HIV concern, PEP?

[robbie75]

Hi everyone—I hope this is an appropriate venue to ask and seek help. I've tried literally every combination of search terms I can think up in Google for numbers of places to call for support, when I thought of these forums. If anyone has any numbers to call or places to visit (especially in the Phoenix area), I'd really appreciate it. My story:

2 days ago, I had unprotected oral sex with a random stranger. I received some 30 odd seconds of a bj before coming to my senses and insisting that we use condoms. We jerked each other off for a bit, but at no point did either of us ejaculate. Aside from skin contact and mouth/nipple play, that was the extent my exposure.

I don't know whether or not to pursue PEP, and I'm having a _very_ hard time finding information about it, especially on places to go to ask a doctor. I don't know whether or not to try to get it.

My anxiety is unbearable, and I'm quite desperate for some help. Please, anyone with any input, help!

 

[AdmiraalW238]

Normally I try to not answer question when someone says that

my anxiety is unbearable

However, in this instance I will.

Given the 'story' you have outlined I would suggest that you will not be eligible for PEP.

Oral sex is a low risk activity. Yes, the is a risk but it is low.

I work on a HIV Information Line and if you called and outlined the same story I would be telling you that you are not eligible for PEP but would also suggest that as you are sexual active you should be tested for STIs.

I would also be telling you that for your anxiety level you should seeking counselling.

I would also suggest you read the HIV FAQ thread.

 

[Corny]

I can't tell you where you can get in the US, but the best place to start probably would be your family doctor or a STD clinic.

Anyway I can tell you that here you wouldn't get PEP treatment. Due to the enormous side-effects you only get it for "risk contacts" and 30 seconds of sucking without ejaculation doesn't count as that.

So calm down, it is much more likely that you got something different than HIV from it. You can go to your doctor now and do a regular STD test to ease your mind, and in 3 months you can do a HIV test, just to be sure.

 

[KaraBulut]

In the US, any family physician or a physician at an emergency room or urgent care clinic can prescribe PEP.

Treatment should start within 72 hours of exposure. The drugs must be taken for at least 4 weeks.

PEP is for high risk exposures. It is designed for occupational exposures- for example, a nurse who has a needlestick from an HIV positive patient or a lab worker who is exposed to blood that tests positive for HIV.

The conditions around sexual exposure are a little less specific, however, as the other people who have responded have mentioned:

1. Your exposure is considered low risk and this would make it unlikely that you are a candidate for PEP.
2. PEP is a 30-45 day course of medications. It will cost you about $1000.
3. About 1/2 of the people who take PEP get very ill. Many never complete the course of the treatment because of the side effects of the drug.
4. Given your anxiety level, the money would probably be better spent on counseling to talk about the circumstances around your exposure and the anxiety it has caused you.

 

[robbie75]

Alright, first and foremost, thank you, to everyone. I typed my entry last night in a bit of a frenzied rush. Nothing is good when you're stressing, not typing, not reading, nada. I took several hours this morning to read over the FAQs again, your replies, and what I kind find on the internet. All signs point to this being an low-risk situation. I suppose I'm still worried, but less so now.

If you'll humor me another question or two… I've read that insertive oral sex is indeed low-risk, but PEP is proscribed in situations where one party is considered "high-risk". As gay men, aren't we all "high risk"? Second this happened in New Orleans, which I've read has a high HIV infection percentage. Should this be a factor?

I've decided to call my family doctor, since I trust her, for an appointment. I've also found a few more numbers at local STD clinics to make some calls. I'm looking into therapy for this anxiety (which was definitely there before, and the reason this happened in the first place). Finally, I've also told my family, and though the support isn't what I thought it would be, it's helped.

Again, from the bottom of my heart, thank you. I know these questions have been asked before by other people, especially the young, naïve ones like me. It's so tough feeling alone in this.

 

[robbie75]

Quick update. I went to talk to my family doctor today and said the same things you all said to me. She said she would be crazy to proscribe these meds to me, and that I shouldn't be worried. She gave me blood work orders to do, which I just completed, so as to set a good baseline. I've just done that—it was easy, but now the waiting.

The best news I think bar far is that she gave me the name of a therapist who deals with anxiety. I haven't called, but this is the biggest step I've made so far.

 

[KaraBulut]

The thing you should be worried about- and this is what your doctor was pointing you to- is that chlaymdia and gonorrhea are still the most common STD. And they are quite frequently transmitted via oral sex.

HIV, fortunately, is much less difficult to transmit. If it were easy to transmit, a big chunk of the western population would be infected (which increasingly does seem to be the situation in Africa).

People aren't high risk. But their behavior can be. And STDs are all about behaviors.

 

[CuriousGuy83]

If it makes you feel any better, I can tell you a story about myself. I had a regular buddy who liked to perform oral on me. He would suck me to completion, make out, and I would jerk him off. After about a month and a half of us fooling around, he went in for a yearly physical and found out he was HIV positive and he was positive from our first encounter. I freaked when I found out, I was very upset and scared. The first thing that I did was call an HIV counseling hot line, that helped a little, but not a lot. The first thing I did the next day was go in for a test, this was probably 12-14 days after our last sexual encounter. This was very soon for anything to show up on a test, so it was kind of pointless to do, but I still wanted it. It came back negative. I had another one done a little over 28 days post exposure. My research told me that about 90% of positives will test positive within 28 days of exposure. To be conclusive, you must wait 3 months post exposure to be sure that you are negative. The three month window was last week and I went in for the test and it was negative. The moral of the story is that I had oral sex numerous times with someone who was HIV positive and I was negative. I also jerked him off and came in contact with his semen and precum. This was a much higher risk than you had and I tested negative.

The HIV status of the guy who performed oral on you is unknown, but it is likely that he is negative. HIV is very hard to contract, there must be a direct way for the infected blood or semen to enter your blood stream. HIV is not contained in saliva, saliva actually kills it. For you to contract HIV via oral, his mouth would have to be severely bleeding and you would need to have a huge cut on your dick, one that would require stitches. A superficial cut is not deep enough. If his mouth was bleeding severely, you would know it and if your dick had a huge cut on it, the last thing you would want is a BJ.

Try and stay calm, the odds are on your side that you will test negative. Honestly, you probably dont need to get tested, but to put your mind at ease, get tested. It will make you feel better. If you have any questions, please feel free to ask via post here or send a PM.

 

[robbie75]

Thank you for your story. As much as I'd love to know he was negative, I just simply can't. It used to be my thinking that, especially considering our risk as a group of people, we would tell each other honestly, so as to give the same considerations as one himself would want. Ignorance of infection aside, it seemed like a safety net at the time. I'm finding that I simply have to start treating everyone I take to my bed as a risk. To tell you the truth, this has definitely scared me out of ever sharing it again.

Like you, an HIV test now, though it makes little sense, was something I had to have. I just got off the phone (really, a phone call?—and the most nerve-wracking call of my life at that) and I tested negative. As pointed out earlier, this was probably just my doctor's way of screening me for other, more common nasties, and everything else came out fine, too.

I'm glad to have be over that hump. My deadline for PEP is officially over now, and I catch myself questioning my decision. In the end, I'm trusting the combined forces of a few dozen people I've asked and received help from. And combined they are undoubtably smarter than I am. Thanks to everyone, again, over and over.