hiv exposure

I had sex(using condom)with a sex worker 3 months ago(6 june 2011)i few hours after the exposure iwent to see doctor and was given pep medication for on month.
1) Is my case consider high risk? After one month of pep i went back to take the test on day 30. The result was negative. I took a second tstt on day 89 after the exposure and result is negative. Is the two result enough to be conclusive? I got sore throat and flu one month later after exposure and now on 91 days having the same symptom.will the hiv symptom now then surface. Can a negative results turn postive at 6 months period or evn on the 4 or 5 month?
2). Do pep cause a delay to the antibody to be detected after 3 months becos i am afraid the antibody with start to surface after 3 months and that is why my result at 89days is still negative.
3). How does pep works? Do it kills the virus or suppress the virus becos two local doctor tells me different thing. One say kills the other says suppress the virus. ,
4).After finishing my pep treatment, i went for a oral swap test using blood and the result is negative. Two day after my result i had unprotected sex with my wife who is negative (cos my daughter is hiv negative) and the next day her period came. Will she have any chance of getting hiv although my 89days result is negative.
5).Hi doctor my local doctor told me because pep suppress the virus therefore my case may need to extend even till 9 months. What is your pt of view. Because my local doctor is a Gp whereas u r specialist in hiv.

[Edward W Hook, MD]

Welcome to the Forum. I will try to provide the information that you seek.  Because there is overlap in the questions you are asking, rather than answering question by question, I will provide answers to your questions below.

The exposure you describe  was virtually no risk for HIV since condom protected sex is safe sex, since most commercial sex do not have HIV, and since even if your partner did, even if you had not used a condom your risk for HIV would only be about 1 in 1000.  If you were my patient I would not have recommended PEP.

PEP is thought to keep the virus from becoming established to cause infection. When it fails, antibody production can be delayed but usually not by much.

In your case you have negative tests for HIV about 60 days (8+ weeks) after your exposure and most people would have developed antibodies in this time.

Given your no risk exposure, that you took PEP and with your negative blood tests, at this time I would recommend that you be confident that you did not get HIV from the exposure you describe.  in my opinion there is no need for further testing, in part because of the nature of your exposure.  Your doctor, in recommending further testing is being conservative and I cannot in any way fault that.  But if you test further, I am confident that your tests will be negative and that you did not get HIV.

There is no risk in this situation to your wife.

I hope this helps.EWH

[scare73]

Hi doctor, But for my case i was on pep for one month, so could it be the pep is causing a delay in the formation of the antibody and that is why even when i am tested negative using the oral swap saliva test on 89 days after exposure.
By the way i notice that i had a flu and sore throat on the fifth week after exposure which lasted about 1 week and now at 91 days i develop flu and sore throat again.
Can the symptom which i mention above at week 5 and on 91 days related to hiv infection?
Is there any chances of me turning from negative to postive base on your expertise?
Is the pep medication really useful?

[Edward W Hook, MD]

These are repetitive questions.  I know how long you took PEP an have explained that for the reasons I outlined you need not to worry.  You did not become infected.  

. EWH

[scare73]

hi doctor, is my 89 days of negative test result conclusive? can i have unprotected sex with my wife from now on?
pls advice, thanks

[Edward W Hook, MD]

LAst answer.  Your questions remain repetitive.  If your result was not conclusive, would I say that you had not gotten infected?  You did not get infected so of course you can have unprotected sex with your wife without fear that you might have gotten HIV from the encounter you described.

The thread is over. EWH