Dear Doctors
I had a high risk exposure with a HIV positive guy (didn't tell me at the moment) on the 6th of May. I was the top and had unprotected sex. Finished inside him once and also I had feces all over my penis. Then we spent 3 weeks together. On Sunday morning the 27th gave me prolonged oral unsafe. On Monday 28th I found out by accident he was positive with CD4 480 and viral load 30,000. On Tuesday 29th went to a GU. They gave me PEP and tested me for HIV. I think they performed 4th gen but they can't confirm until Wed. I know 23 days is not conclusive but shall I continue with the PEP (Truvada and kelletra)? What if I am positive? Will they not affect my medication later? Also the doctor said that they have a scaling system and if the test would come even slightly suspicious would ask me to stop the PEP. Why did they not use NAAT RNA test? In terms of statistics how likely my 4th gen negative on 23 days to turn positive after PEP? Why they gave me PEP if I only received unprotected oral?
The guy is not on medication and he was infected last July.
Thank you
Thanks for the post. I've repeated it just here along with my comments.
I had a high risk exposure with a HIV positive guy (didn't tell me at the moment) on the 6th of May. I was the top and had unprotected sex. Finished inside him once and also I had feces all over my penis. Then we spent 3 weeks together. On Sunday morning the 27th gave me prolonged oral unsafe. On Monday 28th I found out by accident he was positive with CD4 480 and viral load 30,000. On Tuesday 29th went to a GU. They gave me PEP and tested me for HIV. I'm not entirely clear why they gave you PEP at this point - I suppose I can sort of figure it but by then it seems that you'd been having unprotected sex with him for three previous weeks ?? or am I misinterpreting that and actually you only had the penetraive sex once and the single blow job?I think they performed 4th gen but they can't confirm until Wed. I know 23 days is not conclusive but shall I continue with the PEP (Truvada and kelletra)?yep - someone has assessed you as being of sufficiently high risk to take it and I'm not sure I've fully understood the circumstances so yes - you should continue with the PEP. You're right - 23 days is not conclusive except if its a positive result. A negative result at 23 days is reassuring but not certain. What if I am positive? Will they not affect my medication later?well, we test people prior to PEP because if they are HIV positive before beginning it then there might be other treatment strategies available - including not treating at all. I wouldn't worry about it having a negative effect on your future treatment if that was required Also the doctor said that they have a scaling system and if the test would come even slightly suspicious would ask me to stop the PEP. fair enoughWhy did they not use NAAT RNA test?the turnaround time is too long to make it immediately useful in general terms In terms of statistics how likely my 4th gen negative on 23 days to turn positive after PEP? sorry - a question no one can answer. I still don't think I'm getting everything here - if the only event was at the very beginning, why were you given PEP - the long blow job is irrelevantWhy they gave me PEP if I only received unprotected oral?hmmm - no idea - you'll have to ask them that
The guy is not on medication and he was infected last July.well, the available evidence suggests that very newly infected HIV positives are at more risk of passing HIV on than people who have had the condition for a while. A viral load of 30,000 or so does sound high but its relatively modest. Although there is a clear risk here I wouldn't get too panicked by the entire event and also starting the PEP. I would suggest you talk with them again at the clinic.
Dear Doctor
Thank you for coming back to me.
The unprotected insertive event was on the same day twice 6th of May.
We had protected penetrative sex after this event while "dating" but unprotected oral.
No ejaculation in my mouth.
The last sexual contact was 60 hours before the start of the PEP and it was a prolonged oral while I was sleeping.
Hope this clarifies my situation better.
Thank you
Just to recap - there were two unprotected episodes on the 6th May with you topping him. There was then protected penetrative sex but unprotected oral.
Receiving oral - being sucked - does not pose a risk of HIV. Sucking an HIV positive man and getting ejaculate into your mouth does potentially pose an HIV risk albeit very low.
Again, I'm not really able to say why they gave you PEP post oral episode - seems over the top - if you were to become HIV positive then much more likely from the unportected penertative episode on 6th May. They may - as with me - have misunderstood the situation. But, since you've been assessed and prescribed PEP then I would encourage youto continue with it.
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