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Is PEP warranted? Second opinion on clinic opinion.....
I had sex with a MtF transsexual woman I had met online. I've sort of known this person on and off for five years. We've had sex four times and all four times all sexual activities were condom protected. Yet, this last time the condom completely busted. I was the insertive partner (top) and Ipulled out to find the condom completely ripped and all the way at the back of my penis. I was fully exposed for what could've been no more than five to six minutes, seven tops of intercourse. I freaked out and my partner tried to reassure me that they know they're negative. I even tried to tell them that I will go get tested and if there are any surprises that it's best to come clean now. She reassured me again that she knows she is negative and that my test will come back negative.
I went to the local HIV clinic in my city and spoke to a patient educator who mediated with a doctor on call about my situation. I told them everything I wrote above and they said that their clinic rarely recommends PEP for single exposures of unprotected insertive top anal intercourse and unprotected oral sex. They calmed me down by saying the doctor thought he's sure that I'm most likely ok and that people rarely lie about their status. If my partner said they were negative most likely they probably are. He also said that HIV is a tough std to catch and in my situation the odds are in my favor that I don't have it but still left the decision up to me. That the risk was low to almost negligible according to them. I even looked at their website which stated that PEP is rarely recommended for insertive (top) anal intercourse exposure or oral. Is this true? I just want to double check and have decided that no matter what I'm taking the PEP for peace of mind. This was a really helpful and caring clinic.
Can someone at the Body give me a second opinion to see if the info I received at the clinic was on the up and up?
I went to the local HIV clinic in my city and spoke to a patient educator who mediated with a doctor on call about my situation. I told them everything I wrote above and they said that their clinic rarely recommends PEP for single exposures of unprotected insertive top anal intercourse and unprotected oral sex. They calmed me down by saying the doctor thought he's sure that I'm most likely ok and that people rarely lie about their status. If my partner said they were negative most likely they probably are. He also said that HIV is a tough std to catch and in my situation the odds are in my favor that I don't have it but still left the decision up to me. That the risk was low to almost negligible according to them. I even looked at their website which stated that PEP is rarely recommended for insertive (top) anal intercourse exposure or oral. Is this true? I just want to double check and have decided that no matter what I'm taking the PEP for peace of mind. This was a really helpful and caring clinic.
Can someone at the Body give me a second opinion to see if the info I received at the clinic was on the up and up?
But isn't the other option to roll the dice and risk being hiv +? Is the risk from being exposed after one unprotected encounter that low that it would be best not to take PEP even with its side effects? I don't know if I can take the risk because I met this person on Craigslist and sometimes I still see this persons ad for casual sex. That means they are active even though they claim to be negative. I could take their word for it but I just want to be safe.
2 Comments
You'll have to make that decision for yourself. I'm telling you what I would do, based on my knowledge of what PEP does to people. Do whatever you want, but you asked for opinions and I gave you mine.
If this person always used a condom like they did with you, then they would be negative except when one bursts. That doesn't happen often, and it is possible that if it did they took a test to verify they were ok.
Did the other person insist that you use a condom?
Did the other person insist that you use a condom?
Update: I am on PEP, truvada/isentress. Minor side effects, tolerable but mildly annoying. I took it 68-69 hours post exposure, so I made the 72 hour window but very late in the window period. I hope it's still effective.
If my partner, by chance is HIV positive, the risk assessment stat seems to be that 6.5 per 10,000 exposures last I checked. I would hate to play Russian roulette but there must be a reason why the doctor hesitated to give me PEP. Their clinic pamphlets and website state that they rarely prescribe PEP for insertive anal or oral sex. Risk is risk no matter what which is why I am playing it safe with PEP, BUT if the doctor wasn't as worried assuming my partner was positive, should I have been so worried? He just made it seem as though the odds were actually in my favor to come out of this incident negative.
If my partner, by chance is HIV positive, the risk assessment stat seems to be that 6.5 per 10,000 exposures last I checked. I would hate to play Russian roulette but there must be a reason why the doctor hesitated to give me PEP. Their clinic pamphlets and website state that they rarely prescribe PEP for insertive anal or oral sex. Risk is risk no matter what which is why I am playing it safe with PEP, BUT if the doctor wasn't as worried assuming my partner was positive, should I have been so worried? He just made it seem as though the odds were actually in my favor to come out of this incident negative.
24 Comments
You didn't answer my last question. It is about the only way you can guess the risk, and no one here can.
Right, sorry. There wasn't much of an insistence as much as I just asked if she had them first. We had always just used them to be safe. She claims she always uses them but ya never know. She is adamant about being negative though. I can't get a hold of her to go testing. Even then what good would that do if she could've been infected a few weeks before being intimate with me and it wouldn't show up on a test.
AnxiousNoMore, one thing that I forgot to mention is that she didn't want me to ejaculate in her anus even with condom. After I told her that the condom broke her biggest concern was still that I finish out of her and not in her. She wanted NO semen in her. I don't know if that is a sign that perhaps she plays it safe for the most part and is telling the truth about her status.
Nothing else to say except repeating that you run a serious health risk taking PEP.
Even for the brief 30 days?
Bottom line is that only you can weigh the benefits vs risks and make the decision that is right for YOU.
Yes I understand, thank you. I just wanted some proper info before making the final decision. In the end I know it's up to me. I was just trying to get other people's opinions and experiences about HIV risks.
