[Question #10586] HIV risk
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21 months ago
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Dear Doctor,
I apologize in advance if my English is not good enough. I live in Thailand. last Thursday I went to CSW, I got really drunk and I had sex. First I used a condom but after I ejaculated I continued having sex for a while. But I discovered that the condom had slipped off. But I was taught to continue having unprotected sex for a short time. I am now so worried about contracting HIV that the facility informed me that they offer monthly HIV testing, most recently in mid-October. I went to get PEP the next evening. Officials say they have never encountered anyone who had taken all the medication and had a seroconversion. Unless you take additional risks. I've read quite a bit of information here that says it's very unlikely to contract HIV from these events. But I would like to have a more confident answer about what my chances are of contracting HIV.
Thank you
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21 months ago
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Additional information My basic test results are negative (HIV,Syphilis,Hepatitis B) and I have immunity to Hepatitis B.
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Edward W. Hook M.D.
21 months ago
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Welcome to our forum. Thank you for your questions. I’ll be glad to comment. Much of what I’m about to say will confirm which you’ve already heard.
If the brothel where your partner works does test their employees on a regular basis, it is unlikely that your partner had HIV. Even if they did, your risk for infection is low. If your partner had untreated, HIV infection the risk of acquiring infection from a single unprotected episode is substantially less than one infection in 1000 exposures. In addition, having initiated PEP, your risk is lower still. I would encourage you to take your pep as directed, and be confident that you will avoid infection.
In addition, despite this unfortunate occurrence, I encourage you to continue to use condoms regularly. They will do much to protect you and keep you healthy. EWH.
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21 months ago
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The clinic advised me to repeat the test after 30 days of taking the pills, but I read your information that the test should be at 6 weeks. What time should I take the test? And if I test at 30 days, I want to be sure about Syphilis. What accurate method should I use at the same time(RPR or Treponemal test (CMIA / ECLIA))?
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Edward W. Hook M.D.
21 months ago
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Treatment failures after completion of PEP are rare and so precisely when the best time to test is not known however, most experts agree that by six weeks results are conclusive. Six weeks following and exposure is also a good time to test for syphilis.
Testing for Syphilis with they are RPR is probably the best way to follow your concerns. EWH
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20 months ago
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I went for a clinic appointment on the 32nd day after exposure and took PEP for 30 days. The CMIA for HIV test results were nonreactive and conclusion is negative. The urine for Chlamydia trachomatis and and Neisseria gonorrhoeae results were negative. Treponemal test (CMIA/ECLIA) result was nonreactive. The question is, can I have sex with my married partner without using a condom? Because there is a repeat test 3 months after the exposure.
Thank you
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Edward W. Hook M.D.
20 months ago
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Thank you for the additional information. your follow-up testing proves that you were not infected. You can have unprotected sex with your married partner without concern that you might infect her. The additional 3 month follow-up recommendation is conservative. I would not worry and would move forward without concern. EWH---