[Question #10912] Hiv risk
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18 months ago
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Sorry to be here again and forgive my broken english.
day 1 - had sex with csw and condom broke completely. Realised only after finishing. She was 22 years and claimed to be clean. Rushed to std clinic and got pep within 3 hours of exposure(truvada and dolutegravir) and doxy pep(200mg).
Day 4 - visited another std clinic. Was given azithro(1g) and 500mg for next day.
Day 5- visited another std clinic. Was given Ceftraxione 500mg injection on my butt, 5 days doxy(200mg) and 4 days(500mg azithro)
Having neck jaw pain, keep checking lymph nodes and its sore also body ache. Persisting symptoms till now.
Day 15- today got a 4th gen ag/ab rapid hiv test to rule the hiv symptoms. Result came back negative. Can i rely on this result to rule out the symptoms.
I am worried for syphillis and other std and hiv. Having dull on n off pain on penis and keep checking for lesions.please advise whats my risk of getting std and is this hiv ars.
I am married and can i have unprotected sex with her. Also smoked weed the 1st 5days on pep and doxy to easy my anxiety. Will this affect my pep and medication?
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Edward W. Hook M.D.
18 months ago
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Welcome back to the Forum. This appears to be an encounter which is different from our interaction a month ago. I'll address your questions below. For your information, condoms break about 1% of the time they are used. This was a low risk exposure- your partner indicated that she did not have an STI, including HIV and that was probably true- most commercial sex workers do not have STIs including HIV and when they do, most single exposures do not lead to infection. In addition, you have taken an excessive amount of antibiotics which assures you that you are not at risk for bacterial STIs including gonorrhea, chlamydia and syphilis.
Your negative HIV test in the presence of symptoms proves that your symptoms are not due to HIV. For completely conclusive test results you will need to wait to test until 30 days after completion of PEP.
Once again you are worrying far more than you need to. The antibiotics you took completely eliminate any probability that you acquired syphilis, gonorrhea, chlamydia or other bacterial STIs. There is no need to test for these. The symptoms/pain you are experiencing is not due to HIV or STIs.
The weed you smoked will have no effect on your test results. Please don't worry. EWH
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18 months ago
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Thanks for the reply doctor.
To double confirm.
1. Can i rule out STI with the medication that i have taken? So i assume there will be no need for any STI testing since the medication would have worked?
2. I am still having pain under my jaw and neck, can i confirm that this is not related to HIV ARS since the 4th gen test i took yesterday was negative.
3. Will test again for HIV 30 days post PEP.
4. I am worried that this symptoms that i am having now are related to HIV ARS though the result was negative, however can PEP suppress the virus, hence why it is not reflected in the test yesterday? Is my understanding correct? Or regardless i am on PEP or not, with ARS the test will definitely be positive?
5. Based on your experience, what are the chances that i may have contracted HIV if i test 30 days post PEP?
Also i missed out one detail, right after the incident i rushed to a nearby pharmacy to get a HIV test and managed to get the CSW to test, however it was a 3rd gen test, and in the panic state i forgot to get the buffer for the rapid test and used tap water to test the CSW. The results were negative, however i assume this test was invalid as correct buffer was not used.
Can i resume unprotected sex with my wife while on PEP? I am worried of infecting her and have been avoiding sex with her by giving excuses.
Overall what are my chances that i am safe with PEP, in case somehow the CSW is HIV+?
Please advise.
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Edward W. Hook M.D.
18 months ago
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This follow up is a series of repetitive questions. There is no need for confirmation. The answers are not going to change.
1. You are not going to get an STI because of the medication you have taken. There is no need for testing.
2. Correct
3. To assure yourself that you were not infected, the correct time to test is 30 days after completion of PEP.
4. Correct
5. Zero
Yes, the test performed using tap water rather than the recommended buffer should not be counted on.
Your wife is not at risk. There is no reason to abstain from unprotected sex with her.
In my opinion, you have overreacted to the event you described. I hope my comments will help you to move forward. EWH.
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18 months ago
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Thanks doctor, i really value your opinion and experience, will follow your advise.
To clear a doubt.
For question 4 below you replied "correct".
Can i know, was your reply referring to this "regardless i am on PEP or not, with ARS the test will definitely be positive"?
or was it referring to "PEP suppress the virus, hence why it is not reflected in the test yesterday"?
Also would like to check do i need to test for herpes, i am on day 17th post exposure now, do i need to still look out for herpes symptom? Have i passed the window period for herpes and not worry about it?
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18 months ago
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Also i know this is my last quest together with the previous one regarding the ars testing. I have been having on n off itch on my foreskin. Still no need for any sti test?
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Edward W. Hook M.D.
18 months ago
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Final response. Whether or not you were on PEP, if your symptoms were due to the ARS, your HIV test would be positive.
If you were going to develop herpes lesions, they would’ve appeared before 10 days had passed following your encounter. There is no reason to be concerned that you will develop her peace lesions at this time.
It’s you mention above, this completes this thread, which will be closed now. There should be no reason for you to return to the forum related to the encounter you described. EWH.
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