[Question #12509] Back again

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7 months ago
Hi doctors - sorry to be back so soon, but my nerves are getting the best of me and I have some addition follow up. So my regular partner, who I had sex with during my pep treatment told me that she is now pregnant (we’ve been engaging in intercourse the last 10 months- ever since we first had sex while I was taking pep). She shower me the at home test. Now I am needier that I might have infected her while I was taking the pep when we had sex 10 months ago. 

1. I read that having hiv leads to false positive pregnancy tests. How true is this? Is it possible that she can have hiv, which is why the test is false positive. 

2. I went and got another rapid hiv test for myself today and it was negative. Does this 100% rule out the possibility of giving her hiv when we had sex while I was on pep? 

3. We had sex in either day 10 or 12 of my pep treatment- I can’t remember. Does this make a difference? 
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Edward W. Hook M.D.
7 months ago
This is a repetitive post the basis of which were already answered.  You have proven you do not have HIV and persons who do not have HIV cannot transmit it to others.  Your fears reflect misinformation that you have received as well as your guilt over an encounter which you have now come to view as a mis-step.  You need to move on.  If you cannot do this on your own, you should talk this through with a professional counselor.  Specific replies:

1. I read that having hiv leads to false positive pregnancy tests. How true is this? Is it possible that she can have hiv, which is why the test is false positive. 
This sounds like more internet misinformation.  It is incorrect.  You could not have given your partner HIV and HIV does NOT cause falsely positive pregnancy tests.

2. I went and got another rapid hiv test for myself today and it was negative. Does this 100% rule out the possibility of giving her hiv when we had sex while I was on pep? 
You proved long ago that you do not have HIV.  This additional test only confirms that

3. We had sex in either day 10 or 12 of my pep treatment- I can’t remember. Does this make a difference? 
No

EWH

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7 months ago
my apologies for the repetitive questions doctor. I will seek treatment from a mental health professional. Few questions:

1. When I went to get tested today the NP said “you and your partner are fine. It is highly unlikely…effectively zero chance” her saying highly unlikely scared me. Is this just doctor talk? Why didn’t she say it was not possible? 

2. There’s no medical literature on the scenario of transmitting hiv while on effective pep. Is this because it’s just a straight forward and well known impossibility? Have you seen or heard of cases where this happened? 

Sorry for so many questions, I just want to make sure I am asking in a manner that is clear 
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Edward W. Hook M.D.
7 months ago
1.  Health care professionals almost never say never.  This is because in science and medicine, new information is learned every day.  You have nothing to worry about.

2.  As explained several times, the reason there is no medical literature on the topic is because it is not possible.  Get over the misinformation you have gotten.  

You have one follow-up remaining.  After that no further follow ups will be permitted, even if you start a new question.  EWH
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7 months ago
Thank you for your reasoned, straightforward advice doctor. I realize that my guilt is playing a large part in my irrational fears. Last questions

- if my partner is already immunocompromised (eg. they suffer from iga or igm defenciciy or has an auto immune disease) does this change anything about the risk of us having sex during my pep treatment? 

- final clarification point: only those with an established hiv infection can transmit it to others. PEP prevents an infection from establishing so it is not possible to infect someone while on PEP, especially since the pep worked for me. There was never any hiv circulating on my cells, and if there were 1) it wouldn’t be at high levels to transmit to anyone else 2) PEP killed it out of me? 
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Edward W. Hook M.D.
7 months ago
As you know, this will be my final response. You should not respond return following this response. If you do, your question may be deleted without a response and without return of your posting fee. You are clearly having a great deal of problems, dealing with your guilt and anxiety.

If your partner had IgA or IgM deficiency, my opinion would be unchanged. As I have said on multiple occasions, you cannot transmit HIV if you do not have HIV while taking pep. You do not have HIV.

The first two sentences of your final paragraph are correct. It would be impossible to transmit HIV while on. Your last two sentences describe a “what if” situation which is scientifically impossible.  The was never HIV circulating in your system.

Once again, I urge you to address your anxiety. My sense is that you are unable to do this on your own and would benefit greatly from confidential professional counselor. EWH.
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