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HIV & AIDS Information - Post-exposure prophylaxis (PEP) medication


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#1 kuteguy

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Posted 24 December 2014 - 07:14 AM

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It was hard to find this info on here especially since you can't search for the letter words - HIV.

You have 72 hours to get this medication into you if you think you have been exposed. The problems:
1. Not many options in Pattaya. Many in Bangkok.. Best and cheapest being thai red cross
2. General GPs cannot prescribe you this medication.. And they are not qualified to assess you anyway
3. Can only buy this medication from hospital (i have not read that any pharmacist sells it and my ground search from the most resourceful pharmacies resulted in nothing)
4. Very very expensive.. And is said to have tough side effects, although the newer medicines have less so
5. There is no test to determine if you should or shouldn't take PEP. This is because you have only 72 hours (ideally within hours of exposure) - no tests work in such a short time (there is a rapid test which gives kind of rough estimates but it takes a week wait before the test can be taken). And symptoms don't show till weeks later (acute hiv symptoms). The funny thing is GP just say wait 7 days to get tested and then manage from there.. Uhmm then it will be two late

Now the main thing... If you are in Pattaya then you don't want to take a journey to bkk for this perhaps. There are four places that do prescribe PEP medication in Pattaya

1. Bangkok hospital - i have read that the cost is 6-7000 thb including consultation and medicine
2. Pattaya international.. Same as above
3. Memorial hospital.. 3000 thb including consultation and medicine.

Medicine is taken for 28 days same time of day.. Do not stop or your hiv will be strong enough to mutate and not respond to other further treatments... You need to take all 28 days. Again taking pep for 28 days is not a guarantee that your hiv will not take hold (maybe your white cell count was already previously low and the hiv took a quicker hold; maybe the strain you have does not respond to the peps that you have been given).

This might be one good reason for blood test.. To get idea of strain (not sure how that works). The peps that are usually recommended are recovir-em (200/300mg..Two medicines in one) and edurant 25mg.

The best best thing to do is to ask the lb who you think infected you to go to testing clinic with you. Even if you have to pay her St/LT again. This way you can firstly find out if there was a risk of catching hiv and if so what strain she had. I cant begin to tell you how crazy the LBs are. Of the many many i have been sexual with they have always assumed we are doing everything bare back.. Just imagine.. It's only a matter of time before they all become carriers. I always bag up but do do bareback oral sex.

Next if you are in two minds whether or not to take pep then i would say it is a no brainer that you should do it. Even oral sex, which has the lowest risk infection is around 2 percent chance. Now take your entire life's earning and future earnings + non monetary things like family/friends/gfs, etc and try and put a monetary value to them.. Them multiply all that by 0.02 .. And if it comes to more than 3000 thb then go to memorial hospital and get those peps.

And if you want another incentive then probably you can take more risks while on peps because probably your body is not favorable place for any new hiv infections to create copies of themselves.

Good luck, happy mongering, stay safe and please don't let alcohol and drugs impair your judgment. Because eventually you may be able to stop drugs and drinks but you may still want and do things when sober that give you the high of things you did when under the influence (speaking from personal experience). Normal things (eg. Sex with gg) will never be exciting enough.
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#2 kuteguy

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Posted 24 December 2014 - 08:25 AM

Sorry forgot the fourth one: dr philippe seur @ heartt2000.org. He is super committed and helpful but i think he is a one man show trying to tackle a big target population .. Thais with hiv and farangs. It is hard to find him and get his time for getting the prescription but if you do then you are further rewarded that he is one of the most affordable options in Thailand

#3 gosukorean

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Posted 24 December 2014 - 08:26 AM

Next if you are in two minds whether or not to take pep then i would say it is a no brainer that you should do it. Even oral sex, which has the lowest risk infection is around 2 percent chance. Now take your entire life's earning and future earnings + non monetary things like family/friends/gfs, etc and try and put a monetary value to them.. Them multiply all that by 0.02 .. And if it comes to more than 3000 thb then go to memorial hospital and get those peps.

 

 

Source?

This sounds completely and utterly inaccurate, this is much higher than most figures out there for receptive anal.

It is disputed, but many doctors claim there is zero percent chance of catching HIV from oral.

 

Edit: And here's one source for you. 

http://www.aidsmap.c...e/page/1443490/

 

Paraphrasing the pertinent parts:

Estimates vary between zero to 1 in 2500 chance of acquiring HIV if you are receptive, and The risk for the insertive partner in fellatio is thought to be virtually nonexistent.

 

Now just waiting for someone to make some dumb comment about people playing doctors on the internet.


Edited by gosukorean, 24 December 2014 - 08:31 AM.


