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HIV transmission through pre-cum: PEP needed? Very stressed

Dear Dr.,

I had an exposure one week ago with another male. I rubbed/shagged his uncircumcised hard penis with my hand, and then just afterward rubbed/shagged my uncircumcised hard penis with same hand (No cuts on the hand). Is there a possibility that his pre-cum came on my hand and hence, was transferred to my urethra leading to HIV infection.

Also, I visited a doctor who has given me 28 day PEP course starting one week after the exposure, which I don't think is very effective, but have started because I am scared. Please guide me. You are doing great work Sir.

Pep concerned

I know it is a stupid question still I am concerned. If I went on pep 27 hours after the incident for a bleeding scrape after I took my pen out of a bin with used stil wet HIV rapid tests, glucose, cholesterol strips ( wet blood stained) and wet blood stained cotton wools and it wasn't nessasary for pep can I get HIV from pep or any of the above? Hope it make sense?

PEP treatment and concern

Hi,

First of all thanks for this amazing website and helping us clear all of our doubts. I had a high risk event (unprotected anal sex, receiver) with someone I didn't know. I ask the status to this person and said two times that he is hiv-, although I didn't convince me and I started to freak out. There was ejaculation but this happened outside me, seconds after. I went to the ER room to get advice and they recommended me to start a PEP treatment, which I'm actually doing.
At the clinic they tested me for HIV and the result was negative but it came to my mind afterwards, when I already started the PEP treatment that I had another risk event (the 2nd of 3 in my life) but it this ones was less risky as it lasted very little and there was no ejaculation at all. This happened almost 3 months before; actually to be accurate it was 11 weeks and 2 days before getting tested at the clinic.
I have three questions regarding my story;
1) Do you think it's reasonable that I started the PEP treatment considering my risk? Or I'm actually risking more by doing the treatment and considering the side effects.
2) Considering the test was not exactly 12 weeks after my first exposure, if not a couple of days before. Was it a bad decision to start PEP? Will this bring any consequence in case I am infected?
3) Can I test for other STD's while doing PEP? Like hepatitis, Chlamydia,etc.

Thank you very much in advance,
All your answers will be very much appreciated.

How much does a cut on your penis increase HIV transmission rates during unprotected anal sex?

I recently had penetrative anal sex with a stranger while on vacation in Barcelona, and it was unprotected. The next day, I noticed I had a small cut underneath the head (the more sensitive skin or inner foreskin) which is worrying me. At the time, I felt some discomfort which I attributed to friction or a lack of lube, but I now suspect I was feeling discomfort from the small cut. To make matters worse, I read that Barcelona has one of the highest HIV incidences in all of Europe, especially among MSM.

I also read that penetrative anal sex, unprotected, with an HIV positive partner is a 0.11% chance of infection if you are circumcised and 0.62% if you are uncircumcised, per encounter.

This leads me to three questions:
1. Roughly how do HIV transmission rates change/increase if you have small cuts or abrasions underneath the head of the penis (basically on the inner foreskin)?

2. If the receptive partner was recently infected (in the "window period" where their body is not yet producing antibodies to HIV), how much does the transmission rate increase? A friend had said it's 30x as high -- but that seemed like too high of an estimate (implying 3.3% if circumcised or 18.6% if uncircumcised)!

3. What is the best way to treat a cut on the sensitive skin beneath the penis head? Clearly a band-aid is not practical.

Help had protected sex with a sex worker in South Africa

Hi,

I have a issue that has been bothering me. I hired a sex worker yesterday, It was a foolish decision one that I regret. So first we started with foreplay, we kissed for like a minute (I'm not concerned about that- since, HIV isn't transmitted this way). She gave me oral sex for about 30 seconds. We then started intercourse. It was vaginal sex from behind. It did not last long. Lets say it lasted less than 50 seconds. Now I did not test the condom after intercourse. However, from what I saw was that there was no tear or holes visible. Is it safe to assume that the condom was not damaged?

