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Posted

Hi,

 

A few days ago I had unprotected sex with a partner who has now told me she is HIV positive.

 

If I get tested here in Thailand, will it be a 4th gen test?

 

Also, will I have to show any ID?

 

Thanks

Posted

An unhelpful post has been removed.

 

State of the art HIV testing is available in Thailand. Hospitals will want passport to register you as a patient, nothing specific to HIV, routine for all patients. It is possible to get tested anonymously at the Thai Red Cross, see the pinned HIV thread in tbis forum.

 

PCR or NAT test will be positive by 14 days post exposure.

 

As you know the partner was HIV positive, PEP (post exposure prophylaxis) would be advisable if less than 72 hours have passed. If it is already 72 hours then you have missed that opportunity. Red Cross can advise on this as well.

 

If your partner is on ART (medication for HIV) and has been for at least 6 months risk of infection is much lower than if she is not on treatment.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

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Posted

Thanks very much for that information.

 

I have missed the 72 hour window.

 

She has been prescribed ART but does not take it regularly because it makes her feel dizzy.

 

Red Cross said they use a third generation test but that would be OK as soon as 21 days had gone by. This did not tie in with what I had read online so I queried it with the nurse / receptionist. There was a language barrier but I think she was saying that even third generation tests are more sensitive today. Does that make any sense? She knew about the hospital tests as well, but said the periods were 14 days for a fourth generation test or 7 days for PCR/NAT. All the numbers seem low so maybe they have a lower threshold (50%?)

 

I would rather get tested anonymously but at the same time I want to know as soon as possible.

Posted

"4th generation test" is a combined antigen/antibody test.  For early testing in someone with only a recent exposure and no prior likely exposures,  there is no advantage to it vs an antigen only test. In addition the antigen tested for (P24) takes longer to be detectable than does viral DNA (PCR test) or RNA (NAT test).  In other words, I don't see any particular advantage in your situation to a 4th gen test, it is not the quickest way of knowing.  That would be PCR.

 

PCR  can be done early as 3 days post exposure, but is more reliable by about 14 days. In other words, you can get a PCR now but if it is negative you'd need to repeat it later or else have a follow up antibody test at 3 weeks. 

 

I don't know what the reason is for your concern about wanting to be anonymous?  Hospital records are confidential except where you have authorized release of information, most often that occurs with insurance companies. (There is a sort of blanket authorization built into pretty much all insurance contracts). But trying to conceal HIV status from an insurance company would constitute insurance fraud and could invalidate the entire policy so nto advisable in any case.

 

I suggest you consult Dr. Asda at Bumrungrad He is US trained, fluent in English and accustomed to farang patients and their expectations, specializes in HIV and indeed is one of the foremost HIV experts in the country. He will be able to discuss this with you in perfect English at detail and may have more up to date info than I do.  Will cost much more than at the Red cross (inclusive of a PCR test, 5,000 baht+) but may well be worth it for peace of mind.

 

Your partner sounds quite high risk (known HIV+, irregular taking of ART). Fortunately even with a high risk partner, odds of getting this through a single exposure are low but you should absolutely avoid all further contact with this person (and unprotected ex with anyone).

 

 

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Posted (edited)
10 hours ago, Sheryl said:

I don't know what the reason is for your concern about wanting to be anonymous?  Hospital records are confidential except where you have authorized release of information, most often that occurs with insurance companies. (There is a sort of blanket authorization built into pretty much all insurance contracts). But trying to conceal HIV status from an insurance company would constitute insurance fraud and could invalidate the entire policy so nto advisable in any case.

 

General paranoia around confidentiality and especially visas. I will want a retirement visa eventually and you have to be clear of certain diseases. HIV is not on the list ATM but you never know. I think the current tests will normally come out negative if you stick to your ART, so I would still be able to get the visa (and wouldn't feel bad about it because in that scenario the disease would not be transmissible).

 

10 hours ago, Sheryl said:

Your partner sounds quite high risk (known HIV+, irregular taking of ART). Fortunately even with a high risk partner, odds of getting this through a single exposure are low but you should absolutely avoid all further contact with this person (and unprotected ex with anyone).

 

Right now I am concerned about my own status but I would rather help her than cut her out of my life. I have no idea what quality of care she is getting. It could be that nobody has explained to her that the side effects may go away after a while if she takes her meds consistently. It could be that there are other meds available that might be better tolerated, but she has not been told this or cannot afford them by herself. I think the disease has gone untreated for a long time. She is not thirty yet (I am younger than my username suggests) but may not have long left. She can't have a real relationship with anyone because as soon as she discloses her HIV status, they will run a mile. I am worried about my own status but am in tears for her every day. I want to offer her support if I can.

