[Question #12411] Is this just my anxiety?

8 months ago

Hi Doctors. Following up on my last thread I have been thinking and have a few questions. Maybe I don’t understand the science behind it but I have some more questions,

- could I have had a small left over amount of virus in my system, which was passed to my partner, but then cleared from me after I finished my PEP?

- you mentioned that transmitting HIV while on successful PEP is biologically impossible, which is strong reassurance. However, you also said that not enough HIV was circulating in my system? Does that mean that I had HIV in my system to begin with? And if so, what would have stopped my boyfriend from being infected when we had sex?

- I am now on Prep. Is it possible that I can have sex with someone who is hiv positive, have the prep protect me, but still pass hiv on to someone else?

H. Hunter Handsfield, MD

8 months ago

Welcome back, but I'm sorry you found it necessary. These questions were answered last time, or at least the answers should be obvious from that discussion.

"- could I have had a small left over amount of virus in my system, which was passed to my partner, but then cleared from me after I finished my PEP?" No. Negative testing after PEP proves you never had HIV, not that it was only temporarily suppressed. That doesn't happen.

Do my statements "...mean that I had HIV in my system to begin with?" No. You are over-reading my comments.

"Is it possible that I can have sex with someone who is hiv positive, have the prep protect me, but still pass hiv on to someone else?" No. PrEP prevents HIV from infecting you, which means you never have virus in your system and cannot infect anyone else.

I hope these comments help you move on without further worry. Best wishes.

HHH, MD

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7 months ago

Thank you doctor. Your responses make so much sense. Since I am still testing negative for HiV, there is no way that I could have transmitted it to my boyfriend from our sexual encounter while I was still on PEP. There was never any virus in my sperm/blood.

Sorry if I am asking repeat questions as English is not my first language (I am using google translate) so I want to make sure I am asking in the right way.

H. Hunter Handsfield, MD

7 months ago

Your questions were entirely clear. And I'm glad to see you understand my replies. Let me know if you have any final questions about it.---

7 months ago

Thank you doctor. A few final questions to wrap up my thread:

1. I noticed my boyfriend has had oral thrush, that he said started around 6 months ago (around the time after we had unprotected sex). he took 1 anti fungal pill and it started to go away, but now it came back. He is relatively healthy- only has iron deficiency that he got treated with infusions, and has taken several courses of antibiotics more than a year ago. However, everything I read says oral thrush equals HIV. 1) is it possible that our sexual encounter while I was on PEP could have caused him to get hiv and thrush? 2) is it more likely that he has thrush from his anemia and antibiotic use that was very long ago 3) does the thrush not completely going away after him taking the 1 anti fungal pill indicate oral thrush from HIV? 4) Can you share a bit more about why it’s impossible to transmit hiv while I was taking PEP, and still be hiv negative myself? I know doctors never say the word “impossible” so it does give me some reassurance, but I would like to understand the reasoning

H. Hunter Handsfield, MD

7 months ago

"Everything you read" is wrong. Oral thrush is common in people without HIV; and might not be a correct diagnosis. Thrush (yeast infection) is not the same as white coated tongue, common with all sorts of minor infections (like common colds). 1) I remain confident he doesn't have HIV. 2) If he really does have a yeast infection, antibiotic treatment is the most common reason, far more frequent than HIV. 3) Delayed response to thrush treatment does not imply HIV. 4) PEP suppresses the virus to low levels that cannot be transmitted.

Do your best to accept the scientific evidence. Also note the forum policy against repeated questions on the same topic. This being your second about these concerns, it must be your last. Excessive questions are subject to being deleted without reply and without refund of the posting fee. But I'll make a deal with you: if someday you end up with HIV, please return to the forum and let us know and we'll reverse your posting fee. (It would be the first ever: in the 20 years of this and our preceding forum, with thousands of questions from people worried about HIV, nobody has yet turned out to be infected. You won't be the first, especially in the face of PEP.

I hope the two discussions help you move on without further worry. Happy new year.

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