Sorry about my post being too long but I have somewhat specific situation and I have not found the info on the net that would calm me down even though I ve been reading about HIV in the past 5-6 weeks.I have been through probably the worst few weeks of my life so far (and Im not trying to be dramatic). I have several questions and this forum seems the best place to bring it up.
So I am dating a guy since August who claimed to be negative as his test in June was negative. I was still insisting that he did a recent test as I also did one myself. On 17 Dec he turned out to be HIV positive and admitted having a risky encounter back in May (which his June test did not pick up). He was also devastated by the news so I believed him and stayed with him as I really didnt/dont want this to be any reason for a break up. However, this situation is not easy especially that I am still not sure about my status.
We had more and more unprotected sex as time passed in our relationship since I started to become more confident with him. I was bottom 100% of the time and I would say we had maybe 10% unprotected, never with ejaculation though. Since it is a distance relationship the encounters were on a 2-3 week basis. The last risky unprotected encounter was on 13 Dec. I was tested negative on 18th Dec right after he told me the bad news (I was already too late for PEP). On 2 Jan we had an unfortunate condom accident after which I immediately started PEP and I am currently doing it. Basically we found something whitish on the outside of the condom.
I was tested negative again before the PEP started on 2nd Jan (3 weeks after last unprotected encounter) and on the 18th Jan (5 weeks after unprotected sex and 2 weeks into PEP). About a week before my last test I had very bad flu like symptoms (sore throat, headache, shivering, sweating, swollen glands) but it faded away as quickly as it came within 24 hours.
My test centre uses 4th generation testing. I am confused a bit about the effect PEP has on the results.
So my questions are:
1. If I was tested negative on my last test 5 weeks after the last unprotected encounter but 2 weeks into PEP can I take it more or less accurate or the 2 week PEP alters this? (I know about PEP altering the test but my case is again somewhat special as the 3 weeks could have been enough to produce enough antibodies, right? Or the PEP can also reduce the number of such antibodies over time?) The last unprotected encounter worries me much more than the condom accident. So if I can somehow be sure about that encounter I will feel much better.
2. Should the symptoms I had for only 24 hours worry me?
3. My HIV specialist foresees the next test on 11 Feb (5.5 weeks after starting PEP and almost 9 weeks after last unprotected sex). Is this a correct time? Can I sleep better after this test in case it is neg?
4. I really dont want this to be a reason for break up as I love my BF and I want to be there to help him through these very bad times he is going through (he started the ART 10 days ago, and he is going through depression - me being the only one he can rely on). But I cannot live my life continuously taking PEP. Is there anyone here who is in a mix-status relationship? It would be great to hear some good practices we should get used to in order to live happy in such a relationship. (of course he sticks to his medication regimen, fortunately so far no side effects and he is also very worried about my status, and he loves me too :) ).
That's the story. Thanks a lot for reading and for all the info you may have.
Thank you very much for your questions. It sounds like you are concerned about your status, symptoms, and relationship. I will outline my responses to your questions below, in the same format you posted them in.
1) PEP can alter test results for each person, but this is not to say that they will not be accurate. Here at the Helpline, we recommend that testing is done 3 months after the last dosage of PEP in order to get a conclusive result. However, I would follow your doctor's directions and maintain regular testing to keep track of any changes that may occur. Keep in mind that HIV is actually a difficult virus to acquire because there are so many factors associated with it. The body has mechanisms to fight off viruses. Additionally, there needs to be an exchange of bodily fluid through unprotected sex. During unprotected sex, fluid is not always exchanged. The only way to know your status is to keep up with regular testing.
2) Symptoms with HIV are tricky. Some people show them, others do not, and they often get confused with other illnesses like the flu. It may be in your best interest to focus more on the results of your tests rather than any symptoms, because testing is the only way to know if you have HIV.
3) I would follow your doctor's recommendation in regard to test times. It does not hurt to get tested multiple times. However, it would be best to also seek a test 3 months after you finish PEP in order to get a conclusive result. It sounds like you are taking tests for the previous exposure, but taking PEP for the second. For a conclusive result, you need to be considering your last exposure (the one right before you took PEP). This is because you can get HIV twice, so if you acquired it from your earlier exposure, then your PEP would be ineffective anyways. I hope this makes sense to you.
4) It is great to hear that your boyfriend is taking medication. Instead of constantly taking PEP, have you considered PrEP? It is similar to the way birth control works to prevent pregnancy. That is, PrEP works with your body to prevent the acquisition of HIV. This may be a great option for you in this long term relationship. Furthermore, please encourage your boyfriend to keep up with his medication. Studies have shown that taking medication greatly reduced the risk of transmitting the virus (up to 96% in sero-discordant relationships). If you both take harm-reduction and preventative measures to maintain your health, you can continue having a sexual relationship with your partner! I highly recommend using condoms and enjoying other sexual activities other than intercourse! As for your boyfriend's depression, has he pursued counseling services? They are often very beneficial. We can provide you with resources if you'd like. If you are in the Vancouver area, we also have a Health Promotion/Case Management team that will gladly assist you. To obtain these resources, you must phone us, or AIDS Vancouver, directly.
I will provide you with a few resources to find some more information:
http://www.aidsmap.com/No-HIV-transmissions-from-HIV-positive-partner-seen-in-Australian-gay-couples-study/page/2949294/ (an interesting study to look at that pertains to your situation)
www.catie.ca (great for looking at sero-discordant relationships)
http://www.cfenet.ubc.ca/ (take some time to look under the "Treatment as Prevention" tab)
www.smartsexresource.com (general sexual inquiries)
Overall, it sounds like you are in the midst of a life transition. You may just have to wait a while for your PEP to end and test results to be conclusive before you start taking further steps. In the meantime, it may be best to avoid unprotected sex, just to avoid further complications. If you take the conclusive test and get a negative result, then you can start PrEP if you wish to.
Please keep in mind that HIV is no longer the "death sentence" that everyone thought it was. With treatment and medication, HIV+ people often live longer, healthier lives than HIV- people. In your case, it is best to continue healthy and preventative measures in this transition time.
I hope this is of help. If you have further questions, please do not hesitate to contact us again. We are available to speak over the phone on our Helpline until February 1st. After this time, we will be primarily doing forum answers.
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