Had unprotected anal sex and is stressing out

[compnow]

I cannot believe how completely and utterly idiotic and foolish I was but I feel utterly stressed and devastated. I am a bisexual guy who decided last week, on Monday for the first time to try anal sex. I asked the guy to put a condom on, and I have no idea who this guy is although he too seemed around my age of 25. But he did not, and we had unprotected anal sex for a couple of minutes although he did not ejaculate in me but outside. I know what an idiot I am, and will be going for an hiv test as soon as possible. but because i have no idea of this guys history or anything, although I know I was clean before, I am going beserk. These have been the longest days of my life so far truly. Do you know what the likelihood of me having caught hiv would be if he were positive? I wanted to turn back time immediately after it happened and did not know about the pep. i only found out about it yesterday and by then it was already 90 hours after, and it said that maximum efficiency was 74. Just needing to hear what I should do now, and somehow what I can do to remove this anxiety.

[HSci34]

Relax.  

Let's take a look at the facts.  Yes, you did engage in the highest risk sexual exposure.  The fact he did not ejaculate greatly reduces the chances you were infected, but you are still at a moderate-high risk.  Now, an incident of unprotected anal sex to completion usually results in transmission 0.5-1% of the time - if the person was infected.  Did you ask if the person was infected? That's just as important to prevention as using a condom.  You did not know that they were infected (most likely they were not), and HIV is a hard virus to transmit unlike what most believe (as the data I've told you indicates - 0.5-1%? Shocking number to most people).  Overall, sexual transmission of HIV is not highly efficient and the odds are strongly that you dodged the bullet.  It's important, however, that you change your behaviour - otherwise, you are at high risk for future infection.

Now, check out this awesome post by Dr. HHH that has some information I think you would appreciate: http://www.medhelp.org/posts/show/489847

[Teak]

An ELISA is not reliable at 28 days and a PCR test is not an approved diagnostic test.

[compnow]

thanks for the infomation. I guess that I am going to have to stick it out but I do not know how I am going to be able to wait that long for I am already in shreds after 5 days. Everyone has noticed the change in behaviour but will have to somehow find a way. Problem is that also I am not out and that is what led me to this hidden behaviour rather than being open brave and safe. And as for finding out whether he was positive, I still wrack my brain as to why I was too afraid to ask. I guess I had too much trust in believeing that if he knew he was positive, why would he wish to go without a condom. Whatever the case, I have learnt my lesson although it is a very hard lesson to learn and the worst way. Is there any test I can primarily take a few days from now which will be able to give me at least partial coverage and percentage statistics that I have not got hiv?

[Teak]

The only sure way to know that you are not infected is by testing. Any other way is guessing and HIV is nothing to guess about.

[Teak]

You've been reported to Medhelp for giving out false information on testing. There are NO TESTS approved to give a conclusive test result less than 3 months.

[compnow]

thanks for all your comments and help. i do not think j friend means that that is absolute for finding out status, but that at least it can provide at least a temporary assurance at least until the 3 month test. I would rather take all these tests and remove some form of this anxiety rather than wait a whole three months before I can do anything.

[J_friend]

this is your ego talking, and if you need to make me the bad guy, then so be it.  Perhaps I'll be removed from this forum.  I have never (not ONCE) told anyone to not get a 12 week  Elisa test - I suggest that EVERYONE does.  What I AM saying is that a negative Elisa combined with an undectable viral load at 28 days will reveal one's HIV true status; and if one is inclined to obsess, then it's wise to do this.  Then one may relax and collect their conclusive negative at 12 weeks.  

I challenged you and pointed out inconsistencies in your feedback - namely, relying on the CDC when it suits you, and then giving out information which does the CDC does not agree with when it suits you.

If you can't debate rationally, and if you are going to "fall apart" when I confront you with information you're not comfortable with, then I think that is a shame; and what's more, it's telling as to how you handle a debate.

