This article is explicit and confronting. It talks about sex and about sexual health. I make no apologies for that, as this was an incredibly confronting time and one in which I discovered I just had to be matter of fact about everything.
I had just moved. It was my first sex in probably a month. I came. He came. And then the drama began…
“Fuck!” I said, as soon as I climbed off my bedmate. “The condom broke!” It was odd to see, little rubber ring still around the base, but the rest of the rubber limp against his groin, rather than still enveloping the deflating member. He wasn’t exactly a one night stand, but we weren’t exactly dating either. I had never been in this situation before, and neither had he.
He had a shower, I had a shower. He told me he had tested negative recently, had only been safe since then and that he would get tested again. I told him my last test date and that I was also negative. I believed him, but I couldn’t convince myself that I was believing him for a good reason. So I called one of my closest friends, M, and blurted the situation out to him. “What the fuck do I do now?” M is always incredibly matter of fact. “Well you have two choices, you can do nothing and hope that everything is ok, or you can go to the hospital, and demand Post-Exposure Prophylaxis” (PEP) He warned me that I might have to demand it and to make sure I got it before I left. He suggested I go to a hospital near Gay Central, and told me to go now and that I could call him any time I needed to.
I arrived at RBWH at 11:03pm, about an hour after the break happened. I told the triage nurse that I was there because a condom broke and I wanted to make sure I got Post Exposure Prophylaxis (in keeping with M’s advice to ask and keep asking). She was quite understanding and looked sympathetic, asking if I’d asked his status, whether he said if he was negative or positive (in my state of confusion I just answered “yes” to the first question) and whether or not I’d been on PEP before.
I was processed by their clerk and went to sit in the waiting room.
It was at this point that I started feeling incredibly concerned for myself, and decided that my story, however it turned out, might be useful for someone else who would otherwise have no idea what to expect. Because I certainly didn’t.
I was called in for some basic observations and asked again what had happened, and some medical history. I was a bit miffed by their writing “denies” when I told them “no” to a question, because it felt like they didn’t believe me – looking back I suspect that it’s just a terminology thing to be clear about what they are told vs what they have actually verified.
Looking around the waiting room, seeing other people prioritised in front of me, I realised that it could be much worse. I wasn’t in any physical pain and my life wasn’t in immediate danger. I was there mere hours after my potential exposure so PEP had an incredibly high chance of working if he was lying or wrong.
Eventually I saw the doctor, who asked me similar questions to the nurses, but in more detail (“did he come inside you?” and similar). He went away, got me a PEP starter pack, and asked the obs nurse to draw some blood. The doctor advised me of the potential side effects of the medication he was giving me, and told me to make sure I was practising safer sex. He stopped there and looked a bit sheepish, saying he knew I was this time as well, and that rather I needed to continue practising safer sex if I was having sex. He also told me I would get a call in the morning with an appointment time for the Infectious Diseases Clinic.
I got home at about 4am and emailed my immediate boss and her boss saying I’d been at hospital and was ok, but might not make it to work later and would have a number of follow-up appointments I would need to go to. I got myself up at 6:30am feeling refreshed and went to work. My boss was away, and my boss’s boss came into my office and asked what the hell I was doing there if I’d been at hospital that late. I responded with something like “doing normal” and he just told me to go home when I felt like it (and preferably to make it soon.) it was very much in a “do what you need to” kind of way.
I have a good relationship with my boss, and explained the situation to her in more detail when she returned (what the trip to the hospital was and the reason for the follow-ups) and she was incredibly understanding about the whole thing (in context, I’d only recently been made permanent, and didn’t want it to look like I was going to be unreliable now I was permanent.)
To start with I was on a combination of Combivir and Kaletra. I spent a lot of time feeling nauseous and tired in the first couple of days. There was diarrhea too. (I told you I’ve been doing matter of fact, and also that this would be confronting)
On the fourth day, I went to the Infectious Diseases Clinic. I felt awkward, I was an early appointment that day so I was sitting alone in a waiting room which was open to the hallway, whose only posters had “HIV” and some other STI on them. I felt very conspicuous.(handy hint: if you’re facing the posters, anyone else looking at them will only ever see the back of your head.)
They asked me how I was going on the starter pack and what symptoms I was having… I explained and they suggested switching Combivir for Truvada to lessen my symptoms. It helped. I didn’t feel tired or nauseous any more. They also explained what happens from here, being a 2 week appointment, 6 week appointment and blood test, and a 3 month appointment and blood test. They also told me that I was negative based on the sample they took in Emergency. I called the other guy and let him know my results. His came in a couple days later, all clear, he tells me. Again, I believed him, but had no good basis to, so I decided to continue with the PEP for the full course, to be safe…
I have lousy timing. About a week into this whole thing, I was introduced to a boy. We hit it off majorly. About a week in, and after we’d had sex, I explained my situation. That conversation was hard and scary for me. This boy I really quite liked, I felt I hadn’t really done the right thing by, and I was scared that by telling him about it (and the fact that I hadn’t told him sooner) I might push him away. Fortunately for me, I was wrong! He was incredibly understanding, including about me failing to disclose my “unknown” status beforehand.
After the first fortnight of the Truvada/Kaletra, my body adjusted a bit and my nausea vanished, my other symptoms became a bit less problematic too. I went back to the clinic, felt a bit self-conscious in the waiting room again, and they asked me how the medication was going.
Two weeks later, it was done and I was back to my normal rhythms of everything. Another fortnight, and I got my 6 week test taken, and the following Monday got the result: Negative. Thank fuck! Apparently most people get to a detectable level in 6 weeks. That just left the 3 month. At this point I was pretty confident I was free and clear.
I went to my 3 month appointment after giving my blood sample the Thursday before, and got the news: I was negative! I smilingly told the receptionist on the way out that it was nice to have met her, but I hoped never to see her again in a professional capacity!
I was so relieved. I had gone through moments where I imagined I would be positive. Where I envisioned a life forever taking these pills. And I had, to some degree, made peace with that. I told myself I’d done everything right, and so I would feel no guilt over being positive, if that’s how it turned out. What would be would be, and I’d done everything I could to make sure that what would be would be the thing I wanted it to be. If I was going to be positive it wasn’t through a lack of trying not to be. If I was going to be positive, it wasn’t going to be the end of the world, it was just going to make life a little bit harder and a little more stigmatised.
Fortunately, what would be for me was that negative result. And it’s worth a bit of discomfort and awkwardness for a couple months. While that is a situation I never want to be in again, I would take the meds and do the treatment in a heartbeat. I would encourage anyone I knew to be going through a similar situation to do the same.
The shortest I can say it is: “Get tested regularly, and if you’re potentially exposed, get treatment ASAP”
There are lots of free testing options available at the moment. And if you’re ever in a situation like mine, I’d encourage you to go to the hospital as soon as humanly possible. You can basically change your mind at any time if you start PEP, but if you don’t start, it might be too late if you change your mind later.
I hope this look at my experience helps you somehow.
Dylan.
Dylan Carmichael's Blog 