[Question #11581] Follow up question from question #11579
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13 months ago
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Hi doctor- I’m sorry I had to create another account because I lost the password to my email from my previous account (question 11579). If possible can you delete that account so I can use this one only? Below are my follow up questions
1. What do you mean when you say “those on PEP cannot transmit the virus?” Does that take into consideration us having unprotected sex while I was in the middle of my PEP treatment?
2. Your answer to my second question was No. can you help explain why it wouldn’t be possible to pass hiv while I’m taking PEP? I seen a website that says “do not have unprotected sex on PEP as you don’t know your status and may infect your partner”
3. I’ve read that PEP inhibits HIV and kills it before it can infect. So where does the dead virus go once PEP kills it?
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Edward W. Hook M.D.
13 months ago
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Please don't use different names and passwords for your posts, it hinders our ability to respond in context
1. What do you mean when you say “those on PEP cannot transmit the virus?” Does that take into consideration us having unprotected sex while I was in the middle of my PEP treatment?
It means just what I said. Unless you failed PEP, the presence of anti-retroviral medications both prevents you from becoming infected in the same way PrEP does. There is no evidence that you failed PEP, so there is nothing to worry about in transmitting an infection that you do not have
2. Your answer to my second question was No. can you help explain why it wouldn’t be possible to pass hiv while I’m taking PEP? I seen a website that says “do not have unprotected sex on PEP as you don’t know your sta1. What do you mean when you say “those on PEP cannot transmit the virus?” Does that take into consideration us having unprotected sex while I was in the middle of my PEP treatment?
Repetitive -see above. I cannot vouch for something you saw on the internet
3. I’ve read that PEP inhibits HIV and kills it before it can infect. So where does the dead virus go once PEP kills it?
You are getting into the weeds here. If there were dead virus in your system, it would be cleared by your body. The chance that there was dead virus is/was present is miniscule.
You really are worrying needlessly. If you are concerned that your PEP is not working, test. If you are infected, you'll be positive. I am confident that will not be the case. EWH
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13 months ago
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Thanks for the clarification doctor. Today I took a rapid 4th generation test (7 months post PEP) and it was negative. Can I now put this situation behind me and there is no way that I could have passed HIV to my partner when we had sex while I was on PEP? From a medical necessity perspective, Should I tell my partner that I may have exposed her so that she gets tested? If I do this, this will ruin our relationship.
Also, I remembered that in February (3 months after we had sex while I was on PEP), she went for her annual gyno check up. She did tell me that she gave urine and blood. Is it likely that her gyno would have ran STD tests (including HIV testing) during her annual?
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Edward W. Hook M.D.
13 months ago
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Your test results unequivocally prove that you did not acquire HIV from the encounter of concern, There is no need for additional testing or concern. It is time to move forward.
Please stop the repetitive questions about passing HIV on while on PEP- it is repetitive, has been answered and scientifically impossible. Stop letting the internet and you imagination send down rabbit holes!!!!
I cannot comment on whether your partner was tested for STIs or not. Depending on her age it may have been recommended but not all providers follow the recommendations. Don't be paranoid. EWHJ
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13 months ago
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thank you doctor. I have just a few last questions, then will put this thing behind me:
1. A large part of my worry comes from the fact that she has been having BOTH vaginal and oral yeast infection that occur ever 2-3 months, and everything I see on the internet says that recurrent yeast infections are a major cause of HIV. Can her recurrent infection be from other immune system issue? She does suffer from sever iron definitely anemia and low ferritin levels. Can that attribute to her yeast infections?
2. I saw a Reddit post from a guy who said that he got an RNA test a day after unprotected sex that came back reactive. However, he started PEP, then later tested negative on both another RMA and a 4the generation test. He is claiming that the PEP cured his HIV. Is it possible that his RNA test would have been positive just 1 day after his exposure? Is it more likely that his first RNA test was a false positive?
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Edward W. Hook M.D.
13 months ago
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Final responses. There should be no need for follow-ups. Should you return, your follow up questions may be deleted without a response and without return of your posting fee.
1. A large part of my worry comes from the fact that she has been having BOTH vaginal and oral yeast infection that occur ever 2-3 months, and everything I see on the internet says that recurrent yeast infections are a major cause of HIV. Can her recurrent infection be from other immune system issue? She does suffer from sever iron definitely anemia and low ferritin levels. Can that attribute to her yeast infections?
There are lots of reasons for recurring candidal infections ("thrush"), other than HIV. These include having taken antibiotics, being diabetes, taking other medications such as steroids', etc. You do not have HIV. You CANNOT have given it to her. Address your guilt and don't be paranoid.
2. I saw a Reddit post from a guy who said that he got an RNA test a day after unprotected sex that came back reactive. However, he started PEP, then later tested negative on both another RMA and a 4the generation test. He is claiming that the PEP cured his HIV. Is it possible that his RNA test would have been positive just 1 day after his exposure? Is it more likely that his first RNA test was a false positive?
A cannot and will not vouch for Reddit as a valid source of medical information. The person you are referring to may have had a falsely positive test - this is the most likely explanation; PEP is not curative for HIV
I hope the information I have provided has been helpful and will allow you to move forward.
End of thread. EWH
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13 months ago
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I’m sorry doctor you didn’t answer some of my last questions. I will stop asking after this:
- we had unprotected while I was on day 21 of PEP. Is it likely that there was enough PEP in my system for her not to get infected?
- could her severe anemia lead to her getting oral and vaginal yeast?
- would an RNA test pick up HIV 24 hours after exposure?
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Edward W. Hook M.D.
13 months ago
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You simply are not paying attention. The thread should have been closed. You DO NOT HAVE HIV. Your GF is not at risk from you!!!!!!!
- we had unprotected while I was on day 21 of PEP. Is it likely that there was enough PEP in my system for her not to get infected?
Yes
- could her severe anemia lead to her getting oral and vaginal yeast?
Anemia has many causes. Anemia alone is not a typical risk factor of yeast infections.
- would an RNA test pick up HIV 24 hours after exposure?
HIV RNA tests for HIV diagnosis are conclusive any time more than 11 days following acquistion of HIV. They would not be conclusively diagnostic before 11 days and at 1 day would not be expected to be positive.
End of thread. Please do not return. EWH
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