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Author Topic: A few questions...  (Read 442 times)

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Offline tooclosetothesun

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A few questions...
« on: September 28, 2020, 12:50:50 pm »
Hi,

Thankful to have found this forum.
A couple of days ago, I had an encounter with a trans sex worker from Thailand. I received anal sex, gave and received oral sex and rimming, and I swallowed her sperm.

Before the anal sex, I specifically asked her to use a condom, which she confirmed; but I didn’t see her put one on, and she commenced penetration immediately. In addition, we were both high on drugs at the time, so my memory is patchy. Later, she did for sure use a condom, but I suspect there is a risk that she “stealthed” me in the beginning and didn’t use a condom. She was also very insistent on giving me poppers, presumably to incapacitate me somewhat. Furthermore, she stole money from me, making it very hard to trust anything she said.

Unfortunately, after the encounter I discovered that this particular person regularly offers unprotected anal sex. This — in addition to her geographic origin and profession — made me find it reasonable to assume that she was likely HIV+, and after debating with myself whether to do it or not, I ended up contacting the local hospital. The very understanding doctor said she considered it a ‘borderline case’ as I wasn’t sure whether there was actually any unprotected penetration, but they offered me PEP (lamivudine, tenofovir disoproxil and dolutegravir). I went through and have started taking it, 20 hours after the encounter, mostly because I couldn’t live with the uncertainty.

I have a few questions regarding this:

   1.   Do you find it sensible that I went on PEP?
   2.   I’m worried about the side effects. I only had one dose and so far notice general tiredness and malaise. If you took PEP, when did the side-effects start, if any?
   3.   If the side effects get untolerable, do you think this encounter was low-risk enough that I should consider simply discontinuing the PEP, from a risk-benefit perspective?

Obviously, my mental state right now is pretty dire, and I’m full of self-hatred. To be honest, this whole experience was slightly traumatizing.

I’d just like to hear some honest opinions and perhaps similar stories.

Thank you.

Offline Jim Allen

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Re: A few questions...
« Reply #1 on: September 28, 2020, 12:59:44 pm »
Hiya

No judgement but you were stoned so I am not going to trust anything you recall. Whatever this person does or doesn't do with others is irrelevant.

1) Yes, although, PReP and condoms going forward would be a more sensible choice.

2) After one dose doubtful. Keep your doctor posted on how you are feeling thought.

3) if that happens you could talk to your doctor about switching meds, mostly side effects if any are mild and settle in after a few weeks. You're only going to be taking the meds for a short time to prevent having to take them for life.

I'll post a longer response when I get home and I'm at my laptop.

« Last Edit: September 28, 2020, 01:37:05 pm by Jim Allen »
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Offline Jim Allen

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Re: A few questions...
« Reply #2 on: September 28, 2020, 02:22:16 pm »
Quote
  1.   Do you find it sensible that I went on PEP?

Quote
In addition, we were both high on drugs at the time, so my memory is patchy.

Yes, as you can't fully recall what happened. What you suspect about this person or their own HIV risks does not factor into this. She could have had sex with the entire village and be HIV negative.


Quote
2.   I’m worried about the side effects. I only had one dose and so far notice general tiredness and malaise. If you took PEP, when did the side-effects start, if any?

Two of the three drugs you are taking are part of my current treatment and, the third drug is one I used to take. They are all solid, as with any drug, there can be a settling in period. However, keep your healthcare provider posted on any issues experienced.

Quote
  3.   If the side effects get untolerable, do you think this encounter was low-risk enough that I should consider simply discontinuing the PEP, from a risk-benefit perspective?

An unlikely "what if" given the short duration and the meds your taking. If that should happen you could talk to you doctor, depending on the side effects there are several options, as an example taking additional meds to manage the side effects, discontinuing one of the medications or switching meds, etc.

Try not to worry about problems you don't have. 

Quote
Obviously, my mental state right now is pretty dire, and I’m full of self-hatred. To be honest, this whole experience was slightly traumatizing.

I’d just like to hear some honest opinions and perhaps similar stories.

Look I am sorry to hear that you are stressing and about the self-hate. Looks sounds like you were having fun and enjoying sex, there is nothing to feel bad about.

I will say, PEP is highly effective when started within 72 hours. I suspect if this was your only exposure and you finish the course of medication correctly, you will be fine.  ;)

Just test to confirm this. Test with a blood-drawn HIV antibodies test 6 weeks post-finishing PEP for a result, this result will rarely ever change. If you wish for peace of mind, you repeat at 3 months post-finishing PEP for a conclusive result.

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

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. Contuine taking PrEP as an additional layer of HIV protection.

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.

Kind regards

Jim

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HIV 101 - Everything you need to know
HIV 101
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HIV Testing
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HIV TasP
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HIV prevention
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PEP and PrEP

Offline tooclosetothesun

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Re: A few questions...
« Reply #3 on: September 28, 2020, 03:02:50 pm »
Hi Jim,

Thank you so much for your quick and very thoughful reply.

You motivated me to continue on the PEP. I’m grateful that I got access to this so quickly. I took my second dose a few hours ago and felt nauseous for a while, but it is tolerable. For all I know, it could be psychosomatic.

I’ll stick to the medicine and try to get over this.

Thanks for your help again!

Offline Jim Allen

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Re: A few questions...
« Reply #4 on: September 28, 2020, 03:12:05 pm »
You're welcome.

Glad to hear it's tolerable, there are basic tips on nausea should it continue, it's one of the more common side-effects that passes. (Do keep your doctor posted though) https://www.poz.com/basics/hiv-basics/nausea-vomiting-diarrhea

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 tooclosetothesun

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Re: A few questions...
« Reply #5 on: September 30, 2020, 08:24:56 pm »
Hi,

Thanks again for all the info. Certainly feeling better.

I have just one more question: I’m taking the meds now at 6 PM but would like to change it to 9 or maybe 10 PM due to the side effects, so I can sleep through them. Is it OK to do so? Can I change it at once, or should I change it over a few days in increments of X hrs/minutes? My doctor seemed unsure on this.

Offline Jim Allen

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Re: A few questions...
« Reply #6 on: September 30, 2020, 09:28:34 pm »
You're welcome.

Sorry to hear the doc did not have the answer. Generally on PEP, you can adjust the doses gradually by 1 to 2 hours until you are at a standard time.

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

 


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