I get that, but from our perspective, it's a very hard call. Personally? I probably wouldn't take PEP unless I had an exposure with someone who was known to be HIV+.
CurfewX, so even if their status is unknown you'd still avoid PEP? I at least want to know from anyone in here through their own experience or stuff they've read or if they're in the medical field, if what the doctor was telling me about risk and such was at least on the up and up with the rest of the medical community and medical literature. I am just trying to confirm that the doctor wasn't just reassuring me that the odds are in my favor to calm me down but that it does come from well sourced stuff.
I just said I would, and I meant it, and yes, I've had an experience and did not take PEP. No one here is a doctor, but we all rely on the advice of experts in the field.
Here's a good journal written by another member, with references that may help you: http://www.medhelp.org/user_journals/show/97340/HIV-Risk-In-Perspective--Why-You-Should-Fully-Expect-A-Negative-Result
Best of luck whatever you decide.
Here's a good journal written by another member, with references that may help you: http://www.medhelp.org/user_journals/show/97340/HIV-Risk-In-Perspective--Why-You-Should-Fully-Expect-A-Negative-Result
Best of luck whatever you decide.
CurfewX, sorry I keep bothering you but the link seems to be more for heterosexual vaginal sex. My experience was for unprotected insertive anal with a MtF transgender. Does this change the info in the link at all or does it still apply?
Either way thanks for the link
Either way thanks for the link
Here's a good reference: http://www.aidsmap.com/HIV-risk-levels-for-the-insertive-and-receptive-partner-in-different-types-of-sexual-intercourse/page/1443490/ However, all of the odds given assume that the person is known to be HIV+. In order to fully calculate risk, you'd have to also analyze the prevalence of HIV in your area/country.
Ah, thanks. So disregard the first link and just focus on the second?
The second link addresses all risks, but again, does not take into account the prevalence of HIV (unless I missed it).
I live in a first world city in the US not SF, LA or NYC. I'm bad at math but 1 in 909 seems sort of low, IDK. At least when compared to receptive intercourse. I mean 1 in 70 for receptive with ejaculation? That seems high. According to this I am in the 1 in 909 risk factor.
No, it is unquantifiable, since you don't even know if they have HIV in which case it would be zero.
Forgive me if I don't understand, AnxiousNoMore but are we not assuming that they are HIV positive if I am unsure of their status? That's how I figured things would be taken to quantify any potential risk, no?
Their status is dependent on what happened to them biologically, not on what you are thinking about them. If they always used a condom and only yours broke, then they are negative, no matter what you assume.
Statistics are tricky, and would vary by individual situations. You'd have to multiply the rate of infection in your area by the chances of infection from a one-time encounter, and also factor in risk behaviors. It's really not possible to estimate one person's chances.
The fact is that no matter what, it is less than 1%. Likely, way less. That's the info you should use when making a decision.
The fact is that no matter what, it is less than 1%. Likely, way less. That's the info you should use when making a decision.
Less than 1%, Curfew? The stats are starting to make sense as to why the doctor wasn't heavily insistent on PEP. Their clinic lists unprotected receptive vaginal or anal and IV drug usage as strongly recommended. Insertive anal and oral were listed as rarely recommended. I am guessing this clinic is going by the stats to analyze risk?
I just wanted to make sure clinic was on the up and up as to why they rarely recommended PEP for insertive anal.
For future reference, would any further condom breakages with a different partner, say five years down the line, have an elevated risk above the calculated risk stat listed due to this first exposure? Or would it constitute the same risk?
I'm sorry, but that question doesn't really make logical sense.
It's like odds when flipping a coin. Every single coin toss has a 50/50 chance of landing heads or tails.
You're overthinking this. You know the odds and have all of the info necessary to make a decision regarding what is best for you.
It's like odds when flipping a coin. Every single coin toss has a 50/50 chance of landing heads or tails.
You're overthinking this. You know the odds and have all of the info necessary to make a decision regarding what is best for you.
Ah, ok. Now I get it. You're saying that each instance carries the same risk, but obviously if you keep engaging in the risky behavior, you risk the chance of hitting that less than one percent chance.
I wouldn't take PEP unless I was exposed to someone who was confirmed to be HIV positive. For your situation, especially since the clinic people told you it wasn't warranted, I would listen to their advice and not take PEP. It's not like taking an Advil or something minor. It's a toxic, hard core medication that has repeatedly caused side effects that range from mildly annoying to deadly. And people who've taken it and reported back here have said the side effects last long after quitting the pills. I wouldn't take it unless it was a last resort for a confirmed exposure to someone who had proven to be HIV+. Otherwise you couldn't pay me to take it.
How much is PEP without insurance?
1 Comments
I think it can give permanent liver or kidney damage. Check some other posts over the last few weeks until you find another PEP because someone advised they would never take PEP.
You might not get peace if the PEP side effects develop. Serious permanent health issues can occur.
2 Comments
Oh no! Are you saying I should consider not taking it? I am only asking because the doctor seemed to indicate that the exposure was lower risk and that at their clinic PEP is rarely recommended for a single case unprotected insertive anal. The doctor said the statistical risk was actually in my favor.
I would rather live with side effects than have that chance of contracting HIV
I would rather live with side effects than have that chance of contracting HIV
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