I'm panicing

[mikeward]

Hello,

I'll be honest: My life is a nightmare now. I had sex with a prostitute in thailand and the condom broke up. First, I want to know what are the chance of being infected with HIV? Second, what should I do? I'm really really panicing...please help me...please

Mike

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

It is a qualitative test the one I suggested.
Best wishes,
Dr José

[mikeward]

I know I'm asking too much but I'm clueless...my sincere apologies

I called for an appointment for a RNA test. They said they have a qualitative test. Is it ok ?

[mikeward]

Thank you so much for your answer!

I have a last to end-up the discussion.

What is the accuracy of the RNA test after 10 days?

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

I do not think that you need to worry too much about it.  Firstly we do not know the actual status of the othe rperson, and as mentioned above, the estimated risk of your particular sexual encounter, assuming that she was positive is less than 0.1% or less than 1 in 1,000.  I have never had anyone being infected in similar circumstances from one single episode.
Saliva test are less reliable than blood tests. They usually only test for antibodies, which would not be conclusive this early on.  The best option from the point of view of testing would be as follows:
- PCR RNA test after 10 days
- HIV Duo or Combo after 4 weeks.
Best wishes,
Dr José

[mikeward]

One more thing Dr Jose.

After the intercourse, the girl told me that she did a test 5 months ago that turns out negative. Does this timing mean something in terms of risk?

Thanks again!

[mikeward]

Dr Jose,

Since I know the bar the girl work and I've been there many times, the doctor at my office gave me saliva test to give her.

1. Are saliva test reliable?
2. If this test turns out negative, what conclusion can I draw?
3. The 0.1% stat you mentionned is based on my situation or is a general statistic? If it's general, do you have any idea of a stat for my situation?

Sorry for all these questions, but I don't know where to get support.

Thanks a lot!

[mikeward]

Thanks Dr for your response.

After reading your answer, I'm panicking. I didn't took PEP and now it's too late. What should I do?

I can't believe I made this mistake :(

From your personnal experience, how you ever heard people getting HIV from a similar situation ?

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you for your post.
The chances of having been infected with HIV in a situation like this are relatively low, estimated at less 0.1% if the lady was positive.  As it was a condom breakage, the risk to you would even be less as the time of exposure was shorter than if you had had the whole intercourse unprotected.
In a situation like yours, where there was some degree of unprotected penetration, insertive vaginal with an individual of unknown status from a high prevalence group (sex worker) in a country like Thailand, where the incidence of HIV is high, PEP can be considered.  However it needs to be started within 72 hours of the incident.
Best wishes,
Dr José

[mikeward]

One more question to the Dr who will answer. Should I take the PEP?

[lessoninlife]

From the other posts usually a day or two. Maybe a bit longer as its the weekend.

[mikeward]

Thanks for your answer. Do you know I long it take to get an answer from a Dr on this forum ?

[lessoninlife]

Hi Mike,

I'm not a doctor but I am going through a similar scare so this is what I know. If she did in fact have HIV the chance of transmission is about 1 in 2000 if it was penile vagina intercourse. This is if she has HIV and the chances are she probably does not. So the risk of any transmission is low. If the possible exposure was less than 72 hours ago you can go to a sexual health clinic and get a PEP course which I think is about a month of tablet taking and that pretty much means HIV won't develop. After 72 hours this medication does not work. If it has been more than 72 hours sit tight and after 28 days you can do a duo test (HIV p24 antigen + HIV-1/2 IgM/IgG antibody) which will confirm one way or the other.

I missed the deadline for PEP and am now 25 days since potential exposure. It's tough mentally and a nightmare but each day gets a bit easier. Remember the statistics are on your side.

One of the doctors might be able to give a better answer. I hope it all goes well.