|Found out my wife is HIV positive - please advice
Aug 14, 2007
I have been living out of my home country in Africa and I flew back after two years away. I did not have any form of sexual contact during these two years. I fully abstained. I am married and have two kids. While planning to get a third kid, I asked my wife that we do the routine HIV test. It is a practice that we have been having. Unfortunately, she turned out to be HIV positive. I turned out to be negative. However, I had had sex with her at least nine times without protection. After finding out she is positive, we agreed that we stop any sexual contact so that I get to know my status. The two kids are HIV negative. I did a test at 8 weeks and 9 weeks after the first exposure with her. Both Rapid and ELISA tests came back negative though still within the window period. The day she got her positive result, the doctor decided to put me on Combivir for 28 days because we had had anal sex 10 hours earlier on the same day. All the other encounters were vaginal sex. I have the habit of washing after every sexual encounter, after 5 to 10 minutes after each encounter and always use antiseptic soap as standard in the house. I am a circumcised male. I finish Combivir in three weeks and this will be 1 month after the very last exposure to her. What are my chances that I shall maintain negative status? In all the encounters, our sex was ten minutes and below and I withdrew immediately and she was extremely wet. I do not remember having any cuts but there is the issue of microscopic ones. My wife and I have never had an STI.
I shal go for a test 3 months after last PEP dose. Is Combivir alone enough as PEP?
| Response from Dr. Frascino
I'm sorry to hear about your wife's recent diagnosis. Your HIV risk is nine episodes of unprotected sex (eight vaginal and one anal). The estimated per-act risk for acquiring HIV from unprotected insertive vaginal and anal sex with an HIV-positive partner is 5 per 10,000 and 6.5 per 10,000 exposures respectively. The risk of your single anal exposure was mitigated by your use of PEP within 10 hours. Your negative HIV-antibody tests at eight and nine weeks are very encouraging, as the vast majority of HIV-positive folks would have detectable levels of anti-HIV antibodies in their blood by this time. I agree you will need a test at the three-month mark. In addition, since your exposure was significant, the CDC recommends a confirmatory test at the six-month mark to give a conclusive result that you are HIV negative.
Regarding PEP, yes, Combivir is one of the recommended two-drug regimens. Some HIV specialists now prefer three-drug regimen or using newer drug combinations. You can read more about PEP in the archives.
Good luck to both you and your wife.
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