[Teak]

Which is false information. Do you even know what the VL has to be to detected? In the first few weeks of infection you wouldn't even have a detectable VL. VL tests are not approved diagnostic tests for those that believe they were recently infected people. They are screening tests to monitor the progression of people at are positive. Like I said I have HIV and I don't have a detectable VL.

[Teak]

What you think and what is fact is totally different. It's not an approved diagnostic test. If you want to argue the point take it to the Drs. forum where they will both tell you that they are not approved diagnostic tests.

[J_friend]

Incorrect.  In the first few weeks of infection, the VL is literally "through the roof" in most infected people.  Hence, this is why many people experience ARS - they have an enormous viral load; which, when antibodies are formed, the VL decreases dramatically, and the illness subsides.  This is BASIC information, and I find it spooky that you educate people about HIV and claim to be unaware of this scientific fact regarding HIV.

[lookin4answers80]

It is unbelievable how much you claim to know, and unbelievable how you clearly do not know what you are talking about. Viral load is ridiculously high post-exposure. You are harming people on this forum who come here for help by giving them false information - by telling them oral sex poses no risk at all, by claiming that people do not develop a high viral load in the first days and weeks post-exposure. What about if we report you for giving out false information?

[J_friend]

I believe Teak is probably correct in regards to oral sex, although there many out there who swear that is how they contracted HIV.   However, you are 100% correct in stating that the viral load is VERY high during the first few weeks of infection.  There are several things about this virus which can be debated: window period, PCR testing, oral sex, etc.  However, there is absolutely NO debate in the scientific community about the typical progression of HIV.  Google it and get an image - the graph charts show a HUGE spike in viral load during the initial weeks after infection, and then a marked decrease in viral load when antibodies are formed.  To say that there is not detectable virus in the first weeks post exposure is irresponsible, and dare I say negligent.

[lookin4answers80]

The CDC, and any number of other sources, are clear that oral sex poses a risk. Look, there's not some magical quality about oral sex that keeps you from getting HIV. All the components are there - infected fluid and a place for the virus to get in. From everything I've read, there are lots of things about the mouth that make infection a lot harder than the vagina or the anus. It's not likely to go through as much stress as the anus, which means it is less likely to have cuts. Saliva helps deactivate the virus. You can spit out any semen or pre-seminal fluid. Obviously, the risk is tiny. But it does certainly exist, and I believe the CDC and several other sources do have documented case of infection via oral sex. You probably have a bigger chance of being struck by lightning, but the chance is there, based on what I've read. Granted, an amateur opinion. But I'm never going to be so convinced about the safety of oral sex that I'll start letting guys ejaculate in my mouth or something.

[J_friend]

Well, you have no argument with me over here.  And, when you look at the dynamics of transmission, it seems to make sense it's possible.  I mean let's take this scenario:  Someone has an open sore in their mouth (which isn't uncommon) - and let's say it's even a large sore.  They go out, have a few drinks, and although it hurts ... this person meets a guy at a bar and performs oral sex in the parking lot (not an uncommon situation, I'm sure).  Let's say the man getting head is newly positive and has a high viral load.  In addition, the person performing allows the guy to ejaculate in his mouth, and even (in the moment of lust) swishes the semen around in this mouth before swallowing.  So, we have infected fluid (with a high viral load) which literally being sucked into an open wound.  Sorry for the graphics ... but in your defense, it DOES seem like that could be a scenario for transmission to take place.  But who knows, perhaps the air in the mouth, the sailva, and the type of cells located at the wound do not allow for infection.  I guess my point is, we just don't know.  Again, there are people who swear they've been infected this way.  On the other hand, I'd say giving head to someone (even if you have a sore) when there's no ejaculation would be next-to-impossible for transmission.  This is ALL just speculation on my behalf ...

This is ALL just speculation on my behalf ... and of course, we're just playing with different possible scenarios.  And, although I think that oral is a VERY, VERY small risk (if at all), I'm much more convinced of my previous point regarding the 28 day Elisa combined with a PCR.

