Concerns After Unprotected Encounter Following Vomiting
I'm a 24-year-old male, weighing approximately 58 kg. Currently, I'm on PrEP and also using opiates and amphetamines. Recently, I encountered a situation where I might have compromised the effectiveness of my PrEP. About an hour after taking my dose, I vomited extensively, and from what I've read online, that could jeopardize the drug's efficacy. Due to feeling uncertain about taking another dose—concerned it might upset my stomach again—I decided against it. The individual I connected with was an intravenous drug user who mentioned that he only gets tested for STIs when symptoms arise. Over 40 hours have passed since the encounter, and by tomorrow morning, it'll be close to 50 hours. I'm contemplating whether it's worth pursuing post-exposure prophylaxis (PEP) at this stage. Money is tight right now, and I'm uncertain how to reach the nearest health facility since it's late; I could either try to find a place open now or wait until tomorrow. However, I'm aware that time is critical in situations like this. If it turns out that it's too late for PEP to be effective, I wouldn't want to go through the trouble, especially since there's conflicting information about its efficacy so far into the time frame.
Answers (1)
7/21/2025, 7:02:01 PM
OpenHealth AI
It's understandable to feel anxious after an experience that raises such important health questions, especially regarding your PrEP situation and potential exposure to HIV. Here’s a clear breakdown of what you should consider and the steps you can take next.
Main Points:
- Efficacy of PrEP Post-Vomiting: If you vomited within an hour after taking your PrEP, there's a possibility that not enough of the medication was absorbed.
- Timing for PEP: PEP is most effective when taken within 72 hours after potential exposure, but ideally as soon as possible.
- Immediate Action Steps: You have a few options to consider.
Explanation:
- PrEP (Pre-Exposure Prophylaxis): This is a daily medication that helps prevent HIV. However, if it hasn’t been properly absorbed (like after vomiting shortly after taking it), its efficacy could be compromised.
- PEP (Post-Exposure Prophylaxis): This is a medication regimen you can start after a potential HIV exposure to reduce the risk of infection, but it must be initiated within 72 hours of exposure.
Next Steps:
-
Assess Your Symptoms: Consider if you're experiencing any new symptoms (such as fever, unexplained rashes, or flu-like symptoms) that could indicate an STI. While it might not reflect current exposure, it's worth noting.
-
Options for PEP:
- Find a Health Facility: If you have the ability to get to a healthcare provider tonight, this is the best option as PEP is most effective when taken as soon as possible. Call ahead to confirm if they have an emergency or infectious diseases unit open.
- Wait Until Tomorrow Morning: If travel is a concern and you can access a healthcare provider first thing in the morning, that is your next best option. Make sure to explain your situation to the provider.
-
Consider Starting PrEP Again: Depending on the advice you receive, you may consider restarting your PrEP regiment, but ensure you discuss this with a healthcare provider.
-
Practice Safe Sex: Until you can have a follow-up consultation and test, use barrier methods to reduce the risk of STIs.
Reassurance:
I understand this is a stressful situation; many people are uncertain in similar circumstances. The most important step is getting timely support and reassurance from a healthcare professional as soon as you can. You’re taking responsible actions by seeking help, which is a positive step forward. If you need further information or support, don’t hesitate to reach out again. Stay safe.
Related Questions
Teething Process for Molars: Is It Typical?
My son is currently 17.5 months old, weighs 30 pounds, and measures 32 inches in height. He is a white male without any significant health issues and is not on any medication. For the past three months, we have noticed that his gums have become quite swollen. His pediatrician had previously indicated that he was in the teething phase. Today, he has been particularly irritable and clingy, frequently seeking to nurse. Everything seems to be going into his mouth, which led me to examine his gums more closely. Notably, I've observed some white spots appearing. Is this a typical sign of molars preparing to erupt, or would it be advisable to consult the pediatrician tomorrow for a more thorough examination?
Persistent Nightly Sneezing: Seeking Answers
As a 20-year-old male, I've been experiencing a peculiar issue: nightly sneezing spells that last for about ten minutes at a time. These fits occur consistently between 10 PM and midnight. Strangely, they happen regardless of my environment—whether I am indoors or outdoors, in summer or winter, and regardless of cleanliness. Unfortunately, blowing my nose offers no relief during these episodes. I consulted my general practitioner, but he brushed it off since I lack additional symptoms commonly associated with this condition and I have tested negative for any allergies related to dust mites, pollen, or pets. In my search for information, I found little pertinent data online regarding sneezing at night, aside from a focus on dust mite allergies. While I suspect that this may not pose any serious health risks, the nightly annoyance is bothersome. I’d appreciate any insights into what might be causing this phenomenon and any suggestions for how to alleviate or eliminate these frustrating episodes of sneezing that disrupt my evenings.
Should I Seek Testing for Possible MS or Neurological Issues Due to My Symptoms?
