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HIV risks, stop PEP
Hello
I also post this in the free forum, but I would want more professional advice.
I am currenty in PEP treatment for 8 days for having safe oral and vaginal sex with an african prostitute. The reason I am on PEP is because I masturbated with mi fingers deep into the female vagina, and I had hang-nails and wounds in my fingers due to my bad habit of eating my nails. In addition I rubbed my eyes just after having my fingers with her fluids.
I freaked out and run to the emergency center and began the treatment. I didn´t lie at all. They agreed on giving me the treatment, I would think because of my nervousness at that time.
The HIV status of the female is unknown but I have my doubts due to the origin and profession of the female.
Now that some days happened I have the following questions:
1. Do you think i had risk of contracting HIV because of the facts i told you?
2.I am worried about the side effects of the medicaments I am taking Kaletra (4 each day) + Truvada (1 each day). Im having nauseas and diarrhea and had pale stool despite i was completely healthy before this.
Do you think I should take just the Truvada? Could the cut or the total stop of treatment lead to resistance if I finally have HIV?
3.I am concerned too about the long term side effects that I read in the information pamphlet like lypodistrophy, liver or pancreas problems, or lactic acidosis. Could this happen in a 28 days treatment?
Thank you for your time and patience, and sorry for my english. Im not an english native speaker.
I also post this in the free forum, but I would want more professional advice.
I am currenty in PEP treatment for 8 days for having safe oral and vaginal sex with an african prostitute. The reason I am on PEP is because I masturbated with mi fingers deep into the female vagina, and I had hang-nails and wounds in my fingers due to my bad habit of eating my nails. In addition I rubbed my eyes just after having my fingers with her fluids.
I freaked out and run to the emergency center and began the treatment. I didn´t lie at all. They agreed on giving me the treatment, I would think because of my nervousness at that time.
The HIV status of the female is unknown but I have my doubts due to the origin and profession of the female.
Now that some days happened I have the following questions:
1. Do you think i had risk of contracting HIV because of the facts i told you?
2.I am worried about the side effects of the medicaments I am taking Kaletra (4 each day) + Truvada (1 each day). Im having nauseas and diarrhea and had pale stool despite i was completely healthy before this.
Do you think I should take just the Truvada? Could the cut or the total stop of treatment lead to resistance if I finally have HIV?
3.I am concerned too about the long term side effects that I read in the information pamphlet like lypodistrophy, liver or pancreas problems, or lactic acidosis. Could this happen in a 28 days treatment?
Thank you for your time and patience, and sorry for my english. Im not an english native speaker.
MEDICAL PROFESSIONAL
Welcome to the forum.
Unfortunately, we do not give direct medical care -- and that's what it would be if I gave you a specific recommdation to either continue or stop taking PEP. I have to say that I do think you (and maybe the ER doctor) overreacted -- this was not an exposure that in my opinion warranted PEP. Hand-genital contact and fingering are not significant HIV risks, even with an infected partner -- and it is statistically unlikely your partner had HIV. (In most of the US and most industrialized countries, even among commercial sex workers and the most sexually active heterosexual women, well under 1% have HIV.) But now that you are on treatment, for medical advice on whether to continue or stop it, you should return to the ER where it was prescribed, or to your own doctor.
To your specific questions:
1) This exposure was virtually zero risk for HIV.
2) I agree these symptoms are a concern and could be due to side effects of the PEP drugs.
3) These long term problems are very rare with short duration treatment as used for PEP (4 weeks). From that standpoint, it is safe to continue treatment.
Another aspect that you should consider -- and discuss with the doctor you see for professional advice -- is that if PEP doesn't successfully prevent HIV, it may prolong the time to a positive test. Therefore, following PEP many experts recommend testing as late as 6 months after the exposure. Without PEP, valid testing can be done at 4-8 weeks, depending on the specific test (or combination of tests) that may be done. In other words, PEP may unnecessarily prolong the duration of anxiety until a conclusive test can be done.
I'll be interested to hear the decision about PEP after you have been professionally re-evaluated. But whathever the decision, don't lose a lot of sleep over this. With or without PEP, you are at extremely low if any risk for HIV.
