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Unprotected sex, needles, and PrEP

Hi. My story's a bit complicated so I hope you have the time to read it and answer my questions.

I had vaginal intercourse 11 weeks ago with a man of unknown status. 27 days later, I had an Ag/Ab test which came back non-reactive. Since I was really concerned about getting infected, I asked my doctor if I can start taking PrEP. Since an Ag/Ab test is considered conclusive at 28 days and 27 days was too close and was very unlikely to change in a day, I started PrEP the same day. Here's where the complication starts. I started getting symptoms after - from feverish feelings, mouth sores, etc. Everytime I experience "symptoms", I get tested. This is on top of the regular testing that you should get when on PrEP. I got tested on Day 29, Day 36, Day 48, Day 62, and Day 71. These tests were taken while I was already on PrEP. All of these tests are non-reactive.

1. Can I consider that I did not get infected from the sexual encounter 11 weeks ago? Was the 27 day test (which was very close to 28 days) really conclusive.

Here's where it gets more complicated. Everytime I get tested, I worry that I might get infected. The Day 29, Day 36, Day 62 and Day 71 tests are particularly concerning for me since I did not see the needle get opened in front of me. However, the Day 62 test was taken 5 weeks after the Day 29 test, while the Day 71 test was taken 5 weeks after the Day 36 test.

2. Can I rule out that I did not get infected from the Day 29 and Day 36 tests? Since the suceeding tests were taken 5 weeks after these incidents?
3. I was told that PrEP does not change the window period of an Ag/Ab test. This means that the succeeding tests from Days 29 and 36 were conclusive that I did not get infected from these tests right? Since these were taken 5 weeks after these tests.

Now, around 12 days after the Day 62 test, I developed an itchy throat which sometimes lead to very mild coughing. Are these symptoms of ARS? I'm worried since these appeared 2 weeks after the Day 62 test which is when ARS symptoms usually start to appear.

4. Is an itchy throat and a mild cough symptoms of ARS?
5. What are the risks if the nurse accidentally reused a needle when drawing my blood?
6. Since I'm a PrEP user, can PrEP protect me from this incident? My doctor explained the effectiveness of PrEP when it comes to intercourse but not when it comes to needles.

I'd also like to point out that I haven't had any sexual encounter aside from that incident 11 weeks ago.

Please, help me out with my questions. I need some clarity right now. Please. Your help will be greatly appreciated.
2 Responses
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20620809 tn?1504362969
A doctor would not start Prep unless you'd conclusively tested negative.  Your fixation on testing and needle fear are irrational at this point and until you seek help for this anxiety, you'll stay in this spiral.  Your question has basically been answered and your anxiety is getting in the way here.  So, talk to your doctor about your fears and anxiety for the help you really need.
Helpful - 0
Avatar universal
You shouldn't have got into prep if your test 27 days after the exposure was negative. The result was accurate around 98%. Prep is a dangerous treatment, that can produce non reversible damages in your body and has several side effects.

I think you should try to relax or even looking for a therapist.

The protocol indicates to test for HIV 28 days after finishing the prep. There is nothing else to add.
Helpful - 0
4 Comments
Hi, Sir. Thank you very much for your response. My doctor advised me on the effects of PrEP and she was very helpful in answering my questions. Unfortunately, she was out of the country last month so I wasn't able to talk to her. I know you already said that there's nothing else to add, but please allow me to ask some follow up questions and I hope you can still responsd.

1. I'm a bit unsure as to what you meant when you said I shouldn't have gotten on PrEP when my 27 day test was negative. Before someone is given PrEP, the individual has to be confirmed HIV negative. Since my day 27 test was essentially conclusive, I was given the go signal to start PrEP. At that time, my partner disliked wearing condoms and I didn't want to risk having intercourse again with someone of unknown status. So as an additonal precautionary and protection measure for future intercourse, I decided to get on PrEP. (Obviously, this hasn't been the case though since I've never had intercourse with anyone since that incident 11 weeks ago.) Maybe you are referring to PEP? Which is the medication given to someone after a potential risk? Which is why you're suggesting I shouldn't have started on it after I tested negative? Pardon me for assuming but that's the only understanding that I can think of based on your response.

Also, you mentioned that my test at 27 days was around 98% accurate. Would you agree that this is really close to 28 days and unlikely to change in one day? Can I relax that I did not get infected from that incident?

2. Can you clarify that a test should be taken 28 days after stopping PrEP? Again, maybe you are referring to PEP? Which is the medication taken after a potential risk? What I am on is PrEP which is a daily pill that is taken to help prevent getting infected in case there is a risk.

3. Would you consider the potential used needle risk that I'm worried about as no risk? Is there really no risk for infection from a blood draw? Are an itchy throat and a mild cough signs of ARS especially since they appeared about 2 weeks after what I consider a potential risk which is not seeing the needle being opened in front of me?

Again, I apologize for prodding. I hope you'll still find time to respond and help answer my questions.
The advice was correct so there is nothing else to say to your questions.
You are paranoid when you fear needles in a clinic could give you HIV, and that you didn't watch the needles so you feel the person didn't test you. This indicates you have an anxiety problem and some kind of a mental health problem. You should talk to a therapist and your doctor.
Hi. I appreciate your response. I acknowledge that I have an anxiety issue and that my fear of needles is an indication that I may need to talk to a therapist. However, this does not clarify my question regarding the advice on PrEP. If I was cofirmed negative (at least 98% according to the advice given), why shouldn't I have gone on PrEP? PrEP is Pre-exposure phrophylaxis. It is a daily medication given to negative individuals to prevent being infected in case of a risk. It is not taken after a risk. I took it that time because I had a partner of unknown status who disliked condoms so I wanted to be protected in case we have an encounter again and he didn't want to use condoms. I was just wondering whether the advice was meant for PEP which is the medication given 24 hours after a risk and needs to be taken for a month (I think) after a risk. My understanding of the advice given earlier is that since I was already negative at 27 days, I should not have taken the medication to stop getting infected. That's what I'm trying to clarify.

That's the same question that I have for testing while on PrEP. Since PrEP is taken daily (some people have been on it continously for 2-3 years or more), how can someone only get tested 28 days after stopping? Again, I'd like to clarify if the advice was meant for PEP.

Again, I don't mean to ask too many questions. I just want to clarify the advice given to make sure that it's for PrEP and not PEP. I'd love to speak to my doctor about this but like I said, she's out of the country right now.

Again, I apologize for too many questions. But I really hope you can still answer my questions.
It is abnormal paranoia, so is way more than just an "indication that you may" need to talk to a therapist.
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