Need advice - terrible mistake

[Railer]

I just had unprotected anal sex with another man (1200hrs CT June 17th).  I was the giver and did ejaculate.  Then he tells me he is POS - I couldn't believe it. Incredibly risky and selfish, I should have used protection,  and im struggling with why I did it!!!  I realize i am just at fault in all this.  

I have no cuts or abrasions that I can see, so Im assuming the urethra would be the only source of infection unless simple absorbtion through the skin is possible.

There are so many numbers floating around in my head from all sorts of web sites........ but I think the 'odds' (understanding this really doesnt mean anything) are 1 in 2000 for the general population; this number diluted or at least taking into account the prevailing number of HIV cases in public.

What are the 'odds' of contracting HIV with the 'diluting effect' of the general population removed from the equation since I know he is POS?   Or is there even such a number?

What is the earliest I can take a test with reasonable accuracy?

Should I search out PEP meds?

I am already terribly worried, but I dont understand how much of this really appropriate.

How much is a heathly, clean, man at risk when he is the top?

Short of wanting to slit my wrists out of shame and not put my family through the consequences of my actions, anything else I can do?

My appreciation for any insight you all can provide.

[Edward W Hook, MD]

Our exposure was high risk and is appropriate for receipt of post-exposure prophylaxis, the sooner the  better. We should assume that your partner told you the truth.  If he did, you odds of getting infection from a single episode of insertive anal intercourse are in the neighborhood of 1 in 100 (1%).  If your partner is on effective anti-HIV therapy your risk of infection is still lower.  If your partner knows his CD4 count and viral load (the amount of HIV in his blood, this will also help to gauge your risk).  the first thing to do however is to start PEP.

As far as follow-up, an antibody test now (to verify that you indeed are negative) and then again at 6 and 12 weeks will help you to evaluate your infection status.  You should receive your PEP fro an HIV expert if at all possible or at least have your follow-up from such a pesron.

Go out and get your PEP ASAP. Please keep us posted.  EWH

[Railer]

sorry - just saw your note on limiting emotional commentary after I submitted my concern.  I didnt mean to distract from the original intent of my post.

My apologies

[NCR1]

I am by all means not a doctor,

I feel extremely terrible for you and my advice is this,

1, definitely get PEP the earlier the better, your risk is 1 in 100 not 1 in a 1000 that is male to female. In Australia they only give PEP to people with high risk ie up too 1 in 15000, please seek pep immediately, the earlier the better.

The second piece of advice i can give is please do not look at ANY other HIV site other than this one as this is the most reasonable and honest, there is way too much **** out there and that will jst do your head in more. I know this as i didnt have a risk and couldn t believe it and just kept on searching and searching.

Best of luck remember PEP NOWWWWW

[anxiousinuk]

Whilst I am also not a Doctor, I must say that this is by far the absolute best site I have seen on the subject of HIV, Drs. Hook & Handley seem to be absolutely the best out there in terms of their knowledge on the subject.  They just gave me some advice, and it made me feel so much better.  Having now read hundreds and hundreds of their posts, it seems that the possibility of contracting HIV from anal sex if you are the Giver (insertive partner) is something like 1 in 500, i.e. 1 in 500 EVEN IF YOUR PARTNER IS CONFIRMED HIV POSITIVE.  1 in 500 is pretty small, only .02%.  The odds are overwhelmingly in your favor that you are fine.  Having said that, NCR1 is correct - you you should absolutely go get the PEP, I have read replies from Dr. Handley where he says that PEP is effective, and will lower your odds dramatically.  Do whatever you have to do to get your hands on the PEP, surely a local clinic or emergecy room would give it to you, and you'll surely be fine.  Good luck, as long as this is a one-time event, you are almost certainly fine, and we would certainly all be praying for you.

[Railer]

Had rapid blood drawn test yesterday and was negative as expected.  I spent 3 hours talking to people at various clinics and almost no one knew about PEP.  As soon as I mentioned unsafe sex, they clam up - one nurse even told me I had a 90% chance of contracting HIV and that the state of TX doesn't administer PEP for non occupational exposure!  God I miss living in Seattle.  Texas is the most arrogant, hypocritical, narrow minded state in the union!

Looks like I will have to go to an ER, loose my anonymity , and tell them I was exposed via a needle ***** instead of telling them the truth.

[Edward W Hook, MD]

Either go to an ER or talk to an infectious diseases specialist.  Please do not delay.  The benefit of PEP decreases as time passes.  EWH

[Railer]

1) What is the path the virus takes to occupy the body?  In other words does it usually travel up through the urethra?  or absorbed through the skin?  Since I was the inserting partner and ejaculated, as well as went to the restroom immediately, does that assist in cleansing the urethra?

2) Also how much of a roll does my health and genetics play in defense of HIV?  Since I am extremely athletic, weight lift and high endurance cyclist (4 hr maintain HB rate of 160+ is not an issue),  no STD, average life span in my family is in the 90's without cancer and almost no 'blood disease', no diabetes,etc, and I have not even had a cold in the last 10 years - does any of this come into play in the prevention of infection?

Thanks again for all the assistance

[KCL161]

Get PEP immediately. It is only effective if you take it within 72 hours post exposure; beyond 72 hours it is too late. You still have like 12 hours or so. Hope you still read this message on time. As Dr. Hook told you, find an infectious disease specialist (albeit private) and pay if you have to in order to get the drugs.

As far as your genetics is concerned, unless you are among those rare few people who are carriers of CCR5 genetic mutation, and hiv manages to get into your body, you will get infected. For life. So get the drugs ASAP.

And once you have completed the therapy, you will need to take an hiv test at 12 weeks, as dr. Hook told you.

Hope everything works out

[joggen]

You had a HIGH RISK EXPOSURE, PERIOD. I hope from your questioning that your not trying to unbreak an egg, so to speak.

Nothing you can tell the doctor can mitigate your high risk exposure. Get to an ER and demand PEP. Tell them you will sue for malpractice if they don't provide it, and that you will get the ACLU involved.

GET TO AN ER NOW

[Edward W Hook, MD]

The issues of how the virus gets in, how healthy you are, your genetics, etc are really not relevant.  I'm sure your health helps but this really is not somethng to try to rationalize away. The statistics I provided you are the operative concerns as are your need for PEP.  EWH

[Railer]

I had another rapid blood drawn test today at exactly 4 weeks.

Results were negative thank goodness!

How accurate is the test at 4 weeks?  I assume another one is in order? when?

Thanks for all the help to date!

[joggen]

Are you on PEP? That would affect the time to a meaningful result.

[Edward W Hook, MD]

Glad to hear it.  Joggen's question is a good one.  As far as intepretation while on PEP, the further out you are the better it is. At the same time, whhile this hsould make you comfortable, the