Dear Doctor,

Male heterosexual Sorry I am back

1. 31st Jan condom protected vaginal and oral sex with female csw ( Took prep on demand double dose on 30th Jan before exosure and 7 dose after exposure till 6th Feb) ......no further doses .

2. 3rd March ......exposure only condom protected oral sex with female csw and massage with handjob......light kissing on lips only 

( Took prep on demand double dose on 2nd March before exposure  and 7 dose after exposure till 9th March ) no further doses.

Std testing on 1st May on 53rd day after last dose of prep

HIV COMBO test negative

Syphilis rpr test and hep B negative

Questions

1. My hiv test is 100 percent conclusive after 53 days of last prep dose ....,......for 2nd exposure.

2. Can I say that my 2nd exposure is absolutely zero risk as it is condom protected oral sex covered by prep on demand.

3. My hiv test is 100 percent conclusive for 1st exposure .....as test is done after 84 days of last dose of prep .....will 9 tablets taken in between in March will affect test conclusiveness.

4. Can I have unprotected sex with my partner. ( want 100 percent safety)

5. Do I need to test again .

6. For pep conclusive hiv combo test 45 days after last dose on British guidelines 

Is there any guidelines for hiv conclusive test after stopping prep on demand . 

7. CDC 2016 guidelines for Post pep testing is 6 week and then 3 month after exposure so it means 8 weeks(56 days) after last dose of pep ........I have test after 53 days of last dose of prep ..........so my hiv test is very close according to CDC guidelines ...... Am I right or I have read wrong guidelines from internet.

1.  Yes

2. Yes

3.  Yes

4. Yes

5.  No

6. Most experts would use the same recommendations.

7.  These guidelines are 8 years old.  Your results are conclusive

There should be no need to return to the forum.  EWH

Dear Doctor ,

I have accepted my result as conclusive . Thank you very much for your support and patience .........

I decide that I will not come to forum again .  But need to ask last query  about recent dentist visit 

Yesterday visit dentist for my annual scaling . Everything is sterilized and new scaler tip is used .

New disposable suction pipe( tip)  is used which connected to suction hose but later I read about backflow from suction hose. In which waste ( saliva , blood , bacteria etc) inside hose from previous patient can come into my mouth if I close my mouth 

My questions

1. If an earlier patient were HIV positive would virus in any blood have been deactivated by water, suction air, saliva ?

2. Do suction hose can act as safe environment for hiv for 1 hour ...............Time difference between previous patient and me is around 1 hour . Is it enough for virus to become inactive in suction hose .......it remained open from above without attached suction tip ? we know that it sucked air, saliva ,water ,blood, waste from mouth so I think all mixed together ?

3. Do I need pep for above dental visit or just forget about it 

I don't know hiv status of previous patient ( very low prevalence )

Doctor please answer above questions ....... I am very grateful to you and will not come again .......I think I am developing anxiety disorder .

Thanks again for helping me .

1. If an earlier patient were HIV positive would virus in any blood have been deactivated by water, suction air, saliva ?

The "backflow" you have read about is a myth.  Further, HIV would not be transmitted if any of these got into you mouth during your cleaning.  

Thanks for quick reply .

Just want to understand your reply

"Further, HIV would not be transmitted if any of these got into you mouth during your cleaning.  "

My understanding is 

I think it is because blood of previous patient if present in suction hose is mixed with saliva , water and air.........and also time gap is around 60 minutes .....so hiv virus become non infectious and also my mouth remained open during cleaning is not hospitable for hiv virus as it is filled with saliva and water too ......beside this I am doing betadine gargle in between ..........

Am I right regarding above ? Or there is some other reason

Beside this I have read about backflow on CDC though they don't mention about hiv and any other adverse effect reported

https://www.cdc.gov/oralhealth/infectioncontrol/faqs/saliva.html

Thanks again doctor ......I am so relieved after reading your reply ........try to avoid internet in future and move forward without worry 

You are doing wonderful job doctor.

Time for us both to move on.  This completes this thread.  EWH