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I am an idiot: Unprotected Sex

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Original post by lekky
Is it high in this case though? I can't remember exact figures the transmission from a female to a male in vaginal sex is pretty low. I don't know anything about post exposure prophylaxis, though in a lecture we were given the lecturer told us about a colleague of hers who received PEP after a needle stick injury more than 10 years ago and still suffers the side effects, the degree of their unpleasantness was emphasised to us.

I think that you're right though:
http://www.nhs.uk/chq/Pages/1840.aspx?CategoryID=73&SubCategoryID=106
http://www.fhi.org/en/rh/pubs/network/v21_1/nw21-1hivpostexpostretmnt.htm -- basically in this one it says that if the risk is considered moderate/high that the person had HIV then PEP can be considered.

OP; sorry for the digression. We just studied HIV this week so I'm just feeding my own curiosity here. Sorry.


Take a look at the tables on page two and the recommendations on page five of that second link I gave you. Guy has unprotected sex with a person from an area of high HIV prevalence, doesn't know whether she's positive or not but does know she's had multiple unprotected partners from the same area.

I think it would be a very viable option for him, if he presented within 72 hours.
Original post by Jamie
They nearly always cause absolutely awful side effects.


No doctor will take that attitude, thats not the issue.
The issue is studies have shown it has no effect after 72 hours, little effect if taken after 48 hours, and only really has decent effect if taken within 12 hours.
So most places recommend PEP should only be given in the 72hours after exposure.

In this case it is certainly a high risk exposure. The only thing going for the patient is that he is male.

So I would give PEP if seen wthin 72 hours. But his post makes me think that is not the case.

Lekky - look up PEPSE if you want to read more.


We don't know when this happened though. It could have been two hours ago, in which case he has plenty of time.
Reply 22
Avatar for lekky
lekky
19
Original post by TheSownRose
Take a look at the tables on page two and the recommendations on page five of that second link I gave you. Guy has unprotected sex with a person from an area of high HIV prevalence, doesn't know whether she's positive or not but does know she's had multiple unprotected partners from the same area.

I think it would be a very viable option for him, if he presented within 72 hours.


Thanks, very interesting :smile:
Reply 23
Avatar for lekky
lekky
19
Original post by Jamie
They nearly always cause absolutely awful side effects.


No doctor will take that attitude, thats not the issue.
The issue is studies have shown it has no effect after 72 hours, little effect if taken after 48 hours, and only really has decent effect if taken within 12 hours.
So most places recommend PEP should only be given in the 72hours after exposure.

In this case it is certainly a high risk exposure. The only thing going for the patient is that he is male.

So I would give PEP if seen wthin 72 hours. But his post makes me think that is not the case.

Lekky - look up PEPSE if you want to read more.

Cheers :smile:
Original post by TheSownRose
We don't know when this happened though. It could have been two hours ago, in which case he has plenty of time.


His post to me suggests otherwise.

I used to have gay dudes coming into A&E in london all the time after PEP. For some it would be the 3rd or 4th time.

I suppose similar to girls with a seeming repeat prescription of the morning after pill.
Original post by Jamie
His post to me suggests otherwise.

I used to have gay dudes coming into A&E in london all the time after PEP. For some it would be the 3rd or 4th time.

I suppose similar to girls with a seeming repeat prescription of the morning after pill.


Yeah, it probably is, but if it is very recent, PEP is there and the OP should be aware of it because, if viable and deemed desirable, he could seek it.

You mean for another round of it, or for the complications? For the former, I would really imagine a close call would put you off... :confused:
Reply 26
Avatar for lekky
lekky
19
Original post by TheSownRose
Yeah, it probably is, but if it is very recent, PEP is there and the OP should be aware of it because, if viable and deemed desirable, he could seek it.

