transmission and Risks
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

 


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