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Author Topic: Symptoms after PEP  (Read 379 times)

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Offline racheglopez92

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Symptoms after PEP
« on: June 06, 2020, 12:37:10 pm »
Hi,

I am a transwoman who had gender reassignment surgery using the penile inversion method, meaning the surgeon who created my neovagina used penile material. I assume that many community members here are not doctors and/or medical professionals. But I still could use your feedback, support, and knowledge about HIV and PEP. I think it is important for me to have briefly mentioned the aforementioned surgical history within the context of my potential HIV risk. I also assume that traditional HIV risk statistics are out the door in my case because of my gender reassignment history.

On March 3rd, I had vaginal and anal sex for the first time in my life. I had this sex with a guy of unbeknownst HIV status to me. We had used a condom, which I had put on him, but it got in stuck in my neovagina. I donít know if he ejaculated into me or the condom prior to it getting stuck in me. I took the condom out of me and then we switched to anal sex with a new condom. Fearful of my HIV risk, I tried to go on PEP later that day, but the nearest urgent care center would not give PEP because I didn't have an occupational risk. The next day, I visited the local LGBTQ community health clinic near me and went on PEP within 24 hours of my potential HIV exposure. I completed the 28-day trial of Truvada and Tivicay on or around April 1st. I was fairly consistent with taking it. Except for occasional headaches, I didn't notice any potential ARS symptoms. Given the COVID-19 situation and being Type I Diabetic, I was unable to go for follow-up appointments at the community clinic. They are no longer seeing patients in person because of the pandemic.

Around May 5, I started feeling lethargic. About seven days later, my throat started to feel slightly sore. I also had slightly swollen lymph nodes and enlarged tonsils. But I had no discernible fever. I am surprised that I developed the sore throat as I have been in quarantine with limited exposure to people, except for my immediate family, because of the COVID-19 pandemic. No one in my family has had a sore throat. On May 19th, I went to my doctor given that I still had the sore throat and tonsillitis. She conducted strep and mono tests, the results of both of which came back negative. She also ordered a COVID19 test, which also came back negative. During the ensuing weeks since my drís appointment, I developed diarrhea attacks and a few aphthous sores on my lips. The apthous sores are an unusual development for me.
Currently, I still have a sore throat, recurrent aphthous sores on my lips, and tonsillitis. I am very worried and concerned that these and the other symptoms that I experienced might be late onset symptoms of acute HIV delayed because of the PEP.

I have the following questions: Can a person have an onset of ARS symptoms at 8+ weeks since HIV exposure? Can PEP/PREP delay the onset of ARS symptoms/seroconversion? Is Tonsillar Hypertrophy a common ARS symptom?

Prior to this HIV scare and PEP, I do have a history of consistently elevated liver enzymes. Plus, I am diabetic. My liver enzymes were also high on the tests the community clinic ordered on March 4th. Can being diabetic and having elevated liver enzymes impact the efficacy of PEP/PREP?

« Last Edit: June 06, 2020, 01:07:21 pm by racheglopez92 »

Offline Jim Allen

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Re: Symptoms after PEP
« Reply #1 on: June 06, 2020, 12:56:23 pm »
Quote
I also assume that traditional HIV risk statistics are out the door in my case because of my gender reassignment history.

Not at an individual level, no.

You had a risk, the condom fully came off during intercourse and you started PEP within 72 hours post this potential exposure. PEP is highly effective and I suspect if this was your only exposure and you finished the course of medication correctly you will be fine, however, just test to confirm this.  ;)

Understand that clinics might be hard to reach the moment but when you can test to confirm your HIV status. Test with a blood-drawn HIV antibodies test at 6+ weeks post-finishing PEP for a result, this result will rarely ever change and if you wish you can test at 3 months post-finishing PEP for a conclusive result.

In the meantime try not to focus on this and live your life as normal.

Quote
Therefore, I have the following questons for you: Can a person have an onset of ARS symptoms at 8+ weeks since HIV exposure? Can PEP/PREP delay the onset of ARS symptoms/seroconversion?

The most common initial symptoms are none whatsoever or at least nothing noticeable for the vast majority of people. ARS is overrated...

Quote
Is Tonsillar Hypertrophy a common ARS symptom? Prior to this HIV scare and PEP, I do have  history of consistently elevated liver enzymes. Plus, I am diabetic. My liver enzymes were also high on the tests the community clinic ordered on March 4th.