Best regards-- HHH, MD
Unfortunately, we do not give direct medical care -- and that's what it would be if I gave you a specific recommdation to either continue or stop taking PEP. I have to say that I do think you (and maybe the ER doctor) overreacted -- this was not an exposure that in my opinion warranted PEP. Hand-genital contact and fingering are not significant HIV risks, even with an infected partner -- and it is statistically unlikely your partner had HIV. (In most of the US and most industrialized countries, even among commercial sex workers and the most sexually active heterosexual women, well under 1% have HIV.) But now that you are on treatment, for medical advice on whether to continue or stop it, you should return to the ER where it was prescribed, or to your own doctor.
To your specific questions:
1) This exposure was virtually zero risk for HIV.
2) I agree these symptoms are a concern and could be due to side effects of the PEP drugs.
3) These long term problems are very rare with short duration treatment as used for PEP (4 weeks). From that standpoint, it is safe to continue treatment.
Another aspect that you should consider -- and discuss with the doctor you see for professional advice -- is that if PEP doesn't successfully prevent HIV, it may prolong the time to a positive test. Therefore, following PEP many experts recommend testing as late as 6 months after the exposure. Without PEP, valid testing can be done at 4-8 weeks, depending on the specific test (or combination of tests) that may be done. In other words, PEP may unnecessarily prolong the duration of anxiety until a conclusive test can be done.
I'll be interested to hear the decision about PEP after you have been professionally re-evaluated. But whathever the decision, don't lose a lot of sleep over this. With or without PEP, you are at extremely low if any risk for HIV.
Best regards-- HHH, MD
MEDICAL PROFESSIONAL
"Why was my post deleted?"
Because it was irrelevant. It still is. The notion of delayed toxicity from a brief course of PEP when the same drugs are tolerated for 15+ years is a bit silly, and there is no biological plausibility for new side effects to show up after that time, or to appear many years after taking such drugs. "Freakout mode" is an irrational response. I have no other comments or advice for you.
Because it was irrelevant. It still is. The notion of delayed toxicity from a brief course of PEP when the same drugs are tolerated for 15+ years is a bit silly, and there is no biological plausibility for new side effects to show up after that time, or to appear many years after taking such drugs. "Freakout mode" is an irrational response. I have no other comments or advice for you.
Why was my post deleted?
I will repeat what I wrote, as it was not inappropriate at all.
I spoke to the individual who made the statement quoted above - about people not living longer than 15 years after taking HIV meds. He told me that he meant we have no data since HIV meds only came out about 15 years ago. Those people are still alive ... we just don't have data on them as more time needs to pass. Please don't delete my post this time. When i read the quote above, it put me into freakout mode, and its important to note that the author did not intend to imply that people die within 15 years.
I will repeat what I wrote, as it was not inappropriate at all.
I spoke to the individual who made the statement quoted above - about people not living longer than 15 years after taking HIV meds. He told me that he meant we have no data since HIV meds only came out about 15 years ago. Those people are still alive ... we just don't have data on them as more time needs to pass. Please don't delete my post this time. When i read the quote above, it put me into freakout mode, and its important to note that the author did not intend to imply that people die within 15 years.
MEDICAL PROFESSIONAL
We have explained why such exposures aren't risky for HIV many, many times on this forum. Here is one such discussion; you can use the search function to find others: http://www.medhelp.org/posts/show/1319634
Condoms are 100% effective if they do not break wide open.
I disagree with the statement you found in another forum. If there were no serious side effects of PEP drugs after a few years, it is very unlikely any will show up after 15 years or more.
Condoms are 100% effective if they do not break wide open.
I disagree with the statement you found in another forum. If there were no serious side effects of PEP drugs after a few years, it is very unlikely any will show up after 15 years or more.
Thank you very much Dr for your quick response.
Sorry but I would like to ask again about the risks I had.
1. Why finger a women having some wounds could be less risky than having intercourse without a condom?. I keep reading it but I cant totally understand it.
2. And what about rubbing your eyes a minutes later without washing them (I know that was stupid, but i was drunk). I understand the eyes could be a way to go into the bloodstream.
3. One more question that if you answer could reduce my anxiety. Could a condom that is not broken be inaffective cause is not made of latex or is out of date. I couldn´t provide the condom then, so I dont know anything about brand, expire date.
4. I read on this same website from an active user the following:
"Also it has been documented that the earlist users of PEP have not lived for more than 15 years so the long term effects of PEP are still unknown.
Are there any members who can confirm that they felt no effects of PEP post completion? "
Is there any truth in this or we have a troll in the Forums?
Thank you for your time. I will keep you update with everything that happens during the treatment or after, just for the general knowledge, if you consider so.
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