the VA can pay for an HIV doctor, or an Infectious Disease Specialist. You should keep pushing until you get one, so call the clinic and ask to switch.
You still have HIV in your blood, but its likely to be "undetectable," which means the medications are keeping it from reproducing so that its at a really low level.
Finally, I can't tell you whether you can cut back on your pills or not, because I would have to see your labs first - that will depend on if you are resistant to any of the medications we currently have. What I can tell you is that there are several newer medications and combinations you can take that can cut down the number of pills you have to take each day.
But it sounds like the first thing you need to do is talk with the director of the VA clinic and ask to see an Infectious Disease specialist, who should have more up to date knowledge on current meds. There are some medical doctors, like myself, who have a lot of experience with HIV treatment, but there are many more Infectious Disease doctors who have the same training.
At this point, I think you should seek some counseling regarding anxiety - you have more than enough proof at this moment that you are HIV negative on every level, and the more I try to speculate on the risk "possibilities" you are bringing up, I sense there's always going to be one more.
There is a board that deals with issues of anxiety here, so I would suggest you reach out to them about this overriding fear of HIV that seems to be really causing you a lot of distress at this point. Or, if there's something else you haven't told us about, some other risk behavior or thing that you've done that you're afraid to tell us, please let us know - because this isn't making sense to me anymore. You're not sure if the nurse pricked herself or not and with no one being positive here (especially you), there is no reason to even speculate.
At this point I would just tell you to enjoy your newborn, get follow up testing every 6 months to 1 year as you would a mammogram or regular check up, and you should be fine.
I'm so sorry I missed your response! As you can imagine, my primary job and practice keeps me busy and I can't check the website every day. But YES!!! with your HIV RNA test being normal or negative, you are fine!!!! Yes, you can breastfeed. Don't worry AT ALL!!! And congratulations, I truly hope you had an uneventful delivery and a healthy child!
sorry I'm coming in late on this conversation. You don't have to worry at all from getting sucked, unless there is a big cut on your penis, and the person who is sucking you is KNOWN to be HIV positive, not on medications, and has an active cut in his mouth and is bleeding. Otherwise, don't worry. Can you imagine in getting sucked without a condom was an easy way to get HIV? The whole world would have it my friend. You will be ok, do NOT worry.
We can't guarantee anything 100%, but obviously what Gail said is right and you should feel confident that you are ok with a test that is negative after 9 weeks.
If you are worried, however, why not involve your husband, both of you get tested together, and talk honestly with each other about sex. If you are only having sex with one another and you are both HIV negative, you can make the choice that you feel will be best for you regarding condom use or not. But if you are still anxious (and you haven't really explained if there's anything that is driving why you are so anxious about this).
This sounds like a really difficult situation, both physically and emotionally for you, and I hope you are holding up ok. First, as Gail mentioned, take care of the physical issue - you can and should go to your primary care doctor or if possible, an ER as soon as possible to start post exposure prophylaxis HIV medications for a month - this usually needs to be started within 36 hours after the exposure (unprotected sex with your husband AFTER he had sex with the prostitute) to be effective. The medical providers will do a full battery of tests for HIV and STDs then, and follow up with you in a month after you take the meds. This is the best way to protect yourself and reduce your risk from any possible HIV exposure, given your situation.
I would also encourage you to have a one on one discussion with a therapist or counselor. Yes, you will need to talk to your husband and flush this issue out at some point, but the immediate issue is to deal with your feelings and reaction to this series of events and realizations. DO NOT minimalize this part of taking care of yourself, it is going to be the most important. Wikipedia actually has a good lay person's summary of this process (http://en.wikipedia.org/wiki/Post-exposure_prophylaxis ) and the medications, but the important thing is to get yourself checked out asap.
Please keep us updated and I'm sorry that you are going through this.
one other thing I would add - many physicians who specialize in HIV take a certification exam from the American Academy of HIV Medicine every 2 years. This makes sure that we keep up on the science and latest updates for HIV treatment. To see if there's an HIV specialist in your area, you can visit the website http://aahivm.org . It's a great resource. And you are correct about not being "cured" of HIV, this isn't the case. Its just that your body with the medications is keeping the viral low low so that it won't cause many problems with your ability to fight infections.
Pregnancy can cause false positives just for the antibody test - this is a test of the copies of virus in the blood, so NO, pregnancy will not cause a false positive for the RNA PCR test for viral load.
I'm sorry to hear you are going though this, it sounds very stressful. First of all, Dan is correct and I think you can ease your mind if your HIV test was negative at 3 months. It is EXTREMELY RARE that someone would seroconvert to positive after being negative at 3 months post exposure.
That said, however, you are about to have a baby so I would recommend you do this:
- go back to your OB/GYN and ask them to do what's called an HIV RNA PCR test, or a viral load - if the main issue is that you and your doctors are scared that the regular HIV antibody test won't be accurate until 6 months, the best way to put the question to bed is get a viral load, which will absolutely show virus if you were, in fact, exposed. Then you don't have to think about timing of how long it takes to make antibodies, etc - you'll have a direct test that looks for copies of the virus.
And you don't have to apologize about the questions - you wouldn't be human if you weren't worried about your health, and more importantly, the health of your soon to be newborn. But demand your doctors order the viral load test instead of just saying that the antibody test is not conclusive yet and letting you struggle with your anxiety. If they still put up blocks, ask to speak to the medical director of the clinic, and go higher and explain the situation til you are satisfied they are running the appropriate tests to rule out any infection that the HIV antibody test may miss if this is a "window period."
Like we've said, I don't think you have HIV, but your situation is unique, and the viral load results will give you MUCH more certainty that you aren't putting your baby in harm's way. And if the viral load comes back positive (which I don't think it will), you can take meds and give meds to your baby to prevent transmission during childbirth IF it comes to that. But I don't think it will.
Please keep us updated on what happens and good luck to you. Hope this helps.