I am a 31-year-old woman standing 5'3" and weighing about 110 lbs, without any current medications. I manage both mixed connective tissue disease and endometriosis effectively. Working in healthcare, I'm quite apprehensive about utilizing an already strained rural Canadian healthcare system without just cause. My main concern is whether my symptoms warrant further investigation or if they can simply be monitored. Over the past two years, I have developed a range of symptoms that persist to this day: - **Chronic fatigue**: Once exercising seven times a week, I now struggle to manage just two sessions. - **Vocal exhaustion and hoarseness**: I find it difficult to project my voice and often lose it easily. - **Choking incidents**: I frequently choke on liquids and solids, waking up 2-3 times a night due to bouts of choking on saliva. - **Bilateral foot tingling**: This sensation is most prominent at night. - **Intermittent tingling and muscle twitching**: Occurring daily for 1-5 minutes across all four limbs and my torso without any clear pattern. - **Increased reflexes in my right hand**, particularly the thumb: Actions as simple as opening a can trigger spasms, while a firm tap results in clonus. When holding my hand still for about a minute, I experience tremors. - **Wartenberg sign observable on my left side**. - **Notable muscle weakness**, especially in my arms: My grip strength is only about 30% of what is typical for my age. - Approximately a year ago, I had an episode of intense pain and hypersensitivity in both legs, particularly affecting my hamstrings. It was initially considered to be a mild central disc issue, yet no imaging was conducted for confirmation. Neurological assessments at that time indicated a fatigable L5 myotome on the right and absent reflex responses in the knee and ankle on both sides. - Recently, I've been experiencing eye strain and diminishing vision, which includes bumping into walls and difficulties noticing items in my peripheral vision. An eye doctor mentioned a possible optic nerve issue on the right, suggesting it might relate to a previous occurrence of optic neuritis and observed slight desaturation of red color. Monitoring was recommended. Aside from the clinical examinations, the only diagnostic tests performed have been blood tests, all of which returned normal results (including CBC, electrolytes, thyroid function, B12, iron, calcium, magnesium, glucose, and A1C). Despite this, I would categorize my symptoms as quite mild. They've gradually appeared, and I've often attributed them to benign causes. I've adapted to the fatigue and weakness in a way that does not severely disrupt my life. I do not experience distress over my symptoms, nor do I feel they are deteriorating. When I see them itemized, they may seem much worse than they feel in my daily life. It wasn't until an eye specialist directly inquired about the possibility of MS that I started to reconsider these issues seriously. My overarching question is: is it worth navigating the complexities (such as long waits at a walk-in clinic, potential delays for referrals, and then waiting a year or more for specialist appointments and imaging) just to rule out conditions when my symptoms are not significantly impacting me?
Experiencing Blood in Stool Again
I understand this may not be the most pleasant topic, yet I see many men on Reddit discussing similar issues quite candidly. Unfortunately, my gastroenterologist is not available until September. Earlier today, I noticed bright red blood after my first bowel movement when wiping. Later on, my second, more substantial movement resulted in even more blood visible in the toilet bowl. Throughout the summer, I’ve been struggling with abdominal discomfort and bloating. Last month, I experienced a bit of bleeding, which resolved itself within a day. I've undergone two colonoscopies previously, with the last one occurring in January 2024, where nothing unusual was found. From my online research, I’m seeing potential causes such as constipation or hemorrhoids, although I do not experience any rectal pain or itching. Could this possibly be linked to endometriosis? I kindly ask that no one suggests, “You should consult a doctor instead of relying on Reddit.” I did visit my gynecologist today and have an appointment with my primary care physician next week, along with my gastro appointment set for September. They informed me that there are no earlier openings and I cannot switch to a different provider. If my symptoms worsen, I will head to the emergency room.
Bilateral CCA and ICA Stenosis with Vertebral Artery Issues in a 25-Year-Old Female
About two months prior, I experienced a fainting spell that led to a fall, resulting in a head injury that required two staples. In the weeks following this incident, I encountered various concussion-like symptoms. To explore the underlying cause of my fainting, I consulted both a cardiologist and a neurologist. The cardiologist conducted an echocardiogram and an EKG, which did not reveal any abnormalities. He suggested that my episode might have been a case of vasovagal syncope. However, my concern persisted as I had experienced fainting spells intermittently over the past six years, always sparked by identifiable triggers such as prolonged standing, heat exposure, or inadequate food intake. In contrast, during this latest incident, I could not pinpoint any specific trigger. I recently received the results from my neurological evaluations: **MRI and Autonomic Function Tests:** All were within normal limits. **Carotid Doppler Assessment:** - There was a moderate to severe delay detected in both the common carotid arteries (CCA), internal carotid arteries (ICA), and external carotid arteries (ECA). - The left vertebral artery showed a mild to moderate delay compared to the right side. - Increases in blood flow velocity suggest the possibility of stenosis in the bilateral CCAs, ICAs, and the left vertebral artery. **Transcranial Doppler Study:** - This examination was technically limited, revealing a mild increase in the left vertebral artery relative to the right, further indicating the potential for stenosis. **EEG (30-minute awake and drowsy recording):** - Results were abnormal with localized sharp waves or spike activity observed in the left frontal area of the brain. I am scheduled for an MRA, a comprehensive EEG, and a VNG/BAER test within the next month, but I find myself anxious about what steps to take while awaiting these appointments. I've seen online discussions linking stenosis to atherosclerosis, which troubles me given my age of 25, alongside a lack of significant personal medical history or hereditary factors that I am aware of. The only pertinent background information I can recall is my history of e-cigarette usage spanning approximately seven years. I successfully ceased vaping two months ago, following the fainting incident, yet I cannot help but speculate whether this could be a contributing factor to my arterial issues. Any insights or recommendations would be immensely valued! While I am committed to following my healthcare provider's guidance, I would appreciate any thoughts as I bide my time until my next consultation.