Welcome to the Forum. I'm sorry to hear that your condom broke. This occurs about 1% of the time condoms are used. You are fortunate however that this person was willing to tell you that you had been exposed to HIV- not all people would do this. The risk of infection from your exposure is, from a statistical perspective, quite low. The reason I say this is that the risk of infection, ON AVERAGE if one has unprotected vaginal sex with an infected partner is about 1 infection per 1000 acts of intercourse. Your risk however is actually considerably lower than that because she is on effective therapy. you can be sure that her therapy has been effective since her viral load was <250. When studies have been performed they have shown that the lower the viral load, the less likely infection is to be transmitted. In one important study, there were no transmissions of infection when persons had <10,000 copies of virus- your partner's was far, far lower. Further, another groundbreaking study published in the past year indicates that HIV therapy reduces the risk of transmission more than 95%. All of these data, therefore, suggest that your risk of infection is low.
In the overall scheme of things, while you have herpes, this does not affect your risk nearly as much as the fact that she is on therapy reduces it.
Since the exposure was over a week ago, there is no role for antiviral post-exposure prophylaxis (PEP) in your case, even if you wished to pursue it (PEP is effective only within the first 72 hours after an exposure). for better of for worse, there no much to be done at this point but wait and test. At 4 weeks, a test using a 4th generation (combination HIV p24 antigen/HIV antibody) test will provide definitive results for you. I anticipate that, at that time the test will be negative. The odds are VERY much in your favor. EWH
Thankyou for your feedback.. I did however start PEP at exactly 19.5 hours after the exposure & have been on the medicine the whole week & will continue till 28 days is up. This I mentioned in my first post, but may not have made that clear.
I am still very nervous as there hasn't been anything in the way of real world studies done on HSV-2 making you more susceptible to HIV other than that article I posted in the first message..
Hi Dr Edward,
Is this the article you are referrring too:
http://www.aidsmap.com/HIV-treatment-may-prevent-at-least-nine-out-of-ten-transmissions/page/1437839/
This article is not clear to me in the fact that it does not state how often or not the couples in question practice unsafe sex clearly.
Also, it states that when the HIV positive person did commence ARV's in the couple, they also began to practice safe sex more frequently.. Based on this point alone, how can it be reliably said that someone who si HIV positive that is taking ARV's is far less likely to be able to infect someone?
The article you refer to is not this one. This article summarizes it. many of the people in the study I mentioned however had multiple sexual exposures.
If you choose to argue with the data, that is your choice- the data, based on a high quality study, are the data and are believed by nearly all scientists in the field. EWH