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SHOULD I STOP TAKING PEP, HELP ME SCARED STUDENT
Nov 7, 2010

Doc Joe

Here's the situation: Yesterday 2 November 2010, i had receptive anal sex with a guy i had been seeing for like a week, it was protected and according to my knowledge the condom didn't break or slip, as i saw the sperm afterward's, nor did he say it was unprotected, he said he took it out and it was fine, it didn't slip of fail. We used KY gel as lube. He also gave me a BJ unprotected, we are both university students. Afterwards i got scared, and told him to tell me his sexual history and testing history, he told me he slept with another guy 3 weeks ago and he used protection as the top partner.He also said he got tested 2 months ago and it was negative,before that he hadn't had sex for a year.

But i freaked out and told him we had to get tested now, so we went to the campus clinic and we got a rapid test. BOth negative. He didnt even freak out when i told him to get tested, he went freely, an hour after we had sex, we were tested. That put me at ease, that he wasnt even afraid to get tested.

BUt i was still paranoid, i went to see my doctor, and she said i should take pep, because he could have gotten hiv through his last encounter 3 weeks ago and that the rapid test taken on the day of sex wasn't conclusive. And thus i started PEP yesterday( no bad symptoms yet but i am tired). I started combivir, I also have built immunity to hep B.

The doctor advised me to let him do a 4th generation test which combines an elisa and a p24, so if that was negative i could stop PEP.

So i called him again and told him the story, he was like "dude, u are so paranoid, but i will do it, lets go" wow, he agreed to get tested twice, which guy will do that really, which guy.

Ok, i know this feels like some harry potter novel, but pls bear with me. So we go to the lab together(today, November 3) and we tell the story, the woman at the lab says, their is no need to get the test as the window period is still the same and the rapid test is just as accurate as the elisa and a negative test on the 2 nov will not turn positive on the 3rd nov.

So we dnt do the test, he tells me am paranoid and i should relax, we go back to his place and fool around, he gives me an unprotected blow job again and then drops me back at my place. No anal sex.

And now that i am at my place, i am getting nervous again, I have a few questions: 1. Can hiv get through a condom that doesnt fail? ever 2. I know a bj carries minimal risk, but does it warrant PEP 3. Who was right, my doctor or the woman testing at the lab who said a neg test yesterday wnt turn positive 2day. 4. After all he has said and done agreeing to get 2 hiv tests, driving there, cause he has a car and i dnt, using his petrol and money to get this test, can I believe him when he says he is 99.9999% sure he doesnt have hiv. 5. Should i stop PEP? I wont stop till you tell me to stop. 6. Am i just a crazy paranoid freak? or am i right to protect myself and not trust anything any1 says. 7. Can i take combivir even though i have hepB, I have built immunity though.

I am 21 and he is 23, he was the second guy i slept with, i was the 6th he'd slept with.

PS: What i am really afraid of is that,if he got hiv from his random sex with that guy 3 weeks ago,the virus will be producing rapidly now and can spread easily during this window period.

Thanx again DOC

Response from Dr. McGowan

Thanks for your post.

While nothing is perfect, if condoms are use consistently and CORRECTLY, which is the important term, HIV transmission risk is from zero to 2% among couples where 1 partner has HIV.

Approximately 50% of people who become infected with HIV will test positive by 3 weeks post-exposure. The extra day would not matter. Also most (80-90%) will have symptoms during the 2-4 weeks after exposure if they are developing infection (fever, rash, swollen glands, etc). Since your friend used a condom and the HIV status of his previous partner is unknown the risk seems very small indeed since the condom was correctly used in your case.

The fourth generation testing kit for P24 antigen as well as antibody may turn positive about a week earlier than the standard antibody alone test. It can be useful if one suspects a person is experiencing an acute HIV infection. Since your partner has no symptoms it would not generally be needed.

It is refreshing that your partner has agreed to be tested and shared his history with you. If everone gets tested and knows their HIV status we can really impact on HIV in our community.

Best, Joe



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