#4 kuteguy

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Posted 24 December 2014 - 09:08 AM

Aren't we all playing doctor in this section of the forum. I am going to have trouble finding that source.. Will look for it though it was quite good and specific - well researched and catering for msm/gay community... Which, whether we agree or not, we are part off.

World stats are meaningless for lb sex in Pattaya cause lb sex in pattaya would be a very negative outlier on world stats.

Edited by kuteguy, 24 December 2014 - 09:18 AM.


#5 gosukorean

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Posted 24 December 2014 - 09:16 AM

Aren't we all playing doctor in this section of the forum. I am going to have trouble finding that source.. Will look for it though it was quite good and specific - well researched and catering for msm/gay community... Which, whether we agree or not, we are part off.

World stats are meaningless for lb sex in Pattaya cause lb sex in pattaya would be a very negative outlier on world stats. Think i had read in that article that receptive anal sex is 6% infection for bareback

 

Why? It's per act, the percentage of lbs that are infected is irrelevant.

The only possible differences are the intensity of the sex and possibly the strains of HIV, so no, it doesn't make a difference

 

You're never going to find that 2% source dude, nowhere have I seen a figure anywhere like that.

It's just out of the realms of possibility, if there was a 2% chance of contracting HIV from insertive oral sex without a condom almost all of us would be positive by now.


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#6 kuteguy

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Posted 24 December 2014 - 09:19 AM

Yes you are right.. The article is at
http://www.projectin...ications/pep/..Risk is 0.01%

#7 hubert_cumberdale

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Posted 24 December 2014 - 09:53 AM

I think you have got the cost of the PEP wrong I recently spoke to a BM who had a huge risk and got everything from Bkk to the tune of around €1500

Edit - and he said the full course of medicine was not available in pattaya thus travelling to bkk

Edited by Gympy01, 24 December 2014 - 11:15 AM.


#8 Blodstrupmoen

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Posted 24 December 2014 - 11:27 AM

Good information and VERY important for punters to know.
Since I opened the Q&A thread I have had many BM's sending me private messages for advice when they have been in this sorts of situations and quite a few of them has opted to do a PEP course to be safe.
I do think the prices are a little higher tho more to the tune of 20-30 thousand.
And quite a few getting a Truvada and Isentress cocktail.
More info on PEP or PrEP can be found on pages like www.thebody.com and www.aidsmeds.com (very reliable sources)
On thebody there is also an ask the experts page where you can send in questions to real doctors and experts (not like me who is just a wannabe expert).

#9 kuteguy

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Posted 24 December 2014 - 03:58 PM

I would say at 1500euros that was probably the branded stuff, generics are quite a bit cheaper. I have read other threads where they have quoted around the ball park figures i posted. I was happy with the drugs i have mentioned before.. Until i researched them again after all your replies. There are about 10 different other combinations.

Just for completeness i went to the new Pattaya city hospital on soi bukhaow. The answer on there end wasn't clear but what i picked up was that the consult is 500thb with hiv specialist. Then the recovir-em is 28thb/pill so about 900thb for 28 day supply. He wasn't very clear about the other medicine saying edurant is only for thais .. Sure the doctor at the consult can sort it out. Oh their recovir-em is called zilavir (AZT 300 mg.+3TC 150 mg).. Which the pharmacist said is the only thing you need. Again i am sure that is not correct.. You do need another drug. Infact i have just researched Edurant extensively and all research shows it's not the first choice for PEP but rather best for PrEP. Isentress is the best drug instead.

Anyway good to know a 5th resource that is Pattaya city hospital.

Thanks for the links konguk.. Very good resources.

Edited by kuteguy, 25 December 2014 - 06:59 AM.


#10 kuteguy

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Posted 26 December 2014 - 03:36 AM

So i thought i would post a slightly long version of some events that transpired yesterday that gives some interesting insights into how things work.

So the lb who could have infected me (through CIM.. Low risk but i was really really sick the next morning including bleeding in my phlegm) supposedly had to go to bkk (she is from there) and so i could not get her tested for hiv. I went to memorial within 50 hours since possible infection and was put on pep. The lb called me from bkk and told me she was on her way back to patts and i dropped all my plans for her because i wanted her to get the test done. While waiting i looked into testing options and i think memorial hospital is again one of the best. However, due to practicalities i went for my usual bukhao clinic.

So i had it all planned how i would seduce her into getting the test done.. The 72 hour window has passed but i thought there was still a lot of benefit in testing her. Meanwhile ofcourse she ASSURED me that she was hiv negative. She is 22 so had that in her favor but it worried me how easily she wanted to bareback on our first meet. And i met her at 5am on beach road. But she has always been an amazing sweet person.

