Scarleteen

Dear Team,



Good morning



I had protected sex with a Sex Worker in a massage parlour.



It was a Penile Vaginal sex where she was on top of me. Towards the end, She kept riding despite I had cummed and my penis went flaccid at the end. I told it's done and she got up and when she did, the condom was nowhere. She told me look it's here and I found it hanging from her vagina.



I am on PEP medicines which I started within 24 hours and have 1 day of medicines left.



My queries are:



1. What is the chance of getting hiv infection?



2. After PEP, what's the duration after which I should go for testing?



3. Which HIV test do you recommend?


Best Regards,
Samuel B

Hey Samuel B -- the chance of getting HIV in this scenario hinges on whether or not the person you were having sex with also has HIV. If both of you are HIV negative, then transmission simply cannot occur. If this person did have HIV, vaginal sex is a pretty high risk activity. Though the risk is reduced when using condoms, it's hard to know how much contact with fluids you had in this case with the condom coming off. Because of that, it's a bit hard to judge the exposure.

Our resource Positively Informed: An HIV/AIDS Roundup discusses the differences between kinds of tests and when they should be used. As far as when to get tested, it's important to understand that HIV is not instantly detectable. Antibody tests can usually detect HIV 23 to 90 days after exposure, and an antigen/antibody test done with blood from a finger stick can usually detect HIV 18 to 90 days after exposure. When you got the PEP, did anyone tell you about what tests are available to you?

Dear Carly,

Thank you for your response.

The Doctor informed about PCR test after 3 weeks post PEP completion.

I am very much scared if I am infected as it would be complete life changing for me.


Best Regards,

Sam

Hi bosesomn,

I want to begin by expressing that PEP is known to be effective if used consistently and correctly! However, I know the timing of testing might concern you as it does take a while for HIV/AIDS to be detected. With that, I think you should stay alert if you start to experience any early symptoms. From the article Carly sent, please look at the section titled and bolded as "Stage 1 HIV" which occurs 2-4 weeks after a person is infected. Please keep an eye out for the symptoms listed there. I know it will take time to get your results back, but we are here for you and want to support you in the meantime! Possible exposure is incredibly serious and I understand that you feel scared--it is entirely valid. Also, we would be happy to share more ideas on how to have safer sex in the future and provide forms of HIV prevention. Please let us know what type of support you are looking for at this time. Take care!

Thank you so much for your support. I am just waiting for the day when I see Non Reactive in the report. In the meantime I will continue to monitor my health. Just praying to God to give me one more chance.

You're welcome! I am hoping for the best for you. I do know that people who contract HIV can have long and healthy lives as long as they stay on treatment. While I don't know if you contracted it or not, I do want to express how much science has advanced to help those who live with HIV. If you want to keep in touch until or after you receive your results, we are here for you.

Thank you again

I do also want to add for your and everyone else's education that common fears about HIV and many other STIs that male clients of women sex workers have are often based more in stigma than biological reality, and also tend to be backwards.

In other words, in this scenario, the sex worker here -- as the receptive partner, and given that her partner was a client of sex work -- is often at a far higher risk than her client would be.

Sex workers tend to get tested far more often than their clients (and the general public) do, tend to be more stringent about safer sex: that means the risks to clients can often be lower than they are with partners a client has that are NOT sex workers. Too, sex workers tend to more often have vulvovaginal anatomy, and also tend to more often be the receptive partner in sexual activities, which makes them the more vulnerable to contracting STIs than to transmitting them.

Thank you Heather.

Please feel free to comment as any information might be useful.

Hi There,

I am now experiencing Night sweats but not sure if it's because of Humidity. Further my back of neck was Swollen which is now reduced a bit. The PEP course was finished on 21st November. I am unsure if this is seroconversion. I have to wait 6 weeks after PEP to test.

The Anxiety is killing me and I am getting scared with not able to concentrate on anything.



Best Regards,

Sam

Hi Sam,

I'm sorry to hear this is causing you so much stress. We can't really say what's causing those things because, as you pointed out, things like weather could easily be a factor here. But if you notice pain or swelling that just isn't going away, that would something to check with a healthcare provider about just to make sure there isn't something that needs addressing.

In the meantime, it may help to focus on self care when you start feeling that anxiety around all this. You can find a lot of advice on how to do that here:
Self-Care a La Carte

Thank you so much.

The swelling has reduced alot.. does the swollen lymph nodes reduce within a week or two in HIV?


Best Regards,

Sam

As Sam said above, we really can't speak to what's going on with your lymph nodes; really the best thing to do right now is find ways to manage your anxiety until you're able to test. Analyzing your body's reactions and symptoms right now isn't going to give you any definite answers and I think trying to focus less on such close monitoring of your own body will be helpful for the time being.

Hi Team,

I just ate a Painkiller and the Swelling on back of the neck reduced in an instant. Does Swollen lymph node reduces immediately after a Pain Killer.

Just kinda curious!!


Best Regards,

Sam B

Hi bosesomn,

That's the kind of question that would be best directed at either your healthcare provider or at a pharmacist (who often have advice lines you can call).