Bangkok, Thailand; 2017. Condom broke whilst having what started out as a great shag with a Thai massage/ bar girl. I think I felt it snap inside her but I was a little bit drunk, and I carried on shagging away for another 8-9 pumps before I checked. I found it had come off inside her and it had been pushed right up inside her. I don’t know why I carried on pumping when I suspected it had come off; however you or I got/ get into this situation (or similar), it makes no difference. The moment you know the epithelial layer of a mucous membrane (penis, vagina, rectum/ anus, etc) has to come into contact with blood, semen, vaginal and cervical secretions, rectal secretions, then you have created a risk. How you judge that risk is up to you. For me, I have good long life to live, so there was only one option for me; Post-Exposure Prophylaxis. Emergency HIV treatment. If you think there is a risk, just go and get it and start taking it immediately. It took me 10 mins on google to find a local clinic to me in Sukhumvit, Bangkok. It was a walk-in private clinic. Why wouldn’t you? Good question – ‘cos you are lazy/ fear the side effects/ don’t believe it could happen to you (naive)/ can’t afford it. It is said to be effective if you take it before 72 hours has passed – the longer you leave it the less likely it is to work.

PEP Medicine & Cost: 

Whilst I have since been told that the Thai Red Cross will give it to you for free – I didn’t know this at the time. The walk in clinic was super easy – I told the doctor I had shagged a bar girl/ Thai massage girl and that the condom broke, and then paid the following for the treatment:

• 600 Bhat Doctors Fee.
• 200 Bhat Clinic Fee.
• 484 Bhat for the Endurant 25mg Rilpivirine (PEP Drug).
• 1,014 Bhat for the Teno-EM Tenofovir Disoproxil Fumarate, and Emtricitabine (PEP Drug 2 in 1 pill).
• 62.35 Bhat for Motilium (a drug used to control nausea and vomiting).

Total: 2,360.35 Bhat / £53.37 GBP / $69.24 USD / $91.27 AUD

See below images of the tablets and the essential instruction sheet (1 of each per day before sleep for 30 days):

PEP Side Effects:

I didn’t know what PEP was; I googled what to do in this situation when I got back to my hotel room. Most of the advice was aimed at gay people because it seems they are labelled a higher risk group. Also, importantly, a lot of the advice was outdated… which is precisely why I am writing this for you now. Pre-2017, PEP medication side effects sounded brutal! Almost guaranteed diarrhea, nausea, and headaches on most days over the course of the 30 days you need to take the meds. In 2017, the two pill a day cocktail you now have to take, reportedly, has the same symptoms, but to a far lesser extent. I say reportedly because I write this moments after having taking the 1st 2 pills, 32 hours after potential exposure. This blog constitutes my daily diary as I go through the next 30 days of PEP treatment. I expect different people will have different reactions/ experience different side effects, so, to help you gauge how similar yours might be to mine, I will tell you about me. I’m 182cm tall, and white European (52% English, 46% Spanish, 2% Sicilian) according to recent DNA test results. I have no allergies, never had any STI/ STDs before, I’m fit and healthy, 29 years old, weigh 79kg, and am uncircumcised. Apparently having that bit of extra fleshy penis protection still attached equates to having a large mucosal surface membrane through which the HIV transfer could occur.

I’m here for a month in Thailand to hang out and work remotely from my laptop; I really really do not need nor want the nausea, diarrhea, cramps, dry mouth, fatigue, and maybe rashes that are listed as common symptoms alllllll over the internet. What a sh*t trip away it will be if over the next 30 days, I am redundant because of this stupid situation. But! This is why I am writing this for you, because these new medicine combinations are proposed to have far less strenuous and brutal side effects. So instead of reading the horror stories I read and getting the fear, and being put off the PEP meds because of the side effects from the older, harsher drugs. This is a July 2017 diary of how I feel every day as I go through this.

HIV Exposure:

Did you know that you have to wait 3 months following exposure before you would get reliable results from an HIV test? That is a very important piece of information. You can have what is called a “rapid antibody test which gives a positive result based on the presence of antibodies to HIV, not the virus itself. But, it takes your body up to 3 months   to produce these antibodies at levels that can be detected by this test. 4-6 weeks after infection, most people will have enough antibodies to test positive to produce these antibodies at levels that can be detected by this test. 4-6 weeks test positive… 3 months however is still the ultimate answer date. SO! Armed with this information (I knew this already), I of course asked the girl I had been shagging if she had been tested. Straight away, she said yes and asked if I had. I lied and said yes; I know I don’t have HIV, but I wanted to skip past the me questions and get all the her answers I could. So I then started asking if she usually had unprotected sex, or had a boyfriend, or… if this had happened before. Like lightening, she pulled out a certificate of clean health! So in order for her to be employed by GoGo Bars or Massage Parlours that offer a bit extra, you need a bill of clean health. See the image below; this is a photograph of her certificate that says she has proved negative for HIV. The test certificate was dated 5 days prior to when the condom broke with me. NOW! For some people, that would understandably be enough to give you a wagging tail and go away feeling safe. But I kept on asking questions; “why do you need an HIV test if you always use condoms?” She was reluctant to give me a straight answer. I tried to answer for her and gauge her reaction. “If the condom broke, or if you forgot to use one, or if you had unprotected sex, that is why you had a test? Yes?”. she shrugged and nodded. “Last month this happened?” She nodded. ALARM BELLS. If she was potentially exposed to HIV last month and had a test even 2-3 weeks later, that isn’t long enough to give the results of the test certificate she had shown me any value. Could have been a false negative… No two way about it, I was going to get PEP Treatment.