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I put myself at risk for HIV, now I am scared.
Jun 14, 2011

I had unprotected sex with a man for the first time on May 30th, wherein I was the vers/top. I also performed oral sex on him, he tried to penetrate me, but with not much success. I penetrated him several times over a few hours. I also performed the act of rimming for a few minutes. He ejaculated on my abdomen, as did I (I have no wounds or the like on my abdomen). We engaged in kissing and foreplay for hours leading upto penetration. A few hours later during conversation, he tells me that he is HIV positive but undetectable and has been on Atripla for two years. I was tested a few days later, which of course was negative.

On Thursday of this week, June 9th, I developed a small pimple like rash on my pecs and shoulders. However, I also used a different soap on Thursday morning at the gym. I am hypersensitive to soap. I often get folliculitis, and this is the type of rash that I have. This rash itches mildly; almost a warm itch.

I must note that two days later, I had swollen glands and was diagnosed with strep throat, wherein I was put on a Z-pack. I currently do not have a fever, diarrhea, night sweats, or swollen glands. I actually feel fine, minus the rash and worry.

I guess my fear is this; being that there was semen present and he is positive, what are the odds of me being positive as well. Will anti-bodies be present once a rash is present? (which now is mostly cleared) Is it too late to take PEP? Should I take the oral swab test again? I do have an appointment to have blood work done on June 13th.

Thank you so very much for any peace of mind thats you may offer.

Response from Dr. Frascino

Hello.

Your decision to have unprotected sex does place you at risk for STDs, including HIV. That your buddy's HIV viral load is undetectable on antiretrovirals decreased but does not completely eliminate your HIV-acquisition risk.

Symptoms are notoriously unreliable in predicting who is and is not HIV infected. That said, your symptoms are not worrisome for HIV acute retroviral syndrome (ARS).

PEP (post-exposure prophylaxis) needs to be started as soon as possible and no later than 72 hours from the time of exposure. Consequently it would not be recommended for your situation.

My advice is that you get HIV-antibody tested at the three- and six-months marks. It's also important to learn from this lapse in judgment. We must consider all our sexual partners could be HIV infected and therefore take all the necessary precautions to prevent transmission of the virus.

Good luck. I'm here if you need me, OK?

Dr. Bob



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