[Question #7337] Possible HIV Exposure/Pep Question
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58 months ago
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This morning, about 3 hours ago I had a possible hiv exposure. I was hooking up with a random guy. He was rubbing the tip of my penis around his anus and the tip inserted inside him for possibly two seconds. I pulled it immediately and that was the only penetration during the episode.
He said he is HIV free and was last tested in June. Is this a high risk exposure? Should I take pep? What would be the odds of me contracting hiv if he was positive? What should I do?
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H. Hunter Handsfield, MD
58 months ago
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Welcome to the forum and thanks for your question.
There was little or no HIV risk from this event and I definitely do not think PEP is warranted. First, it is obviously unlkely your partner has HIV. Even if he does, unprotected insertive anal sex (topping) to completion (several minutes) with an HIV infected male has an average risk of roughly 1 in a thousand. With the very brief exposure described, it's a whole lot lower than that. All things considered, the overall chance you caught HIV is under 1 in a million -- far too low to consider PEP.
What should you do? From a strictly medical standpoint, there's reallly no need to do anything -- unless more info becomes available, such as learning that your partner has HIV after all; or if you develop any STD symptoms, such as urethral (penile) discharge, painful urination, or penile sores. If you remain nervous, you could have an HIV test in a few weeks, but I suggest it stricly for the reassurance you might experience from a negative result, not because I think there really was any significant risk. I do not.
I hope these commetns are helpful. Let me know if anything isn't clear.
HHH, MD
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58 months ago
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They are very hopeful. This will relieve a lot of anxiety. Thanks for your answer. If any other pertinent info becomes available I will update this thread.
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58 months ago
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So I’m guessing you wouldn’t prescribe it in this situation? You think it’s really more than 1 and in million chance?
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58 months ago
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Also if I had an STI such as gonnorhea or chlamydia and didn’t know it. Would that greatly increase my risk of being infected?
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58 months ago
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Also would that change the status of me needing to take PEP. I am just worried because I am coming up on the 24 hour mark and want to make sure it is not needed.
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H. Hunter Handsfield, MD
58 months ago
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First and most important, this is not a site for PEP advice. We do not guide specific PEP decisions -- it come too close to medical care from a distance, which we cannot do. PEP decisions must be made with a health care provider in person. In addition, a local expert -- someone familiar with the local HIV situation is in a much better position to judge the chance a partner like yours has HIV. You have my assessment that this situation is sufficiently low risk that I believe PEP is not warranted. But if you remain sufficiently concerned, my only advice is to see a local doctor or clinic (preferably an HIV or STD expert) to discuss the pros and cons of PEP.
If you consider PEP, also consider a downside that many people forget to think about. Although PEP is highly effective, it doesn't always work. Therefore, after PEP, testing for HIV must continue. And if PEP doesn't work and HIV takes hold, it can take a lot longer for reliable blood test results. If you take PEP, you will need to plan on testing for HIV for 3 months (and some experts advise even 6 months). In other words, PEP prolongs the time of anxiety until conclusive testing is done. Keep this in mind if you go ahead with seeing a doctor or clinic about PEP.
It is true that other STDs elevate the risk of catching HIV if exposed. If you happened to have gonorrhea or chlamydia, your risk might be double. "Double" sounds like a big deal -- but if you think about it, doubling a risk of 1 in a million means 1 chance in 500,000, still extremely low. And without synmptoms, the chance you have either of these STDs is very low.
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58 months ago
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I went ahead and got PEP morning. I took one dose at approximately 27 hours post exposure.. I understand this isn’t a place to ask PEP but please bare with me. These will be final questions.
I’m on the fence about continuing the treatment after you talked about the prolonged anxiety.. if I discontinue use today will it affect the test results at 4 weeks out after one dose? How affective is prep starting it 27 hours post exposure? What would my overall odds be if i finish the treatment? I’m just scared and don’t really know what to do at this point. I feel like it was really low risk. But at the same time I want to be sure that I don’t get it..
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H. Hunter Handsfield, MD
58 months ago
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A day or two of PEP drugs probably won't have any effect on the timing of future testing.
Putting the situation in personal terms, if somehow I were in your situation, and knowing what I know, for sure I would not have sought PEP. But now that you have started, the doctor or clinic where it was prescribed should be your main source for discussion of whether ot not to continue it.
That completes the two follow-up exchanges included with each question and so ends this thread. I hope the ciscussion has been helpful.
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