Edited by Dan1971R
Quoted wrong section
Posted

There is absolutely no implication for visa of any type.

 

Retirement extension of stay does not require any type of medical certificate or clearance. Work permits do, but HIV is not one of the diseases checked for. Like most reasonably enlightened countries Thailand has policies against discrimination based on HIV status.

 

And, immigration has no means of accessing your hospital records.

 

There are many HIV+ farang living in Thailand and none have encountered a visa issue.

 

By all means help this woman, just don't have sex with her again. Not only is she infectioys, she may be carrying drug resistant strain (happens when ART taken irregularly).

 

By the way, once HIV antibody positive you remain so for life, ART has no effect on that. But there is not and almost certainly will never be any immigration requirement for an HIV test, for the reason explained.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

Posted

You can get the P24 Antigen test from MT Interlab on 3rd road Pattaya, 900 baht. Ok to do after 2 weeks. But you'll need a follow up test to be sure. You'd be very unlucky to catch HIV from one encounter. There was a guy on another forum who had been having unprotected sex with his girlfriend for 5 years, she was +, he didn't catch it

Posted
You can get the P24 Antigen test from MT Interlab on 3rd road Pattaya, 900 baht. Ok to do after 2 weeks. But you'll need a follow up test to be sure. You'd be very unlucky to catch HIV from one encounter. There was a guy on another forum who had been having unprotected sex with his girlfriend for 5 years, she was +, he didn't catch it
P24 takes longer to be positive than PCR.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

Posted

Thanks guys for the reassurance on the chances of it having been passed on.

3 hours ago, Sheryl said:

By the way, once HIV antibody positive you remain so for life, ART has no effect on that.

Well, that does change things as far as anonymity is concerned - thanks. I was going off "undetectable = untransmittable" but they must be talking about viral load there.

 

3 hours ago, Sheryl said:

By all means help this woman, just don't have sex with her again. Not only is she infectioys, she may be carrying drug resistant strain (happens when ART taken irregularly).

I had not considered the drug resistance angle at all. That makes things much more complicated. The info you've shared in this thread is really helpful so thanks again.

Posted

It turns out she is on a generic version of Atripla. As I said above, she is only taking it intermittently, and I think she will go on the same way unless/until she switches meds. I feel as though I have one chance to help her find something she can stick to, because I have to leave Thailand in a couple of weeks and will be away for some time.

 

Atripla contains efavirenz, which is known to cause dizziness to the point where you can't get through your daily tasks. This is the exact problem she originally described. Other meds do not have this side effect, so if we can get to see the specialist, I think it will be possible to get her switched.

 

Although the dizziness is definitely real, she has also gone from having a perfectly flat stomach to having a slight belly. I think this is another major reason why she hates taking the tablet.

 

So far I have not been able to find an ARV that she could switch to that does not have weight gain or lipodystrophy as a possible side effect.

 

I am not sure it is lipodystrophy anyway, because her shape looks normal to me, whereas from what I read, lipodystrophy tends to give you a belly that is out of proportion.

 

If it is lipodystrophy, there is a drug called tesamorelin that has been developed specifically to address this side effect of ARVs. Is there any way to find out whether this is available in Thailand?

Posted

It could be that there are other meds available that might be better tolerated, but she has not been told this or cannot afford them by herself. 

 

OP, one of my relatives has HIV/AIDS and she takes her medication every day, without any remarkable side effects, the medication is btw free and covered by the 30-baht card.

 

All government hospitals have an HIV/AIDS group, where patients meet from time to time, blood tests are made to find out how high, or low, the CD 4’s are. Important is also a viral load test per ml to be able to give the right medication.

 

 The chances that you've caught the virus are so slim that I wouldn't be that concerned about it now. I had sex with two girls, who at that time, didn’t know that they had the disease, and I didn’t get it.

 

You should be more concerned about her honesty concerning her disease and an eventual drug addiction. The fact that she didn’t tell you that she’s positive before you had unprotected sex, says it all. 

Posted
58 minutes ago, BritManToo said:

Dear Dan,

You are trying to help a woman who deliberately exposed you to a life-threatening disease.

What's wrong with you?

+1 to that, if it was me I'd be fuming and wouldn't give the bitch the time of day. In many countries it's a criminal offense to deliberately expose someone to HIV.