Anyway, I don't mean to illicit a rant from Teak ... but as we all know, HIV is such an odd disease in that has so many variables regarding so many different aspects: transmission, window period, testing, etc.

[Teak]

Oral sex and saliva
http://www.aegis.com/news/pr/1998/pr980105.html

[compnow]

ok, i need to talk about further developments because my body is going haywire. I have now got a very itchy anus, and it is swollen and red on three quarters and has thickened around the sides. That is causing me severe worries that I will have at least got a sexually transmitted disease. This was my first time ever that anything has been inserted there so could it just be trauma? In addition, it has been six days now, but I am getting an incredibly dry mouth, am sweating profusely although I do not believe I have a fevour although my body feels weak and I am unable to sleep. I beleieve that all these last symptoms are due to the incredible anxiety I am feeling. I just needto know if I can go for an std test immedtaely and not wait so long like i do for the hiv test

[Teak]

See your doctor if you believe you have hemorrhoids.

[lookin4answers80]

You're giving us a link from 1998 to prove that saliva blocks the virus? The article is optimistic that "This finding could lead to the development of natural inhibitors to HIV transmission." Well, ten years later, we're still waiting for that, aren't we? I'm not sure how much stock I would put in that study.

[Teak]

Yes it's been known for years.

[lookin4answers80]

Well, then I'll keep waiting with eager anticipation for the saliva-based vaccine or cream that will enable us all to have unprotected vaginal or anal sex without risk of infection.

[Teak]

You just keep waiting. I've been waiting for 23 years.

[lookin4answers80]

Alas, I think it's going to take a while for any vaccine or really revolutionary new treatment. So discouraging when the vaccine trials start out so promising and end up failing. Viruses of any kind, and particularly this one, are so hard to deal with.

Anyway, though, I don't want to continue to hijack the original purpose of this post, which was for someone with a high risk potential exposure to get answers. It's probably not the proper forum in which to debate the risk from oral sex.

[J_friend]

I agree with you about hi-jacking the forum, and I also think it would be irresponsible for someone to say that is is literally impossible for oral sex. But, if you can get it from giving than wouldn't you HAVE to be able to get it from receiving?  I mean, we're talking dynamics, right?  And if you're soley talking dynamics, then you'd have to concede it's POSSIBLE to get it from receiving if ALL the conditions are present (open wound on penis, blood gushing into open wound).  But, it doesn't happen.  I've read (forget where I read this) that they've tried to inoculate the mouth's monkeys with highly concentrated virus, yet it doesn't take for some reason.

So, here's what we DO know:  you don't get HIV from receiving - not one documented case.  There have been three MAJOR studies (and large ones) performed with couples in which one partner has HIV and one doesn't.  And, when condoms were ALWAYS used for anal and vaginal sex, there was NO transmission of HIV - zero.  And I'm talking large studies in which unprotected oral (even with ejaculation) occurred thousands of times. These studies tell us that although the transmission dynamics DO exist, for some reason (probably MANY reasons - some we know, some we probably don't know) it just didn't seem to happen in these THOUSANDS of documented episodes. I guess you take from that what you will.  Personally, I think it would be irresponsible to say there's NO WAY it can happen; and I've yet to ever hear a doctor say that it's 100% impossible.  However, it does seem to be more theoretical than real.  

[Med Help]

Hi,

Just a clarification on the testing advice posted here previously. We sent this to HHH for clarification and he does agree that Elisa is not reliable or approved. Here is his reply, and please note, this is an exception that we get clarification from him, and not something we will do by request:

I believe it is true that PCR tests for HIV is not FDA-approved for diagnosis of early HIV infection; they were developed to monitor viral load in people with known HIV infection, not for the primary purpose of initial diagnosis. However, they certainly have been used to detect HIV infection in people in the seroconversion window, including routine use by some health agencies.  I believe blood banks routinely do it as well, on all blood donations.

[Teak]

Dr. H is correct they are monitoring tests and are also used in blood banks and tissue banks but are not FDA approved for diagnostic use.

