[Question #12272] HIV anxiety

Avatar photo
9 months ago
Hi doctor I had protected vaginal and anal sex with a female at massage parlor.. anal was brief and vaginal few minutes.. condom was on the whole time.. this was about 2 weeks ago.. I'm not feeling symptoms just keep thinking about it and googling a lot.. I asked my doctor after the encounter and he said I don't need to take PEP since I practiced safe sex.. what do you think?
Avatar photo
Edward W. Hook M.D.
9 months ago
Welcome to the Forum. Thanks for your questions and your implied confidence in our service.  I agree with your doctor.  Inmy clinic I would not prescribe PEP for you following the exposure you describe.  Here are some of the reasons;

1. Most CSWs do not have STIs including HIV, they tend to test regularly and take precautions.
2. Most single exposures do not lead to infection.  For a male having UNPROTECTED vaginal sex with a woman with untreated HIV, the HIV is transmitted, on average about once in every 2000 exposures (i.e. no transmission occurs more than 99.9% of the time.  Transmission rates for anal sex are similar although slightly lower
3.  Condom protected sex is safe sex.  As long as the condom appears intact after sex, it is and has done it's job.

I hope that this information is helpful.  EWH
---
Avatar photo
9 months ago
Do you think a test would be necessary? If yes when is the earliest I would be able to test?
Avatar photo
Edward W. Hook M.D.
9 months ago
Testing is a personal choice.  Test are of little value while taking PEP.  If you choose to test, a 4th generation, combination HIV antigen/antibody test will be conclusive 6 weeks after your last dose of PEP.  An HIV PCR test will be conclusive more than 11 days after completion of PEP.  EWH---
Avatar photo
9 months ago
I am not on PEP as I was told this wasn't such a high risk.. is this something I need to worry about? Can I move on and stop having all this anxiety? Is it safe to have sex with my wife? 
Avatar photo
Edward W. Hook M.D.
9 months ago
Apologies, I misunderstood.  In that case testing with a 4th generation test will be more than 98% conclusive at 4 weeks and entirely conclusive 6 weeks after the encounter.  Alternatively, HIV PCR testing will be conclusive any time more than 11 days afterward.  EWH---
Avatar photo
9 months ago
Is testing something I need to do after this since i used a condom.. or can I just move on and stop thinking about this.. sorry to keep asking I'm just having lots of anxiety right now
Avatar photo
Edward W. Hook M.D.
9 months ago
Final response.  Testing is always a personal choice.  Your risk is virtually zero however some of our clients appreciate the confidence that a negative test provides.

This completes this thread.  Take care. EWH
---