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help i'm stressing out after having unprotected anal sex

Question: 

So I had unprotected anal sex 3 times with ejaculation with 3 different guys last year. I lost my virginity to one of them. I was told by all 3 of them that they were clean. after the 3rd guy(which was summer time), I got really scared and it was really really stupid of me that I didnt get tested. I didn't have sex till recently this week. Through the months of not having sex I did not have any symptoms of any sti/hiv. Recently I had sex with the guy who took my virginity again. I told him before having sex, that he should get a condom. But when we had sex, he did not use a condom and just went in without telling me and just ejaculated afterwards. I've been looking through google about hiv/sti's and I am panicking. I've scheduled to get tested next week and I just want to know that... If I get a positive is it too late to use PEP and if I get a negative how many times more can I get tested without having sex?.. I really hope to get an answer because im getting anxiety and thank you so much if I do.

Answer: 

Hello and thanks for reaching out to the AIDS Vancouver Helpline.

It sounds like you have been holding onto this for some time, and I appreciate that is increasing your distress. I hope that I can address all of your concerns and give you some good resources.

As you are likely aware, unprotected anal sex is a high risk activity in regards to acquiring HIV. However, if your partners are not living with HIV (or if they have clinically undetectable levels in their blood), then they cannot pass the virus to you. The only way to find out your status is through testing.

Testing can give a good indication of your HIV status from around 4 weeks post exposure, and testing at 12 weeks is generally considered conclusive. AIDS Vancouver recommend that all sexually active people include HIV and STI testing as part of their regular healthcare, so perhaps once you have your status confirmed, you might like to think about routine testing for the future.

As to when you can have sex; given that you have a test scheduled, would it be unreasonable to abstain until you receive your results? Would you be able to have a fulfilling sexual encounter whilst you are feeling anxious about your HIV status?

PEP is available in Canada and other countries and can reduce the risk of acquiring HIV if taken within 72 hours post exposure (ideally within 36 hours). As PEP is still quite new, the data on efficacy is limited and there have been cases where people have still acquired HIV even after taking PEP. Also, as there is a very limited timeframe to take PEP, this is not an option in your case.

Another option is PrEP, which is a PRE-exposure prophylaxis for people with a negative status who may be at risk of acquiring HIV (for example, those whose regular partner is living with HIV). PrEP is quite expensive and not available in all areas, but certainly worth investigating if your status is negative and you are in relationships with men who are reluctant to use condoms and may be living with HIV or have unknown statuses. PrEP is not designed to replace condom use and will not protect against other STIs, however it is an additional line of defense against acquiring HIV.

You mention that your partners were "clean". This is an ambiguous term. In part, it implies that someone who is living with HIV is "dirty", which is not the case. Equally, the term "clean" is also used in regards to drugs and alcohol, and STIs generally. It is important to be very clear when you have these discussions that you are talking about the same thing, which is why we recommend that this term is avoided.

In regards to symptoms, many people have no reaction at all after acquiring HIV. And as many viral symptoms are similar, it is always best to speak with a healthcare provider to determine what is causing them and the treatment required.

Please be aware that the internet is full of well meaning people, but most of them are not healthcare professionals and most of the stories are anecdotal. What happened in their specific encounter will be different to yours, and as such, the outcome will likely be different too. There are some excellent HIV resources available, created in consultation with healthcare professionals, which can give you information on risk factors, medical advances, and what it's really like to live with HIV - please find some of my favourites below:

CATIE - HIV and Hep C Basics

AIDS Vancouver - Risk Assessment

CATIE - Living with HIV

World Health Organisation

I hope that this information goes some way to alleviating your stress. If you are resident in North America and would like a more detailed conversation, please do not hesitate to call our toll free number (1-800-INFO-HIV).

Very best of luck with your upcoming test.

Wendy (Volunteer)

Thank you for contacting the AIDS Vancouver Helpline.
AIDS Vancouver Helpline/Online
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