[overlyworried]

Hey compnow, your situation is similar to mine. I didn't really partake in anal sex but about a month ago I got way too drunk and this friend of mine and I started fooling around and he tried to have anal sex. basically, his attempts to have anal sex sobered me up enough to stop the advance. I know there was definite penis to anus contact, i don't think there was very much penetration before I ended the act. Anyway, I too feel the need to get tested for HIV. I did do a baseline at about 7 days post possible exposure and it was not surprisingly negative. I am going to have another rapid test down at four weeks just to easy my own fears. I will probably have another at 8 weeks and my final one at 12 weeks. The good thing is that I work in a medical laboratory and so i can just perform the test on myself so it isn't like I am shelling out loads of money. I am optimistic that both you and me are negative. I hope your anxiety level goes down because I know how it feels to worry.

[overlyworried]

Your comments on this thread have certainly put my situation into perspective and helped me relax a bit. I thank you for that. The uncertainty is what gets to me and I know the only way to truly know is to test...it's just a long time to wait and think about the outcome. This site overall is just a great resource!

[compnow]

Thanks to overlyworried so much for your words of support- they truly are encouraging for me. I am just writing again because i have just in the last day developed many small red sports just like an extended rash on my chest and am afraid that this might be a symptom of ars. I am now 9 days down the line. Please could you tell me if the rash is localised or spread everywhere. Also, I have just decided to take the p24 antigen test just now and was given by the doctor the double test which i am assuming is the elisa and blot as well as for hep b. now i know that you guys have said the latter two will not be sure until 3 months, but is p24 the one is should take for regarding viral load, or is that the pcr and how different is that, and if so, how do it get the test. many thanks,

[ECN44120]

P24 test looks for the p24 antigen present in early infection up to 30 days is very encouragin but not conclusive, the PCR test is used to control the viral load of hiv positive people, not for diagnostic.

[wonderingaloud]

Hi I am certainly not an authority or anything more than a person that was in your shoes waiting for proper time to test after an exposure.  I just read the postings here and noticed no one suggested that you might be in contact with the guy or be able to find him and go for testing together.  If he is negative you can rest a little easier in that knowledge even though there still remains the risk that he was infected and in the window period himself.  Just a thought because dude, been there, anxiety is killer and I know what you are going through. Any little boost of confidence that you are HIV free gets you a small reprieve from the anxiety.  I think you will be ok and the good thing is if you are you have a chance to change things for your future.  good luck I am pulling for you.

[ECN44120]

That is a good idea also, try to get him tested, and then you will now.

[regularjoey]

The only thing that the ELISA and WB tests will tell at this point is if you were infected prior to your incident.  The p24 test looks for the presence of a major HIV protein, it has nothing to do with the viral load test.  This test is also not very informative at 9 days.  I'm sorry, but you have no choice but to wait a while...

[lookin4answers80]

The rash associated with HIV is pretty non-specific. It would usually be reddish in color and tends to show up the most often on the chest, neck, and face. It's most often accompanied by other symptoms, especially a fever, sore throat, and the usual other symptoms. Regardless, there are dozens, if not hundreds, of things that could cause a rash, and HIV is probably not the most likely of those. And you can't use symptoms to diagnose HIV, as I am sure you know.

At this point, only a couple of weeks out from your unprotected sex, there's no test that will tell you much of anything, although, as was already said, a negative p24 antigen test would be encouraging. An antibody test will do you no good at all, and a viral load test would be unreliable too. Much as it's hard to do, you're just going to have to wait a few weeks for your test to have any degree of reliability.

