Apr 6, 2006
I have a question and I would really appreciate it if you could help me out.
I am a 23-year-old male living in England. Last night I had sex with a bloke whom I have met once before. We used condoms and I was active throughout in the role.
However, once we had both climaxed, I withdrew to find the condom, which I had most definitely used, had vanished.
To cut a long story short, it turned out that the condom had come off either during the deed or afterwards when I withdrew.
I asked the person involved once he had gone back home if he was HIV negative and to my horror he said he was actually positive but not to worry.
Now, I called a help line last night and also google'd PEP therapy as this is something which I had heard of previously.
Can you tell me more about this PEP therapy? I understand that there is a cut off period of 48 hours?
I have spoken to my local GUM clinics but had no luck at getting in today to discuss further as it has been appointment only.
I am worried sick. I understand that I shall have to go and get a blood test (apparently new testing methods mean the virus antibodies can be detected as soon as 8 weeks? Is this correct?) BUT if the 48 hours with the PEP is true, should I try and get to a clinic ASAP?
What I really want to know and I know it is a completely unanswerable question I guess, but are the chances stacked in my favour? I have studied Science and understand anatomy and the way virus' work as a general rule. I am just desperate for some sort of reassurance as my local clinic were not the most helpful, would even say they were quite rude.
If I was active in the role, the chances of the passive HIV carrier passing the virus to me is surely quite slim? Especially considering I assume the condom was present at all times during sex and (hopefully) only slipped off once I withdrew?
Anything you can say would be greatly appreciated.
Response from Dr. Frascino
The estimated per-act risk of acquiring HIV from unprotected insertive anal sex with a partner confirmed to be HIV positive is 6.5 per 10,000 exposures. Your estimated risk may well be even lower, considering the condom was in place "at all times during sex and (hopefully) only slipped off once I withdrew." Other factors that may influence the risk of HIV transmission include the viral load of the positive partner, concurrent STDs and trauma due to rough sex (increasing the risk of blood exposure). The question of whether or not you should take PEP is dependent on level of risk and exposure. An HIV specialist is usually the best resource in helping to determine if PEP is warranted or not. Any chance you could see your buddy's HIV specialist? Also, PEP has the best chance of being effective the sooner it is started after an exposure. It is not recommended if it's been longer than 72 hours since the exposure. Any urgent care center or emergency room should be able to evaluate you and begin PEP if necessary. You could then have a more thorough evaluation and discussion with an HIV specialist over the next few days and discontinue or modify the PEP regimen if need be.
You can read additional information about PEP in the archives. The important information is that it should be readily available and started as soon as possible after a significant HIV exposure. It is my personal opinion that anyone who experiences an exposure significant enough to warrant PEP should ultimately be evaluated and followed by an HIV specialist.
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