Posted

Maybe try calling or going to the Bangkok Red Cross near Nana, they should give the right advice for her. Whether drugs are available there or elsewhere they should know. Its possible they don't treat people on the game but will know who does

Posted (edited)
6 minutes ago, TSF said:

+1 to that, if it was me I'd be fuming and wouldn't give the bitch the time of day. In many countries it's a criminal offense to deliberately expose someone to HIV.

 Love seems to make men blind. Very blind. As already mentioned, the Red Cross seems to be the right address. They also know where and what she can get in her province. 

Edited by jenny2017
Posted

Don't worry too much. There is a 1/2000 probability she infected you through vaginal sex. 1/200 if anal. Anything else hasn't been proven yet. Just relax and get tested.

Posted
On 8/10/2018 at 5:44 AM, Sheryl said:

 

By all means help this woman, just don't have sex with her again. Not only is she infectioys, she may be carrying drug resistant strain (happens when ART taken irregularly).

 

 

 

 

 

Does that include sex with a condom?

Sounds to me like the OP should not have unprotected sex with anyone until it is confirmed he is HIV - negative.

Posted
46 minutes ago, Lacessit said:

Sounds to me like the OP should not have unprotected sex with anyone until it is confirmed he is HIV - negative.

You're right, no intention of doing that.

 

Still interested in post #12 and tesamorelin / alternative ARVs.

Posted
40 minutes ago, Dan1971R said:

You're right, no intention of doing that.

 

 

Well, you're showing more moral responsibility than the girl you may have acquired HIV from.

Posted (edited)
1 hour ago, Dan1971R said:

You're right, no intention of doing that.

 

Still interested in post #12 and tesamorelin / alternative ARVs.

Why don't you talk to a doctor who's familiar with HIV/AIDS first? It has to be a doctor who's confronted with the virus on daily basis. And the Red Cross in Bangkok is definitely a good place to start. My relative is in a good physical and psychological mood, no side effects that are worth to talk about, with the usual medication. There's a high possibility that the dizziness goes away once the body is used to it. But that won't happen if she stops taking it once she's feeling dizzy. 

Edited by jenny2017
Posted
2 hours ago, Lacessit said:

Does that include sex with a condom?

Sounds to me like the OP should not have unprotected sex with anyone until it is confirmed he is HIV - negative.

yeah! - but that is the other type of PEP (Pre Exposure Propylactic) the wearing kind..............

Posted
12 minutes ago, jenny2017 said:

Why don't you talk to a doctor who's familiar with HIV/AIDS first? It has to be a doctor who's confronted with the virus on daily basis. And the Red Cross in Bangkok is definitely a good place to start.

Yeah, that's the plan. Maybe the Red Cross, maybe one of the HIV specialists in the sticky, just because they will have more options. I always like to look into things before I go to the doc though.

 

Glad the treatment is working out for your relative.

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Posted
56 minutes ago, BigT73 said:

Jebus  all this time I thought you were a female from your username.

Er - it is possible for girls to have sex with girls, haven't you heard?

  • Haha 1
Posted (edited)
55 minutes ago, Dan1971R said:

Yeah, that's the plan. Maybe the Red Cross, maybe one of the HIV specialists in the sticky, just because they will have more options. I always like to look into things before I go to the doc though.

 

Glad the treatment is working out for your relative.

Please make sure that she doesn't have TBC as well. Many people seem to have Tuberculosis when their Immune system is down. Even hospitals in the sticks have some good doctors who know what they are doing. But they also have those who don't really know it. 

Edited by jenny2017
Posted

It is quite possibel the Atripla would be fine if she would just take it regularly and weather the initial side effects as these decrease in most people.

 

Of course, by now she may be resistant due to the irregular taking.

 

While you could take her to a private doctor and get other meds prescribed after a test for drug resistance:

 

1 - these too will have initial side effects and if she is not prepared to endure that/won't comply with treatment it will be a waste of time

 

2- you need to consider long term costs. She is better off going through govt system, and they will insist she start on first line meds until they either do not work (as indicated by viral load) or serious or intractable side effects occur. The side effects she complains of are normal and usually go away with prolonged treatmen so they would nto change drugs on that account. ART meds have to be taken for life so even if you are willing to foot the (considerable) bill for private treatment now you have to think of the long term.

 

I suggest you bring her into TRC for a talk with the doctor and counselors there to try to persuade her to take her meds regularly and also get a VL done. Be sure to tell them about her irregular taking of the med and ask about tests for resistance.  But mainly, have them explain clearly to her in Thai about the need to take the medication daily without fail.

 

That is all you can do. It may or may not help.

 

 

Posted
14 hours ago, Lacessit said:

Er - it is possible for girls to have sex with girls, haven't you heard?

heard and encouraged and im always the dirty one

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