[compnow]

I just got back results from a blood test which gave me a negative, but I think I will go again and do that test when the viral load is most probably highest. When would that be? I am now on day 10. What other tests soon would be partially conclusive? I realise that the elisa at 3 months is what is definately needed, but I would rather keep on taking tests which would at least provide some good percentages of whether i have got it or not. The doctor also looked at my lymphocyte and other blood tests and said that all parts of my blood were functioning properly. Should there be other warning signs if i did have hiv, that would show a high or low amount of something in my blood. Could i also ask why a pcr test is not good for diagnosis and why I cannot try and take that?
In addition, I have started to develop a rash and sore through, and have extreme fatigue although this might be due to the depression and anxiety which is why the doctor has put me on zoloft, xanax and sleeping tablets. This incident of risk taking was not a usual form of behaviour for me and unfortunately it has brought upso many previous issues. Unfortuntaley also with the case of getting the guy tested, the sex was anonymous and I was drunk and I have no idea who he is or how I would get in contact with him. there is no possibility that way. also, I just have nightmares since I was sure I saw a black blotch around his waist at one time but cannot be too sure since it was so dark. In any case, I would very much appreciate it if there were answers to my previous questions and thanks for your info again guys. it has been of support in many times.

[compnow]

btw. i was referring to the p24 which indicated negative at 8 days

[ECN44120]

Well your test were to early even to bo encouraging, if you can handle the waiting on the window period, test at 4 weeks with a DUO test p24/Antb for a 90% accurate result, then at 6 weeks for a 95%accurate, and then at 3 months for the conclusive result, Dont get a PCR, just imagine how you`ll feel if you become one of the 8% of people that get false positive results, and then have to wait the same 3 motnhs to get the confirmation, I know that is very hard, but there is nothing else to do just waiting and praying.

Good luck

[regularjoey]

This is the general timeline of HIV:

day 0 - infection
day 10 - viral load becomes detectable
  a week later - p24 becomes detectable
3 weeks - ELISA becomes positive
  3 days later - bands appear on the Western Blot
1 month - Western Blot becomes fully positive

This is what happens most of the time.  Now you need to discuss with your doctor how to go about this.  As ECN said, p24 test is worthless at 8 days - p24 is never detected this early on.  My opinion: you should get a regular ELISA after a month (a fourth generation ELISA can be even taken a week earlier, but you won't get it if you're in the US).  If that test is negative that should relieve your anxiety.  You should follow that up with another test after 3 months to be sure.

[something]

First of all, think before You do. I have had an anxiety about HIV before one year., I tested myself just in case and I was negative for HIV. Big stone went off from my shoulders, anyway, as I come back to these days when I was worried about HIV now I think it is ridiculous! There are more horrible illnesses in this world- CANCER, Terminal cancer, RABIES and many many more. HIVis not so scary anymore. When I though I have HIV,it was just anxiety. Because I was never sleeping around with anyone I meet anywhere..You should think before U do it... NEXT time remember this. Moreover, Test Yourself in HIV in order , not to infect anyone else You do not know! GOOD luck!

[compnow]

ok, today is day 14 now, and when would taking the p24 be the best effective within the 30 day window

[compnow]

??

[Teak]

3 weeks is the cut off on a P24 test. Waste of money.

[Teak]

The viral load will test undetectable, which doesn't tell you wether you are positive or not.

[Teak]

Move on. PCR tests are not diagnostic tests and VL tests are not approved to be used for diagnostic use. They are monitoring test for people that are known to be  HIV positive.

[compnow]

i am confused. so you say that a p24 is inefficient 8 days after, but also 30 days after. so when would be a good time to try it. i dont care whether pcr is not for detection I would rather take it to get it all over. the longer I wait the more anxious depressed and suicidal i am getting and need to try or have something. anything

[compnow]

otherwise i will just go for a blood donation and try and get a confirmation that way

[nursegirl6572]

I understand that you are stressed......but going for a transfusion is NOT the way to go...actually, you'd be forced to lie when they ask if you've had any high-risk behavior.  That is just very irresponsible.  Also, by the time they found out and told you....your window period would most likely be up anyway.

See your doc for some anti-anxiety meds.  Remember....your chances are pretty good that it will turn out okay.  Keep the faith and hang in there.

I know the waiting is hard...but you will know soon enough.

[nursegirl6572]

Is there any way of tracking this guy down and having him go for a test?  That would be a sure fire way to find out.