Anyway as plans go... Mine completely went to shambles. Including her being almost two hours late and bringing her two other hot lb friends/roomies with her. Time was running out as clinic was going to close in an hour and i didn't want to push the testing agenda too much. We went to dinner and on the way she took out the topic that she is definitely not infected. I liked that they didn't take my dinner offer as a reason to have a seafood feast. Hating to talk about testing during dinner but with little choice left.. I opened the topic. Her friends assured me that she is disease free and that they are gong to the markets after dinner and i should come.

I had decided previously that it was important for me to have her tested and i was prepared to drop some serious money to persuade her.

So i pushed on a little bit more.. Very rare for me to do this. And she agreed. Again they were so nice they were happy to walk to the clinic while i would be happy to taxi them there and back. So once we are there and she has had her blood taken through finger prick .. There is this tension in the group. Turns out this is the first time she is getting tested!!!! How could any of them give the assurances they gave me previously!!

Anyway she turns out to be negative which is a bit of a relief for me (i don't trust these pregnancy type tests fully.. ) but i will keep taking my hiv medication anyway.

We walk to beach road get lots of beers, sit on beach. Then i invite all three of them to my room.. The look on the receptionists face is unbelievable as all three have to leave ID there. Then the rest leave and my lb tells me 'now no need condom nah'. I ofcourse still insist on codom. Practice safe sex always... Except oral :-\ she ofcourse refuses any money whatsoever but i want to keep our interactions very professional although even i don't have the coldness to keep stopping her from calling me her bf and making heart symbols of us in the sand. I have to literally walk her out of the room and back to her friends so i can get back to my bed and have it to myself.

This time i am just doing ST only.. No LT and enjoying it more.

#11 dogs

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Posted 26 December 2014 - 05:35 AM

Helpful informative information! Play safe but accidents do happen. If this information save one person its priceless.

#12 POWERLIFTER666

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Posted 16 January 2015 - 10:35 PM

Had to take the cocktail Kaletra and Truvada already for 28 days straight i was so damn sick from the medicine pfiuuuu just good enought to remember that i dont want to take those things for an entire life so i think im carefull enought (touching wood)
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#13 yes13

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Posted 17 January 2015 - 09:41 AM

For the guys that have already been through this stuff:
Would it make sense to buy the meds beforehand and save the time scramble ?
Do you know for how long can you keep them before they go bust ?
Do you think it is a good idea ?

Presumably you can start taking the meds the moment the accident happens

#14 Blodstrupmoen

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Posted 17 January 2015 - 04:06 PM

For the guys that have already been through this stuff:
Would it make sense to buy the meds beforehand and save the time scramble ?
Do you know for how long can you keep them before they go bust ?
Do you think it is a good idea ?
Presumably you can start taking the meds the moment the accident happens


Better to just take Truvada as PrEP then I guess.
Don't know what caused Powerlifter's side effects but probably the Kaletra cocktail. Truvada has very little side effects and most people don't have any. They use a heavier cocktail in PEP than PrEP as keeping it out of the system takes less drugs than removing something that might already have gotten in.
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#15 Thaiman12

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Posted 17 January 2015 - 04:21 PM

It was hard to find this info on here especially since you can't search for the letter words - HIV.

You have 72 hours to get this medication into you if you think you have been exposed. The problems:
1. Not many options in Pattaya. Many in Bangkok.. Best and cheapest being thai red cross
2. General GPs cannot prescribe you this medication.. And they are not qualified to assess you anyway
3. Can only buy this medication from hospital (i have not read that any pharmacist sells it and my ground search from the most resourceful pharmacies resulted in nothing)
4. Very very expensive.. And is said to have tough side effects, although the newer medicines have less so
5. There is no test to determine if you should or shouldn't take PEP. This is because you have only 72 hours (ideally within hours of exposure) - no tests work in such a short time (there is a rapid test which gives kind of rough estimates but it takes a week wait before the test can be taken). And symptoms don't show till weeks later (acute hiv symptoms). The funny thing is GP just say wait 7 days to get tested and then manage from there.. Uhmm then it will be two late

Now the main thing... If you are in Pattaya then you don't want to take a journey to bkk for this perhaps. There are four places that do prescribe PEP medication in Pattaya

1. Bangkok hospital - i have read that the cost is 6-7000 thb including consultation and medicine
2. Pattaya international.. Same as above
3. Memorial hospital.. 3000 thb including consultation and medicine.

Medicine is taken for 28 days same time of day.. Do not stop or your hiv will be strong enough to mutate and not respond to other further treatments... You need to take all 28 days. Again taking pep for 28 days is not a guarantee that your hiv will not take hold (maybe your white cell count was already previously low and the hiv took a quicker hold; maybe the strain you have does not respond to the peps that you have been given).

This might be one good reason for blood test.. To get idea of strain (not sure how that works). The peps that are usually recommended are recovir-em (200/300mg..Two medicines in one) and edurant 25mg.

