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Insertive Anal Blood Present
I am a male and had a possible exposure one week ago with another male I met another male on an online app. I was the insertive partner during anal using a condom. After a short time (couple minutes) I noticed the condom broke (stupidly used oil based lube). There was considerable blood on the broken condom. I was freaking out and asked if he had diseases. He said "no" but very unconvincingly and I felt like he wasn't actually sure. He rushed out so we didn't really discuss it more than that. After a day of thinking, I started to panic that this hookup app probably has high incident of disease so I went to an urgent care and ended up starting PEP at 35 hours after the exposure. I am currently on day 7 and intend to be very diligent about the PEP for 28 days.
I know the insertive partner typically has a less chance of getting hiv than receptive but how much more does the risk increase with the presence of blood. I realize there is a chance he is negative but if I assume he was positive, is this a high likelihood of transmission given MSM, stranger from online app, blood, etc? Even though 35 hours is in the window of PEP to work, I wish I had started sooner. Are my chances still good for stopping transmission? Is there any point to doing a HIV RNA test at day 11 or will the PEP make the result delayed (even if not 100%, I would be willing to do it if it could give any reassurance). Will all my testing windows be delayed because of PEP or when can I test for reliable results? Like everyone on here, the stress of waiting is consuming my life. Thank you in advance for any advice or insight.
I know the insertive partner typically has a less chance of getting hiv than receptive but how much more does the risk increase with the presence of blood. I realize there is a chance he is negative but if I assume he was positive, is this a high likelihood of transmission given MSM, stranger from online app, blood, etc? Even though 35 hours is in the window of PEP to work, I wish I had started sooner. Are my chances still good for stopping transmission? Is there any point to doing a HIV RNA test at day 11 or will the PEP make the result delayed (even if not 100%, I would be willing to do it if it could give any reassurance). Will all my testing windows be delayed because of PEP or when can I test for reliable results? Like everyone on here, the stress of waiting is consuming my life. Thank you in advance for any advice or insight.
COMMUNITY LEADER
The risk for a one-time anal encounter is between 0.04 and 0.06%. In other words, a 99.94-99.96% chance of NOT being infected - and that is without using PEP.
There is no point in taking any tests until you finish PEP. PEP inhibits the replication of the virus, so there won't be anything to detect until after you've finished PEP. You could take an RNA test mid-PEP, but it would only serve as an encouragement, and not necessarily an indication of whether you will remain negative following PEP.
Keep in mind that any one-time encounter carries very low risk.
There is no point in taking any tests until you finish PEP. PEP inhibits the replication of the virus, so there won't be anything to detect until after you've finished PEP. You could take an RNA test mid-PEP, but it would only serve as an encouragement, and not necessarily an indication of whether you will remain negative following PEP.
Keep in mind that any one-time encounter carries very low risk.
3 Comments
Thank you for the response. Based on that risk, it sounds like my choice for PEP may be extreme but I will stay the course for extra protection. Does the statistic account for the blood that was present or does that fact make me worse off? Are all exposures accounted for in that statistic and there isn’t a way to know how much more risky the presence of blood makes it? I truly appreciate your help and responses. It is a great service you provide to people.
The statistics aren't that granular. They cannot possibly account for every permutation of unprotected intercourse. The only factor known to put the risk toward the lower end is circumcision - but really, we are talking about an 0.02% difference, which isn't really statistically significant. There is NO factor known to dramatically increase the risk outside the bounds of the risk statistics.
Thank you. I really appreciate your time.
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