[regularjoey]

Don't go for the blood donation, that's a crime.  Besides, they don't tell you the test results unless something is wrong.  Which means that you will be spending weeks waiting for that phone call - how is that good for the anxiety?  I agree with nursegirl, anxiety has to be dealt with separately.  As far as testing, you have multiple options while you are in the window period, as I already told you above.  I recommend a standard ELISA at 1 month, 90% infected people will test positive by that time.  So a negative result at that point should take care of most anxiety issues.  PCR is also an option, but I don't recommend it.  It often takes a long time (like a week) to run, so you will need to wait anyway and it won't save you any time.  Bottom line: wait a little while, take some valerian root in the meantime.  Then take a standard (or even a rapid) HIV ELISA.  Best of luck

[compnow]

i cant stand the anxiety anymore.please tellme what to do.i feel like just taking pills and overdosing. i just need to have something i can do proactively. im reading everyone elses situations and not one of them is as stupid a risk as mine. i know ive been a bloody idiot but ive never been so down. i didnt ask if he was positive,it was anonymous, i didnt have it protected i didnt do pep, i didnt wash straight away and have huge hemmroids now. an elisa at one month. which test is that.it has to e done cos i dont thinki can take much more.

[regularjoey]

Chill out!  Take some Ativan if you have to!  Go to a clinic and ask them what tests they offer and how long is the wait for results.  Take a rapid test at 4 weeks and CHILL OUT!

[compnow]

i would if it werent for the fact that i had this in a really promiscuous place and he seemed like the kind of guy who had done it before, and if he refused to be protected with me then he would have with someone else too, and it just seems like the kind of thing. he had a blackmark on his waist. and i was so pissed. but will just chill.

[icegrill]

I know what you are going through. I've been there, and I would not want anyone to go through what I did. I'm still waiting for my 3 month mark, but I've started to hit the gym. Don't let anxiety and stress overtake you. I've experienced many of the ARS symptoms but it was probably due to anxiety.

My buddy suggested I start working out, but I was reluctant because I was concerned whether I had HIV or not. Hitting the gym was the best medicine and it calmed me down. Take control of the situation, believe me, I was in the same boat as you.

[compnow]

ok. so took an p24 antigen and a double test a week or two after my exposure and they all came back negative. they then put me on zoloft for antidepression, and xanax for panic attacks due to my thoughts of impending doom, and also dormicum to help me sleep. i tried to overdose on all these the other day but i am still here. the only thing is decided to stop taking all these drugs all on one day after taking them for three weeks at double the prescribed amount. i went through some real bad withrdrawal symptoms, but I fear that these were not withdrawal symptoms at all like people try and persuade me they were and instead hiv symtoms. for example, I never have night sweats and yet in the last week have been having to wake up several times every night due to soaking the bed completely with sweat. the doctor said this was not a symptom of hiv but i know that to be wrong since i have since found that it is. I had cold symtoms, muscle tremors and spasm, numbness, diarrhea, nausea all in week three which lasted for a week. I am now scared utterly ********. Can anyone tell me whether night sweats truly are a big problem with ARS or if it is most likely anxiety or such. its just i have never had them before and for such a long time- over a week. also, how fine would my results be. i know they are not 100 percent conclusive but what chance is it that it is correct percentage wise. cheers

[nursegirl6572]

No offense, but you need some serious help.  Did you seek attention for the OD?  Keep in mind that you may end up with bigger problems than HIV if you attempt something like that.....you could have LONG term disabilities...it just isn't worth it.

Going off those meds cold turkey will wreak absolute HAVOC on your body.  Especially withdrawl from a benzo like Xanax....it can be absolutely hellish.

My advice is TAKE your meds AS PRESCRIBED, and hang in there...you're almost there.  The only person that is truly convinced that you have contracted it is YOU...everyone else knows the risks aren't nearly as bad as you are thinking.  There is a good chance that this will all turn out okay...give yourself a chance.