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Condom broke during sex with sexworker (PEP after 28 hours)
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Condom broke during sex with sexworker (PEP after 28 hours)

I had an incident a few weeks ago. I was very drunk and went to see a thai sexworker (transvestite). We had some mutual oralsex and penis-*** rubbing. Afterwards i put on a condom, and we had analsex. The condom broke during this, and i didn't notice it before i finished. The intercourse lasted for less than a minute, and i assume i was exposed for 20-30 seconds. 28 Hours later I started a PEP treatment, and now i'm 17 days in. I now that PEP i higly effective according to various studies, but there is still a risk of getting infected. The treatment itself does contain alot of nasty side effects. I have experienced diarrhea, fatigue, sore throath (mild), yellowing of the skin and some muscular and joint pains. My question is regarding the pain i am experiencing, and whether this could be a sign of PEP failure:

I have some pain in the neck which has been there since day 8, and during the past week I have experienced pain in the armpits/breast region, comming and going like a lightning. Further i have this constant feeling that my neck/face is swollen. It feels like by my neck and some times the region around the ears are going to explode,  

I am higly aware of the fact that swollen lymph nodes are a sign of ARS. This freaks me out a little bit. I have checked my lymphs allmost everyday, and even though they feel tiny, I cant avoid to link the pain with swollen lymphs or at least lymphs that are about to swell. So here are the question in mind.

1. Is there a link between pain in regions containing lymphs (neck, armpits, breast) and swollen lymphs nodes?
2. How do you now, if your lymphs are swollen? Will they appear directly for the untrained eye, and will they come with nasty side effects, such as high fever?
3. How high is my risk considering the following facts, and assuming the sexworker was HIV positive and not under treatment. - During analsex, I was exposed for about 20-30 seconds because the condom i was wearing broke.
- I am circumcised
- Mutual anal/penis rubbing
- Mutual brief oralsex with no precum or ejalucation
- I dont have any STD
- I started PEP 28 hours after the incident with the following medication: Truvada, Rayatez and Norvir - one pill of each one time a day.

I hope you can help
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12 Comments Post a Comment
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Avatar_m_tn
I forgot to mention: I didnt have any visible cuts on my penis nor was there any blood on my penis, when i finished. There could have been microscopic cuts on the penis, because i shaved it 12-14 hours earlier (also the lower of the shaft, which was exposed), but when i shaved it nothing went wrong. So i assume the skin was intact. This leads to question four:

4. Could there have been microscopic cuts on my penis because of shaving, even though nothing went wrong and there wasnt any blood when i did it.
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Avatar_m_tn
Does any one know what my risk are for seroconversion? I am now experiencing sore throat which is spreading in my mouth. I dont have fever, and i don't think i have a swollen lymphs.
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186166_tn?1385262982
sounds to me like you are experiencing anxiety...not ars.

swollen lymph nodes from ars are not painful and are ALOT larger than normal pea sized.

as you know...you were protected up until the condom failed and 20-30 seconds is minimal exposure.  i'm quite surprised you were even given PEP for this exposure as it is usually given to those who were exposed to a KNOWN hiv + person.

you know the drill...3 months post pep for a conclusive result.
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Avatar_m_tn
Elisa test 6 weeks post exposure came back negative. I know this isn't really reliable but the doctor at freedomhealth mentions that he hasn't seen a case of a negative test imediately after PEP turn positive. This gives me some hope but I have some questions:
I had a very very bad sore throat 8-9 weeks post exposure, which means 4-5 weeks post PEP. I haven't had a sore throat like this before in my life. I wasn't very very sick all though i might have had a little fever (but i didn't meassure my temperature, so I don't know).

I have heard that due to PEP the body can behave abnormal over usual infections, and give a very very sore throat. Is this true or did i experience ARS?
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Avatar_m_tn
No that is not true. AVR's do not cause sore throat.
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Avatar_m_tn
I didn't say that ARV could cause sore throat. I said that PEP might alter the bodys reaction to a very normal infection as a seasonal virus (its -10 degrees here). If no research has been done on the subject, it's difficult to speak about. But could you answer me this:

Do you think my very unsual sore throat at 8-9 weeks post exposure has anything to do with ARS? Isn't unsual for ARS to show up so late even though I was on PEP?

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Avatar_m_tn
What do you think nPEP is?
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Avatar_m_tn
I know that ARV=PEP. So this doesn't change a thing. My concerns are regarding a month of PEP (or call it ARV) altering your bodys natural response to a harmless infection. It sounds like you haven't heard anything about this, so this is probably not the case in most patients.

Anyhow you might know the answer to my second question. ARS at 8-9 weeks post exposure when you have had 4 weeks of PEP?
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186166_tn?1385262982
if you had read any of this forum, you would know that symptoms dont diagnose hiv.  the same symptoms of early infection are also associated with many common, everyday illnesses.  this is why it is "useless" to discuss symptoms.
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Avatar_m_tn
In other words we cant know if the symptoms are ARS related or not. It's just frustrating that there are so much information regarding ARS, window period and HIV but not that much about people who have had PEP.

Several times have I heard that my risk was low and I didn't needed PEP in the first place even though i was exposed for under a minute. So PEP should give me some comfort. To be honest it has given me a lot of comfort and especially the negative test at 6 weeks. But then this sore throat showing up a few weeks later gives me a lot of anxiety.

In your experience, what would you expect my outcome to be knowing the following:
- 6 week elisa negative
- 3drug pep
- condom split exposing me through insertive anal sex for under 1 minute
- sore throat 4-5 weeks post pep
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186166_tn?1385262982
a 6 week test is a good "indication" of your status and with today's tests, unlikely to change.

with that being said...test at 3 months for that conclusive result.

not much else to say...
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Avatar_m_tn
Here is an update on my case:
3rd generation 2 months post pep test just got back from the lab, and they were negative.
This will be conclusive for me, due to the brief exposure, due to me taking PEP and due to the 3rd generations test detecting up till 99% at 6 weeks... At 8 weeks (post PEP) this number would be no less. What are your thought on this? Here in my country they state 8 weeks post exposure as conclusive.

My very very sore throat 1 month ago was nothing! It did freak med out, but this had nothing to do with acute HIV.
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