HIV - Prevention Expert Forum
HIV Exposure Anxiety
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HIV Exposure Anxiety

I pulled the trigger & explored my sexuality, and I HATE myself for it. I was drunk. I gave & received oral (protected & unprotected), and received anal sex (unprotected) from two different male craigslist strangers over the course of three days. Neither man came inside me. I plan on getting tested for sure, first thing tomorrow (2 days after intercourse), and will follow-up with HIV testing at 4  & 12 weeks. I've read my chances of contracting HIV from this scenario range anywhere from 1:300 to 1:1200, maybe lower since they were inside me only for a few moments. Exploring, for me, was SOOO not worth it. I'm freaking paranoid.

Should I have this level of anxiety, or am I over thinking this? I'll have to wait & see, but it sounds like the odds are in my favor. Can anyone confirm these odds? I feel I'm being overly pessimistic about the likelihood I've contracted HIV & have extreme anxiety.  Is it worth it to take the 72 hour pills, or anxiety pills? Please help.
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Welcome to the forum.

Tell me more about the exposures. What did your partner say about their HIV status?  Most people don't lie when asked directly.  If you didn't ask, or if they said they were negative but you would like additional reassurance, I suggest you speak with them at this time and ask if they are willing to be (re)tested; you could offer to pay for the tests.  If they are documented to be HIV negative, then your worries are over.

If your partners had HIV, or if you can't find out. then you should immediately see a doctor or clinic with expertise in HIV and discuss possible post-exposure prophylaxis (PEP) (which is what I think you mean by "72 hour pills").  Do it ASAP:  72 hours is the latest it will work, but the sooner the better; ideally such treatment should begin within 24 hours.

And you can do both of thse things at the same time.  Sometimes PEP is initiated, but then stopped if after a few days it is possible to learn for sure that no exposure occurred, i.e. that your partners don't have HIV.

Whatever happens, do not allow yourself to be paralyzed by anxiety.  ACT NOW!  All things considered, the chance you acquired HIV is low, even if one of your partners was infected.  But the worst thing you can do, both in regard to prevention and to the anxiety itself, is to sit around flagellating yourself with guilt over a sexual choice you regret.  There's time for that later -- but not now.

Let me know how it works out after you have spoken to your partners and/or have received professional evaluation and advice about PEP.

Regards--  HHH, MD
7 Comments
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Avatar_m_tn
Thanks Dr. Handsfield.

I asked both partners directly if they "had anything", and they both said no. One guy said it was his first time with another man (32 year old married man), but the other guy has been "out" for about six years (20 year old kid). Again, both assured me they were clean, but who knows. I will be seeing my doctor first thing this morning, not only for STD screening, but also for a general physical check-up & routine blood work. Side effects of PEP seem severe, & considering my overall low chance of contracting HIV, I'll be discussing this with my doctor.

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239123_tn?1267651214
As I said, most people don't lie about HIV status when asked directly, and if the information about their past sexual lifestyles is true, then both partners would seem to be at relatively low risk.  I agree you should discuss these and other issues with your doctor and come together on a decision for or against PEP.

Now that we're past the acute anxiety phase, probably it doesn't need to be said -- but as a general educational point, for other readers as much as for you personally, a comment about your decision, in particular having anal sex with other men without condoms:  WHAT WERE YOU THINKING???  You probably have dodged the bullet this time, but if you continue this approach to sex with other men, even occasionally, you can expect to have HIV someday.  I would also encourage you to plan on having a more specific conversation than "do you have anything?"  Ask specifically about HIV status and avoid sex -- even protected or otherwise safe -- with those who are positive (and not on anti-HIV therapy), don't know, or seem evasive about it.

I know you described these events as one-time "exploration", but many people in that situation -- if not you, then perhaps other forum readers -- find themselves drawn back to additional episodes.  Just a word to the wise.
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Avatar_m_tn
Noted. My doctor & I discussed this issue, and considering the CDC guidelines for administering PEP (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5402a1.htm), specifically considering the unknown HIV status of my partner, and a lack of bodily fluid exchange during the episode, he agreed that my risk was slight & the odds were in my favor, but he suggested I take PEP if it would reduce my anxiety over the issue. Considering the side effects & low(er) risk, I'm leaning towards not taking a PEP regime. I did get a full STD screening 36 hours after the exposure, but will follow up in one week (for non HIV STD's) & I'll be specifically tested for HIV in one month, three month, and six month intervals. I imagine I'll have anxiety until a six month check-up. Never again will I put myself into this high risk group, and this is truly a one time exploration. I didn't like it & the risk is too high. I truly hoped I've dodged a bullet, as you suggest, and I appreciate this forum. I'll follow up as I learn more about my health & test results.
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Avatar_m_tn
Additionally, I was prescribed Ambien to help me sleep, because thinking about this & how I've potentially destroyed my life was keeping me up at night, which effected my energy level throughout the day. Hopefully I can sleep tonight.
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239123_tn?1267651214
The other thing you should consider -- in a discussion with your doctor -- is that when PEP is not effective, it may delay the time until defnitive testing.  PEP will delay the time unitl you will know for sure you weren't infected at least to 3 months, and some experts recommend 6 months.  Without PEP, you'll know for sure -- almost certainly negative test results -- after 6-8 weeks.  Think carefully about how well you will tolerate taking that much time to know for sure.

That will end this thread. You needn't post the results of your medical evaluation, testing or treatment; I won't have any further comments or advice.
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Avatar_m_tn
Thanks for your feedback, it's truly helpful.
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This Forum's Experts
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
University of Alabama at Birmingham
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