The best best thing to do is to ask the lb who you think infected you to go to testing clinic with you. Even if you have to pay her St/LT again. This way you can firstly find out if there was a risk of catching hiv and if so what strain she had. I cant begin to tell you how crazy the LBs are. Of the many many i have been sexual with they have always assumed we are doing everything bare back.. Just imagine.. It's only a matter of time before they all become carriers. I always bag up but do do bareback oral sex.

Next if you are in two minds whether or not to take pep then i would say it is a no brainer that you should do it. Even oral sex, which has the lowest risk infection is around 2 percent chance. Now take your entire life's earning and future earnings + non monetary things like family/friends/gfs, etc and try and put a monetary value to them.. Them multiply all that by 0.02 .. And if it comes to more than 3000 thb then go to memorial hospital and get those peps.

And if you want another incentive then probably you can take more risks while on peps because probably your body is not favorable place for any new hiv infections to create copies of themselves.

Good luck, happy mongering, stay safe and please don't let alcohol and drugs impair your judgment. Because eventually you may be able to stop drugs and drinks but you may still want and do things when sober that give you the high of things you did when under the influence (speaking from personal experience). Normal things (eg. Sex with gg) will never be exciting enough.


Thank You, Good Doctor.
My root cause analysis suggests that I may have a pre-treatment option;
75 cents at a Pharmacy near you.
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#16 wildrover

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Posted 17 January 2015 - 04:53 PM

Had to take the cocktail Kaletra and Truvada already for 28 days straight i was so damn sick from the medicine pfiuuuu just good enought to remember that i dont want to take those things for an entire life so i think im carefull enought (touching wood)

 

Was the same, bloated and a bit nauseous all day long. However, these drugs are very tough on the kidneys and the liver as well -  and are not to be taken lightly. The NHS here in the UK will check the functioning of those organs after you complete the course. 

The one drug i would keep well away from is Efavirinz (Sustiva) - really weird dreams, horrible drunk like feeling staggering around bedroom in the middle of the night. Took it for one day and switched. I feel sorry for people who are prescribed that drug, cant imagine the challenge of taking that drug every day of your life if diagnosed with a particular strain.

Total cost for one month'medication in thailand was 19,000 baht



#17 Blodstrupmoen

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Posted 17 January 2015 - 10:32 PM

Was the same, bloated and a bit nauseous all day long. However, these drugs are very tough on the kidneys and the liver as well -  and are not to be taken lightly. The NHS here in the UK will check the functioning of those organs after you complete the course. 
The one drug i would keep well away from is Efavirinz (Sustiva) - really weird dreams, horrible drunk like feeling staggering around bedroom in the middle of the night. Took it for one day and switched. I feel sorry for people who are prescribed that drug, cant imagine the challenge of taking that drug every day of your life if diagnosed with a particular strain.
Total cost for one month'medication in thailand was 19,000 baht


I would say that since you only took one days worth of meds it's not really worthwhile posting your problems with it and potentially scare people away from a medication that can save their life.
Most side effects with all HIV drugs comes during the first two weeks and then disappear all together.
Most people wont have any side effects at all. Problem is that you will only hear about the once that had problems.
I'm on a daily dose of Stribild and I have not had any side effects what so ever.

#18 wildrover

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Posted 18 January 2015 - 12:09 AM

I would say that since you only took one days worth of meds it's not really worthwhile posting your problems with it and potentially scare people away from a medication that can save their life.
Most side effects with all HIV drugs comes during the first two weeks and then disappear all together.
Most people wont have any side effects at all. Problem is that you will only hear about the once that had problems.
I'm on a daily dose of Stribild and I have not had any side effects what so ever.

I was trying to get across the point that the Kaletra/Truvada PEP has less side effects that Efavirinz. That drug's side effects are well documented and i wanted to emphasize them as that is a drug that is widely prescribed in Thailand. They may go away sure but they may also be so nasty that someone will give up the PEP completely.

I am trying to emphasize that there are alternatives...Its not about 'scaring people away' - quite the opposite in fact.


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#19 Blodstrupmoen

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Posted 18 January 2015 - 04:08 AM

I was trying to get across the point that the Kaletra/Truvada PEP has less side effects that Efavirinz. That drug's side effects are well documented and i wanted to emphasize them as that is a drug that is widely prescribed in Thailand. They may go away sure but they may also be so nasty that someone will give up the PEP completely.
I am trying to emphasize that there are alternatives...Its not about 'scaring people away' - quite the opposite in fact.


OK sorry I miss read you then.

#20 dantae

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Posted 13 May 2016 - 08:38 PM

you can get the truvada generic tenvie em made by cipla from Singapore for 256 dollars 3 months supply from a Canadian pharmacy so can not be that expensive in thailand. also kaletra is outdated and has nasty side effects ill find out what we are prescribing at the hospital i work at in England for you guys 




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