I had unprotected sex with a 44 year old thai woman on 11/02/2016. It was a poor decision which involved alcohol. The woman runs a mini bar (essentially a hot dog stand that serves alcohol past 2AM when conventional bars close) in the nana area of Bangkok. She told me that she has few sexual partners and that she has a boyfriend who is an international business man whom she sees when he happens to come to Bangkok on business. She said that she got tested for stds for him because she didnt want to infect him and she came out negative. I am slightly suspicious of all of this though because she did have unprotected sex with me after knowing me for two nights and the area she resides in doesn't have the best reputation in the world.
After having sex with her I noticed that she had bled quite a lot on the bed sheet. I assume she was menstruating due to the amount of blood. The sex probably lasted 15-20 minutes. I am an uncircumcised 28 year old male. We engaged in only penetrative vaginal sex. We showered promptly after finishing. Upon sobering up the next day I panicked and went to the Bumrungrad International Hospital to see a doctor. He proscribed an HIV PEP regimen of Isentress and Truveda which I have been taking now for 8 days. I have experienced some diarrhoea and stomach problems. I have felt fatigued, but this could be attributed to jet lag. I am back in Canada now. I accepted the medication without thinking much about it, but since getting home and researching this medicine I am starting to have some questions.
1) Does the nature of my sexual encounter warrant HIV PEP?
2) If we are to assume that this woman was HIV+ does the presence of menstrual blood sky rocket my odds of catching HIV from this woman? I understand that the likelihood of infection in a HIV - male from a single unprotected encounter with an HIV + female is somewhere in the realm of 1/2000. If the blood during sex doesn't effect those odds significantly is there not more of a danger of long term side effects from the PEP than from catching HIV from this single encounter?
3) I have read of some pretty concerning long term effects associated with PEP - namely, chronic fatigue. Is this common? Are there concerns that the medication may be carcinogenic?
4) As of right now I am simply taking the medication as directed on the pill bottles. Should I be doing more? Making an appointment with a physician? Avoiding even protected sex with other people/not drinking/ smoking, etc?
I would like to thank anyone who takes the time to read or respond to this in advance. I am an emotional wreck right now and your help and support is greatly appreciated.