[Question #10868] Question for MD H. Hunter Handsfield
19 months ago
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Hello doctor,
I need some clarification on whether I should be testing or not for hiv. I’m not really worried but I would appreciate the extra assurance and medical Advice.
Basically I had sex with a girl who had an HIV exposure about 6 months ago. She had been exposed through her Ex boyfriend who was confirmed HIV positive. She got on PEP 40 hours post Exposure. So the first day she got on PEP we Had UNPROTECTED Vaginal sex. I didn’t use a condom.. looking back now that was really stupid because I knew she was On PEP but still had intercourse with her. Anyways we continued to have sex almost everyday while she was on pep.
The Girl I had sex with said she would let me know her test results (3) Months Post PEP and (6) Months post PEP. Well today is 6 months post PEP for (HER) and she showed me her HIV test results which Is NEGATIVE for HIV. I thought to myself great she’s HIV negative meaning I wasn’t at risk at all when we did have sex while she was on PEP. But then my mind started overthinking.
What if the PEP drugs only worked for her and she passed the HIV virus onto me since I wasn’t on any PEP. Or am I incorrect? Since she could have only transmitted the virus if she had been HIV positive 6 months later being today. Meaning she would have had to been infected regardless of pep taken or not thus resulting in the only way possible of infecting me? Am I correct?
19 months ago
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Questions
1. Could she have passed HIV to me during her PEP treatment even though her PEP treatment was successful and didn’t Infect (HER)? But somehow infect (ME)?
2. Since we had sex on her first day of taking PEP does that increase a great risk to me? Even though she’s negative for HIV currently?
3.do you recommend I be tested? after everything I stated above?
4. I see that the CDC recommends against sex while on pep. Is this just in case the person taking pep turns out positive? Or is their another reason such as possibly the person taking pep could possibly infect the partner regardless if the person who’s taking pep turn out negative?
19 months ago
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Also I would like to Add just so theirs no confusion. WE HAD SEX 6 months ago and todays 6 months Post pep and she tested negative. (Just in case my wording above confuses you)
Also I didn’t have Sex with anyone besides her during these 6 months.
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H. Hunter Handsfield, MD
19 months ago
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Welcome to the forum. FYI, it is by chance I am responding; users do not have the option of selecting the moderator who responds.
As you seem to understand yourself, you are overthinking this situation. There is no such thing as anti-HIV drugs (including PEP) preventing infection but still allowing transmission of the virus. There is no "window period" after acquiring HIV when the virus can be transmitted before PEP works to prevent it from taking hold in the exposed person. You can rely on both your partner's negative test result and that you were never at risk for HIV from sex with her.
Those comments pretty well answer all your questions, but to assure no misunderstanding:
1, 2) These are the same question in different words. The answer is no.
3) From a medical/risk perspective, there is no need for you to be tested. However, many or most anxious persons tend to be more reassured by negative HIV test results than by professional opinion, no matter now expert. (We don't take it personally!) If that applies to you and you'll sleep better having testing negative, by all means feel free to do so.
4) Yes, the reason is the straightforward one you state yourself: the slight possibility that PEP doesn't work and HIV infection is present. This has not been reported to have ever happened, except maybe e in people prescribed PEP who failed to take the drug(s) as prescribed.
I was aware of the timing of your sexual exposures with your partner.
All is well. She doesn't have HIV, you were never infected, and there is no possibility you have HIV. But feel free to test if the negative result will help get past your worries about it.
Best regards-- HHH, MD
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19 months ago
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Thanks for the advice Doc, I will trust your expertise and won’t bother getting tested. As you said it would be impossible I could have gotten infected because she’s negative correct?
19 months ago
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Doctor some nurse over the phone told me I was still at risk since she was on pep. Idk how to feel about this. Are you 110% sure it’s impossible for me to have been infected?
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H. Hunter Handsfield, MD
19 months ago
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"impossible I could have gotten infected because she’s negative correct?" Yes
The nurse is wrong. It is impossible you have HIV because your partner doesn't have it!!
No more questions asking me to repeat the advice already given. Thanks.
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19 months ago
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Okay doctor I’m sorry for the repeated questions I just want to be clear as possible. This will be the last question I ask,
And doctor I’m sorry for the repeated questions. In all honesty It’s not even me who I’m worried for it’s my Girlfriend who I’m engaged with and planning on having kids with. I couldn’t bear the thought of me infecting her and then infecting my children all because I wasn’t sure and fooled around with someone 6 months ago. I just want to set the record straight that I’m 1 million percent negative and can’t transmit anything. So I don’t ruin the lives of my future family. Also I don’t want to tell my girlfriend to get tested because we come from a religious background and she believes I was celibate before I met her which would ruin our relationship. She’s my soulmate.
19 months ago
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1. since she was on Pep couldn’t she have had a possible Viral load such as the first day starting pep? Then in theory she could have possibly passed it onto me?
2.Can a negative person who had an exposure and was on pep have a viral load or is that only for people who are HIV positive which can’t be reversed?
3. Is there any chance in theory She could have infected me? Like scientifically is it still impossible? I just can’t wrap my head around the fact that she may have had the virus in her body but the virus was killed by the pep and somehow transmitted to me.
Again I’m so sorry for the repeated questions doctor and please if you could answer each question and not skip as it would reassure me. I can’t afford to buy another question as money has been very tight doctor. God bless you.
19 months ago
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4.To add to the worry I won’t ever know if that girl ever really had HIV in her body or if she never did.
Would it ever made whether or not she ever did since she tested negative 6 months out
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H. Hunter Handsfield, MD
19 months ago
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1. No. It takes several days for viral load to be nigh enough to transmit the virus. Newly infected people are not infectious before then even without treatment.
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2. This also is not known to happen and is against everything known about the biology of HIV infection. I am confident nobody in the world has ever caught HIV in the circumstances you have described.
3. No.
4. This of course doesn't change my judgment and advice.
If you're so worried, go ahead and get tested for HIV. There is no chance you have it and you will test negative. Really, just suck it up and stop looking for arcane reasons the science might be wrong. It is not.
Perhaps it will help you to know that in the nearly 20 years of this and our preceding forum, with thousands of questions from people worried about HIV exposures, not one has yet reported they eventually tested positive. You will not be the first If and when it finally happens, it will be a genuine high risk event (think anal sex with a known infected partner) and certainly not one in which the science clearly proves there was no risk!
That concludes this thread. Please do not return to the forum with any further questions about these events and issues: there is no chance that anything else you might think of has any chance of changing my assessment and advice! I do hope the discussion has been helpful. Best wishes and stay safe.
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