Exposure

[alirehman22]

Hi,
I am a male and I had sex on Friday night with a male. It was oral and anal, using the same condom.  As I was entering him I heard the condom break and came right out and put on a new condom.  I went to the ED saturday around 3 pm and they gave me PEP. I'm currently on that.  It turned out he is positive.  I was wondering what the chances are that I may have contracted it are? Is PEP helpful, and how helpful? Is this exposure more high risk than an occupational needle stick with an HIV infected sample or less?  Please any information or help would be great. I'm totally freaking out.  

[Edward W Hook, MD]

That is good information and makes transmission form him still less likely.  As I said, the odds are in your favor. EWH

[alirehman22]

Sorry about that. As you can tell i'm worried so my sentences aren't complete. His viral load he said was <75 and CD4 count of 550

[Edward W Hook, MD]

You mention is viral load and CD4 count but only give one number.  If his CD4 is 550 and his viral load is less than 50, that would be very good.  The lower the viral load the lower than chance of transmission.  Even  aviral load of 550 however is good if that is the case.  EWH.  

[alirehman22]

He said that his viral load is 550, and he takes atripla.  I'm not sure how honest his viral load and CD4 count are though.  You think that i'm in a good position and shouldn't worry?

[Edward W Hook, MD]

Welcome to the HIV Prevention Forum. I am sorry to hear of your condom breakage.  Your concern over your risk is appropriate but, at the same time, you have done everything correctly.  As the insertional partner with an infected partner your risk of getting HIV without PEP is about 1 infection in 200 exposures or 1/2 of 1% (if your partner is taking anti-HIV therapy and has a good response to therapy your risk is even lower than quoted).  PEP will further reduce your risk of infection substantially although knowing just how much is difficult to say as the studies of this intervention are still in process.  It is reasonable to presume that with PEP, taken properly, your risk will likely be less than 1 in 1000.

So, what to do.  See an HIV specialist who will monitor you and your progress as you complete PEP and follow-up.  Please be sure to take you PEP as prescribed.  Following completion of PEP your docotor will follow you, most likely with but HIV PCR tests and antibody tests.  

Agian, sorry to hear of your misfortune.  Keep doing as you are doing. The odds are in your favor.  EWH