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Risk, PEP, and Waiting
Dr.,
I am gay man and a strict adherent to safer practices. I always wear protection for activities outside of oral. My last negative test was in May of this year.
One night I was intoxicated and went to the bath house here in town. This was my first time there. I was there for about an hour and a half. The problem is that I don't remember all of the events. I do remember providing and receiving oral to/from at least one individual and fingering but after that it gets hazy. I am just not sure what else happened.
I did not have any of my usual signs of being receptive partner next morning. I had no blood on the toilet tissue I used after a BM. I also did not have any sphincter soreness. I think was too intoxicated to be the insertive party but I just do not know, which is driving my concern.
Following this incident I went to the emergency room and began a PEP treatment. I am on Combivir and Kaletra. My first dosage was taken about 20-22 hours after the potential exposure. I've been taking it like clock work every twelve hours since.
After seeing my doctor today I am concerned. First, my day of lab blood tests for HIV aren't back yet (it's been two days) so that is concerning. Like I said, no unprotected activity short of oral since a negative test in May. That doesn't seem to ease my worried mind much though. Secondly, on the PEP I had diarrhea for three days but it's cleared up. All I have now is a bit of nausea and some fatigue. My doctor said healthy individuals often had severe side effects and potentially positive people sometimes saw lighter side effects. That has me even more concerned.
Can you provide any context for the effectiveness of a PEP treatment like the one I am on? Can you provide any context for my concerns about not having severe enough side effects? I know this was a ridiculously stupid incident in a very high risk environment. Can you provide any risk information on likelihood of a positive test?
I am gay man and a strict adherent to safer practices. I always wear protection for activities outside of oral. My last negative test was in May of this year.
One night I was intoxicated and went to the bath house here in town. This was my first time there. I was there for about an hour and a half. The problem is that I don't remember all of the events. I do remember providing and receiving oral to/from at least one individual and fingering but after that it gets hazy. I am just not sure what else happened.
I did not have any of my usual signs of being receptive partner next morning. I had no blood on the toilet tissue I used after a BM. I also did not have any sphincter soreness. I think was too intoxicated to be the insertive party but I just do not know, which is driving my concern.
Following this incident I went to the emergency room and began a PEP treatment. I am on Combivir and Kaletra. My first dosage was taken about 20-22 hours after the potential exposure. I've been taking it like clock work every twelve hours since.
After seeing my doctor today I am concerned. First, my day of lab blood tests for HIV aren't back yet (it's been two days) so that is concerning. Like I said, no unprotected activity short of oral since a negative test in May. That doesn't seem to ease my worried mind much though. Secondly, on the PEP I had diarrhea for three days but it's cleared up. All I have now is a bit of nausea and some fatigue. My doctor said healthy individuals often had severe side effects and potentially positive people sometimes saw lighter side effects. That has me even more concerned.
Can you provide any context for the effectiveness of a PEP treatment like the one I am on? Can you provide any context for my concerns about not having severe enough side effects? I know this was a ridiculously stupid incident in a very high risk environment. Can you provide any risk information on likelihood of a positive test?
Thanks so much for the response.
Good to know that PEP is effective and that it is likely my risk was minimal. However, without knowing for sure what happened I'm going to continue on with the PEP.
This board is a great resource. When I asked my doctor many of these same questions she was hesitant to provide answers and risk assessment, which I get. I was even told, "we've all seen cases of HIV transmitted from oral sex." The problem is that I have to live with the anxiety for the next several months, granted it's of my own doing.
Thanks again for the response! Fingers crossed for continued negative results.
Good to know that PEP is effective and that it is likely my risk was minimal. However, without knowing for sure what happened I'm going to continue on with the PEP.
This board is a great resource. When I asked my doctor many of these same questions she was hesitant to provide answers and risk assessment, which I get. I was even told, "we've all seen cases of HIV transmitted from oral sex." The problem is that I have to live with the anxiety for the next several months, granted it's of my own doing.
Thanks again for the response! Fingers crossed for continued negative results.
MEDICAL PROFESSIONAL
Welcome to the Forum. I'll be happy to comment some on your PEP but first I'd like to place your risk in context. Certainly a bath house is a risky site for meeting sexual partners and I endorse your commitment to condoms. My guess (and admittedly it is only a guess) is that you were not anally exposed during this visit since even when inebriated unusual events, and for you receiving unprotected rectal sex would be a bit unusual, are usually remembered. Further, as you note there are no signs of receiving rectal sex either. this being the case, I'm not sure I would have encouraged PEP. There is no risk of HIV, even if you were with an infected partner, from either giving or receiving oral sex and, as you are experiencing, side effects are rather common with PEP.
I would not worry that your tests are taking more than two days. The timing of tests depends on when the specimen was taken and received in the lab, the lab's internal schedule, etc. for such tests to take even 3-4 days is not all that unusual.
Finally, the GI symptoms you describe are well describe with the PEP agents you are taking. Most people do not have SEVERE (whatever that means) side effects but side effects are rather common.
Bottom line, you may or may not have been exposed and if exposed your partner may or may not have had HIV. You opted for PEP. It's highly effective. You are having expected side effects. I would not worry (not that there's too much else you could do). EWH
I would not worry that your tests are taking more than two days. The timing of tests depends on when the specimen was taken and received in the lab, the lab's internal schedule, etc. for such tests to take even 3-4 days is not all that unusual.
Finally, the GI symptoms you describe are well describe with the PEP agents you are taking. Most people do not have SEVERE (whatever that means) side effects but side effects are rather common.
Bottom line, you may or may not have been exposed and if exposed your partner may or may not have had HIV. You opted for PEP. It's highly effective. You are having expected side effects. I would not worry (not that there's too much else you could do). EWH
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