No, see above.

Quote
Can being diabetic and having elevated liver enzymes impact the efficacy of PEP/PREP?


No, not in the slightest.

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider taking PrEP as an additional layer of protection against HIV going forward.

Keep in mind that some sexual practices which may be described as safe in terms of HIV might still pose a risk for transmission of other far easier to acquire 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.

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: June 06, 2020, 01:13:11 pm by Jim Allen »
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You can read about HIV prevention here:
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Offline racheglopez92

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Re: Symptoms after PEP
« Reply #2 on: June 06, 2020, 02:02:22 pm »
Hi Jim,

I hope you are well during the COVID-19 pandemic.

Thank you for answering my questions.

Note: I say that I was fairly consistent with taking the PEP as I might have inadvertently taken two Truvada pills or two Tivicays on a few days instead of one Truvada and one Tivicay as I was proscribed. The Tivacay pills proscribed to me by the community clinic had come out of the container and would take them from my purse. Plus, I was having lots of headaches and not sleeping well because I have been worried about my job situation. But I finished the PEP on or around April 1st, which is keeping with the 28 day timeline.

Kind of weird and disappointing that my first time having sex has at least mentally done me in lol. Yes, I have abstained from further sex since the aforementioned incident with the guy. I have been going back and forth with asking him in hindsight his HIV status. He wanted to see me this week. But I declined given that I haven't been well and because of the COVID-19 situation.

I have been in contact with my local LGBTQ community health clinic. The PEP specialist there told me that he has never had a patient with seroconversion. He wants  me to go in for HIV testing at other facilities. But that's difficult for me, especially given the COVID19 pandemic. I do have a telemedicine appointment next Friday with the clinic's medical provider who proscribed me the PEP.
« Last Edit: June 06, 2020, 02:11:41 pm by racheglopez92 »

Offline Jim Allen

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Re: Symptoms after PEP
« Reply #3 on: June 06, 2020, 02:11:04 pm »
Quote
Thank you for answering my questions.

You're welcome.

Quote
Kind of weird and disappointing that my first time having sex has at least mentally done me in lol. I have abstained from further sex since the aforementioned incident with the guy. I have been going back and forth with asking him in hindsight his HIV status.

First times normally are disappointing in my book (At least as far as I can remember)

Asking him about his HIV status is pointless. Nothing he says or claims means anything at all and even if he recently tested then due to the window period it means nothing either. Stop torturing yourself about this as it's pointless.

Quote
He wanted to see me this week. But I declined given that I haven't been well and because of the COVID-19 situation.

 :) Well, at least it's a compliment that he wanted to see you again and smart move with regards to the COVID19 pandemic. He can wait.

Quote
I do have a telemedicine next Friday with the clinic's medical provider who proscribed me the PEP.

Cool, although, I am guessing if they are half decent the answer will be near enough the same that testing is needed to confirm your HIV status. Look, if the clinic is not an option, for the time being, I would then suggest as an alternative to test 3 months post-finishing PEP with an OTC Rapid test from a pharmacy for peace of mind.

Take it easy. Best, Jim
HIV 101 - Everything you need to know
HIV 101
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 racheglopez92

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Re: Symptoms after PEP
« Reply #4 on: June 06, 2020, 02:21:07 pm »
Hi Jim,

Thank you for your additional response.

I have one more question. Do you think accidentally taking two Truvada pills or two Tivichoy pills on a few occasions as the daily PEP dossage instead of one Truvada and one Tichoy as originally proscribed might reduce the efficacy of PEP.

I will refrain from asking anymore questions until I have my telemedicine appointment with the medical provider.

Offline Jim Allen

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Re: Symptoms after PEP
« Reply #5 on: June 06, 2020, 02:39:37 pm »
Double dosing during PEP on occasion when taking Tivicay (dolutegravir) or Truvada  (emtricitabine/tenofovir disoproxil fumarate) is not going to change the outcome in terms of your HIV status.

Quote
I will refrain from asking anymore questions until I have my telemedicine appointment with the medical provider.

Look this was your last free question. To be honest, unless your doctor is moron there is nothing to say just test as per guidelines above to confirm your HIV status.

As hard as it might be, try to relax, PEP is highly effective and I suspect if this was your only exposure and you finished the course of medication correctly you will be fine, however, just test to confirm this.
HIV 101 - Everything you need to know
HIV 101
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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