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Avatar universal

HIV risk

Hi there,

Yesterday (Sunday) at 7pm I had protected anal sex with another guy. However, there was about 40-60 seconds where he wasn't - I know I should have spoke up sooner. I don't think he ejaculated cuz I purposely touched his penis after, and he did end up ejactulating about 15 minutes after. However, I was still concerned and I decided this time to get the PEP -- I went to the hospital closest to me but the triage nurse said my thing wasn't urgent, and that I could be waiting a long time. So I went elsehwere - anyway, I got it at 7am, so 12 hrs later.

I know the doctor at the hospital I went to said it's a personal choice, that the doctor she spoke with said the risk of getting hiv through needle exposure to someone that had it is 1/200 , and they assume the same is through anal intercourse. The same with PEP that it's not fully tested on intercourse, but they assume it's the same as those that take it after a needle exposure.

So, I know I was at risk, but I don't think it's as high as it could have been -  but I was wondering - is precum worse usually or less likely to give someone the disease. And, assuming he did have HIV and assuming that it got into me, how likely would you say PEP will stop it since I got it at the 12 hr mark?

The dr. said it was likely any damage done would by the medication would probably reverse itself but that she couldn't say for sure... was wondering if you knew about that?

I will NEVER put myself in this situation again - even to be with someone I don't know because this is too much. They gave me combivir and electra and then sending me to a disease specialist. So far, I haven't had much side effects - I felt a small headache coming on but it went away and I seemed to sleep okay -- I was wondering then is this likely to be the worse of the side effects that I, personally, will experience from PEP given that it's been 8 hrs?
4 Responses
936016 tn?1332769204
MEDICAL PROFESSIONAL
Hello

You do seem to have been given very odd and inconsistent advice about all of this.

"Yesterday (Sunday) at 7pm I had protected anal sex with another guy. However, there was about 40-60 seconds where he wasn't - I know I should have spoke up sooner. I don't think he ejaculated cuz I purposely touched his penis after, and he did end up ejactulating about 15 minutes after. However, I was still concerned and I decided this time to get the PEP -- I went to the hospital closest to me but the triage nurse said my thing wasn't urgent, and that I could be waiting a long time. So I went elsehwere - anyway, I got it at 7am, so 12 hrs later.

THIS IS BIZARRE - THE NEED FOR PEP PST SEXUAL EXPOSURE SHOULD BE VIEWED AS AN URGENT - SO VERY ODD AND ILL INFORMED

I know the doctor at the hospital I went to said it's a personal choice, that the doctor she spoke with said the risk of getting hiv through needle exposure to someone that had it is 1/200 , and they assume the same is through anal intercourse. The same with PEP that it's not fully tested on intercourse, but they assume it's the same as those that take it after a needle exposure.

THE CHANCES OF ACQUIRING HIV THROUGH THIS ROUTE IS ILLUSTRATED IN THE GUIDELINES WHICH YOU CAN SEE HERE BY COPYING AND PASTING THIS LINK INTO YOUR BROWSER http://www.bashh.org/documents/58/58.pdf

PEP HAS BEEN EVALUATED IN HUMANS AND YOU CAN READ ABOUT THAT BY LOOKING AT THIS LINK http://www.freedomhealth.co.uk/sexual-health/pep-post-exposure-prophylaxis-after-sexual-exposure/174/

So, I know I was at risk, but I don't think it's as high as it could have been -  but I was wondering - is precum worse usually or less likely to give someone the disease. And, assuming he did have HIV and assuming that it got into me, how likely would you say PEP will stop it since I got it at the 12 hr mark?

I THINK EVEN ASSUMING THE WORST CASE SCENARIO THEN THE CHANCES OF YOU ACQUIRING HIV ARE SLIM ESPECIALLY SINCE YOU HAVE SUCCESSFULLY OBTAINED PEP IN A SHORT TIME FRAME.



The dr. said it was likely any damage done would by the medication would probably reverse itself but that she couldn't say for sure... was wondering if you knew about that?

AGAIN, THERE IS A FAINT RISK OF LIVER ETC DAMAGE FROM PEP - BUT ACTUALLY MINISCULE

I will NEVER put myself in this situation again - even to be with someone I don't know because this is too much. They gave me combivir and electra and then sending me to a disease specialist. So far, I haven't had much side effects - I felt a small headache coming on but it went away and I seemed to sleep okay -- I was wondering then is this likely to be the worse of the side effects that I, personally, will experience from PEP given that it's been 8 hrs?"

YOU SEEM TO BE LUCKY. I THINK MOST PEOPLE WITH THIS COMBINATION TOLERATE IT WELL

YOU ASK A FURTHER QUESTION RELATING TO TESTING AND AGAIN THE ADVICE YOU HAVE RECEIVED IS WRONG. THE CURRENT ADVICE IS THAT PEOPLE RECEIVING PEP SHOULD TEST AT 3 MONTHS AFTER FINISHING THE COURSE - SO THREE MONTHS AFTER THE LAST TABLET AND 4 MONTHS AFTER THE EPISODE ITSELF.

Best wishes, Sean
Avatar universal
Hey, I wanted to add one more thing -- I know they said they recommend getting tested at 6 months because PEP can slow down your body's response to the disease and wouldn't pick it up -- do you think though a 6 week, and 3 month rapid test would still be pretty good at picking up if I have anything? I woudl still go at 6 months but as you can imagine that is a long ways away.,,, oh, and btw, I don't know the status of the guy I was with but he did say he's careful with sex because he doesn't want to contract anything... well, he better start being more careful, as well as myself.
Avatar universal
thanks for your reponse, Well the first place I went to the triage nurse didn't know what gardisil was, and after I explained what PEP was, she said as far as she knew they were only giving that to needle exposures. I knew she was wrong. I waited an hr and then asked to speak to her again, they had put me on a priority of 4 out of 5, where #1 would be the most urgent.

She said there's only 1 doctor there, and she spoke to him about it, and that the dr. himself said this was not a priority, even though I had explained that the last time I was at the Ottawa hospital they let me in in almost right away - so I left for Ottawa which was about a 90 minute drive, and the triage nurse there knew what PEP was, but said I would be waiting again. After I mentioned last time they didn't, she said that she couldn't say for sure, but thought that the timing wasn't so critical anymore.

I hope that there wouldn't be much of a difference between let's say 6 -7 hours when I likely would have got it, and 12 hrs when I actually did get it?
936016 tn?1332769204
MEDICAL PROFESSIONAL
Hello again

PEP needs to be started before HIV "gets a hold" on your cells so that it can start replicating itself. Triple therapy is used as PEP to abort the replication enzymes and processes that start quite rapidly.

PEP should be started as soon as possible after an exposure - but certainly your twelve hour time frame is very good indeed. The New York public health authorities want everyone to start within 36 hours which in theory is a great target but unless your services locally are organised and informed (as yours clearly were not) then this is not going to work.

The UK recommends "within" 72 hours - but obviously ideally as soon as possible. I have stretched that in extremely high risk situations to a week or so.  

Your twelve hours was good.

best wishes, Sean
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