You mean for another round of it, or for the complications? For the former, I would really imagine a close call would put you off... :confused:


I was thinking that & the side effects first time would put you off, but then unlike the morning after pill you can hardly just use other forms of protection. if you're gay and the condom breaks and your partner may be/is HIV+ what else can you do?
Original post by TheSownRose
Yeah, it probably is, but if it is very recent, PEP is there and the OP should be aware of it because, if viable and deemed desirable, he could seek it.

You mean for another round of it, or for the complications? For the former, I would really imagine a close call would put you off... :confused:


Evidently not.
MAybe they were lucky enough to have no side effects. My friends were hideously unwell when they took it (after stabbing themselves with a needle in the hospital, not from unprotected sex)
Original post by lekky
I was thinking that & the side effects first time would put you off, but then unlike the morning after pill you can hardly just use other forms of protection. if you're gay and the condom breaks and your partner may be/is HIV+ what else can you do?


In my lifetime I've only had one condom break.
Maybe I'm not vigorous enough...
Original post by lekky
I was thinking that & the side effects first time would put you off, but then unlike the morning after pill you can hardly just use other forms of protection. if you're gay and the condom breaks and your partner may be/is HIV+ what else can you do?


You could ask them and not have sex with people that are/may be HIV+? :dontknow: Or wear two condoms.
Reply 30
Avatar for lekky
lekky
19
Original post by TheSownRose
You could ask them and not have sex with people that are/may be HIV+? :dontknow: Or wear two condoms.


Two condoms makes the chance of them breaking more likely due to friction!
But yes, waiting to get tested would be good.
Original post by lekky
Two condoms makes the chance of them breaking more likely due to friction!


Two very different sizes - reduce friction, but still keep a barrier around any semen? :dontknow: The avoid sex with HIV+ people is a sensible suggestion, though.

The real best way is to not have sex or only with a single person who is not HIV+ ... but I think my outlook about the prospect of reduced/absent sex as someone with no sex drive is very different to most peoples', so not the best discussion to have with me, I'm afraid.
(edited 13 years ago)
Original post by TheSownRose
Yeah, it is quick - best if you do it within an hour, it's what they do for medical people that get pricked by needles. Up to 72 hours I think is accepted, but the quicker the better.


The intervention for those with needlestick injuries is a vaccine to protect against hepatitis B not HIV.
Original post by mummyperson
The intervention for those with needlestick injuries is a vaccine to protect against hepatitis B not HIV.


She evidently knows better than you, because she is right, and you are not. (we are talking post expsure not pre)

Edit - Just seen your profile and your list of qualifications. I'm guessing you didn't have Post Exposure prophylaxis in the A&E in your time, but surely you've come across it with juniors getting needlestuck?
(edited 13 years ago)
Reply 34
Avatar for Huskaris
Huskaris
16
South Africa has one of the highest HIV rates in the world.

Good luck man... :-(
At least you have learnt a lesson, hopefully.
Original post by Jamie
She evidently knows better than you, because she is right, and you are not. (we are talking post expsure not pre)

Edit - Just seen your profile and your list of qualifications. I'm guessing you didn't have Post Exposure prophylaxis in the A&E in your time, but surely you've come across it with juniors getting needlestuck?


He didn't present within 72 hours. She is wrong.
Original post by mummyperson
He didn't present within 72 hours. She is wrong.


If you read the thread properly you'll realise that no where does it say when the incident occured.
My position is that it sounds like it was more than 72hours ago, but if it was within 72hours PEP would be given.

She says the OP might have been written within 72 hours and acknowledged that time limit early on
"Yeah, it is quick - best if you do it within an hour, it's what they do for medical people that get pricked by needles. Up to 72 hours I think is accepted, but the quicker the better. "
Reply 38
Avatar for Astra_K
Astra_K
8
Well you know the saying:

Once you go black you never go back.........to being HIV negative :wink:
It doesnt matter if your are drunk or not, you should just stop being such a horny beast and i wanna get into her pants and put the condom on!!

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