I had an exposure on January 2nd. I am male, partner was male who had recent HIV (-) test from a week prior (physically confirmed with copy of report), and was on Truvada for PrEP (could not get a read on how often he took his pills, but from limited conversation 50-75% of the time). We had sex (I was insertive anal partner) for approximately 10 minutes after trying sex with a condom; alcohol was involved, I had poor decision making, but I'm working on forgiving myself now. Afterward, he told me had sex with about 3 other people in the past month's time without condoms, though he stated they were HIV (-). He sadly was not willing to get retested during my course of PEP (which I realized was a lot to ask).
That night, I could not sleep and freaked out and went to the hospital that afternoon to start PEP, ~22 hours after the exposure. The regimen I was placed on was Truvada + Isentriss, for which I am not on my last day. Overall, well tolerated.
I have a few questions.
1) Given that he was recently HIV (-), even though he could have theoretically been in a window period from his other partners, was my risk high enough to start PEP? The things working in my favor were that he had a recent negative test, was on Truvada, and I was the insertive partner. Using stats available online, I feel my chances from those information together put my risk well above 1/100,000 before PEP is even added to the equation.
2) For PEP regimens with Isentriss, a relatively new regimen, I have not found any studies that have shown active PEP failures, granted the two studies only had N=100 and incomplete follow up (~85-90%). How effective have you found this regimen to be, and is it likely more effective than the previous forms of PEP? How often to insertive anal partner PEP failures occur from your moderating of the board/professional practice and knowledge?
3) I began having urethral itching after the encounter (neg for G/C/Herpes). No additional burning on urination, no urgency. Just a discomfort near the urethra. I don't know if my anxiety is driving it, or if it's potentially irritation from the sex (potentially too rough), potentially fungal (starting an -azole cream) but the fact that it started 4 days after the encounter, would that help or hurt the infectivity of HIV if it were hanging around in the urethra?
4) The doctor said she would do an NAAT test two weeks after i stop PEP along with the p24 antigen test and antibody test, as if the virus was in my system and the drugs were out of my system, viral particles would likely be present. Is that true to give me SOME form of early reassurance, or does PEP completely throw the dates off on all tests.
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