The important information is that she was black South African (I don't think she was from a rural settlement as she lived in an urban area. However, HIV is highest among low socio-economic groups in South Africa (black South Africans). So the risk that she was HIV positive was higher.

Also I wanted to ask what are the chances that a condom has small holes in it, because it clearly wasn't damaged. I want to conclude that the risk of HIV transmission was low since, no bodily fluids were exchange and the duration of intercourse was very short.

I understand that the chance of transmission was very low, and many people say that the test will likely come out as negative after 3 months. Should I still go for one. It has been approximately 24 hours I don't know if I will be infected, is it a viable option to see a practitioner as ask for post exposure prophylaxis. I know what the side effects are and honestly I'd rather suffer the side effects than live with HIV for my entire life.

Please advice, I am really double minded on what to do. I want to go for the post prophylaxis option but at the same time I keep on telling myself there is no need because the risk of HIV transmission was very low.

Regards

James

Had protected sex with sex worker in South Africa

Hi,

I have a concern right now. I made a really foolish mistake. I hired a black sex worker (found her on a website) in South Africa. I have not had sex in the past. This was my first time. The sex worker proceeded with foreplay only kissing. She gave me oral sex with a condom. I did not give her oral sex. We proceeded with vaginal sex. It didn't last long, about 50 seconds. I didn't inspect the condom properly, but I did not see any holes or damages on the condom. The condom was on during the whole experience. Now I am worried that I might be at risk for contracting HIV. I know the risk is low, but considering that black South Africans have higher risks for spreading HIV.

So I really don't want to get tested for HIV because I know there is a slight risk and besides waiting a few months then getting tested, and finding out I'm HIV positive. I was wondering if I could take post-exposure prophylaxis to almost eliminate the chance of being HIV positive. I would rather bear the side effects of the medication than have a disease for the rest of my life and constantly regretting.

Please advice

Regards

Should you seek PEP after insertive oral with a condom from a CSW

If a male recieved oral from a csw with protection should that male seek out PEP to ease anxiety?

feel suicidal had unprotected receptive oral sex with ejaculation with 8 men

I have been feeling suicidal my family left me my wifè got pregnant by another man it's been awful I went and put a add on craigslist to perform oral sex with ejaculation i performed on 8 men i flipped out after i did it i went on pep 3 days later earlier that day i felt tired nauseous and joint pain my throat feelstight and i still have mmuscle pain and bone pain also been having very itchy skin i have been so stressed since the oral sex how effective is truvada and isentress for pep could hiv be causing my symptoms or could it be the pep causing my symptoms what are my chances i stay negative

4th gen result on 24th day post PEP

After unprotected vaginal sex with a HiV Positive sex worker , I had taken 28 days PEP medication (started after 56 hrs). I have hard and painless lymph nodes below jaw and armpit from 20 th day onwards. Also developed 3-4 lymphs around neck and groin area from 35th day ( 7 th day after pep) and still it exist (Today 24 th day after pep)

I have conducted following test.

1. Dna pcr proviral on 18 th day after pep :- Result obtained as NOT DETECTED

2. 4th Gen Duo test on 18 th day after pep :- .11 index value , ie non reactive

3. 4th gen duo test on 24 the day after pep:- .25 index value. ( non reactive)

I have two queries regarding test results

1. How conclusive my result ?? If not conclusive when I have to tested further ?

2. What is the index value increase from .11 to .25 in a span of 6 days means. ? It's scaring.

Please help.

Freaking out, PLEASE HELP health worker

Hi I performed a numerous of rapid tests on patients the other day without gloves (stupid of me). The atomo rapid got a small tube infront in which you catch the blood, if that little tube with blood in it scratch me afterwards, what is my change getting HIV. Also a drop of blood ( while pressing her finger)of a HIV+ client fall on my index finger with quite a deep cut in it. I went after 27 hours on pep, must I be scared ( because I'm freaking out) or can I relax. Please pray with me that I don't get HIV.

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