My PEP diary

I have made it to day 5. Side effects are greatly improved and I feel so much better than I did. I’ve had no rashes, no swollen glands, no flu like symptoms. However I have begun to notice now that I am feeling more anxious and more sad about what happened. I don’t want to go back to where I live and have to face everything that’s happened. I want to be as far away as possible. I am having to miss work for appointments at the clinic and I have had to just say to my manager that I am going to a hospital appointment which is true but what if she asks for more information?

What if I really have been given HIV by a total stranger who raped me when I was passed out and totally helpless? I feel differently about myself. I used to think that I felt really safe where I live and that nothing could change that but now I feel anxious and the thought of walking alone at night is something that scares me. Maybe when all this is over I can address how I feel mentally about this experience. I have become almost obsessed with messing up my medications and I am terrified I am going to miss a dose or take them wrong. I think it’s a stress reaction to how insane the last week has been. I feel like my life has been changed forever.

Today I headed up to my parents to stay with them for 11 days and I have to admit that thinking about how I’m going to hide the fact I’m on PEP from them is stressing me out. We are really really close but I just cannot bare to tell them that I’m on PEP because I was sexually assaulted. It would kill them. Plus I am praying that it works so that it never becomes an issue and they never have to find out.

I have hidden my pills in the deepest darkest recesses of my bag. I am desperately preempting my pep alarms on my phone so they don’t ask me why I have alarms set at such odd times. I’m sneaking off to the loo with a glass of waiter and my tablets so as not to be discovered. Needless to say, it’s exhausting! So far so good though.

To date I haven’t missed or even delayed a single dose. They have all been completely on time. It kind of takes over your life if I’m honest! If I wasn’t on annual leave from work for 2 weeks I wondered if I would be able to cope so well. My symptoms from the meds have almost totally stopped now thank god. The diaorrhea has ended and the stomach cramps are a thing of the past. I barely ate though today because I knew I had a 6 hour drive to my parents house and I didn’t want to end up getting caught out on the motorway with explosive diaorrhea.

So, if like me you initially go to A&E to get your PEP don’t think that they will give you a full 28 day course and send you off never to be seen again. They will only give you 5 days worth of meds to begin and they will insist that you book in to see a health adviser at your local sexual health clinic as quickly as possible. Ideally within 3 days. This is so you can discuss what happened, they can further risk assess you (let’s not forget that sexual health doctors, nurses and health advisers are the real specialists when it comes to sexual health and HIV and will have a far better understanding and range of knowledge regarding this than most A&E doctors will) they can get the next 2 weeks of your medication prescribed and they can carry out any tests that need to be done to check for other possible sexually transmitted infections.

I was very nervous to see the health adviser. I was booked in to see a man and usually a male will see a man and a female will see a woman so there is less awkwardness. My health adviser was very good. He asked me to tell him what had happened and I told him that the possible exposure was from sexual assault. He asked if I wanted to report it and if I consented to the sex. He also asked that if I had consented to it was I really in a fit state to do so considering how much I had had to drink. He also told me they could assist me in reporting it to the police. I know this may sound crazy but I have decided at this point not to report it to the police. The main reason being that I was so drunk and I don’t remember anything leading up to the rape. I don’t remember his face. I know he had an accent which was maybe Turkish or middle eastern but I couldn’t pick him out in a line up or give any clues about what he looked like. I don’t know if I consented to the sex but I certainly do not recall having ever met him before I woke up face down on the ground with him raping me. Basically I feel that if I report this I will be judged for being so silly and getting myself into a situation like that by drinking so much.

I was at the clinic over an hour today and it has to be said it was not an enjoyable hour. I had to tell a health adviser and a doctor the story behind why I was on PEP and then I had to have an instant HIV test to check I wasn’t already HIV positive which I knew I wasn’t anyway because I have been tested this year and I hadn’t had sex since January so I knew I was all clear. Anyway, the test came back negative which I knew it would.

Then I had to have a swab taken of my throat which a doctor did as well as examining my stomach because I told them about the side effects I was having from the tablets such as diaorrhea and abdominal pain and they were worried it could potentially be a form of infection that he had given me such as shigella or LGV which is a particularly strong form of chlamydia. This meant I had to also give stool samples and do an anal swab (trust me, trying to collect 3 stool samples into little pots in a clinic toilet is not easy and definitely NOT glamorous!) Finally I had to give a urine specimen. All of those have now been sent off and I have to wait for the results.

I also had to have another appointment made to return in 2 weeks in order to do more swabs and get my last 2 weeks of PEP. Do not underestimate what a big commitment PEP is! It will require roughly around 4 or 5 trips to a sexual health clinic in total and all in all, including HIV testing will go on for around 3 months before you have a definitive all clear. I now have 3 more clinic visits to attend before this is over. PEP is in ZERO way a replacement for safe sex using condoms. It cannot be viewed as being similar to a morning after pill for unsafe sex. Please use condoms and please keep yourselves safe.

So now I am at the stage of the process where I am on PEP and have begun my second full day I will say a little more about PEP. With these medications it is VITALLY important that you don’t miss doses, double up on doses, take your tablets at different times or stop during the middle. PEP must be taken for 28 days in order to be effective and it must be taken exactly as prescribed by your doctor. I have got alarms set on my phone which is a great trick to remembering and I never leave the house without my PEP incase anything happens and I can’t get to it. I have managed to swallow the tablets with ease despite the fact they are very big. It is not recommended that you crush the tablets as they are ideally meant to be taken whole. If you struggle with tablets discuss with your doctor as they are quite big. Always eat with your PEP. It reduces the side effects and is generally much better I found when you have had a good meal or substantial snack. I have chosen not to drink whilst on PEP. This is an ideal choice because even though having 1 small drink is unlikely to affect your medication, for a lot of people, myself included, getting drunk may affect their ability to remember to take the pills or to keep them down if they vomited from drinking or left them at home when on a night out etc. I personally mainly chose not to drink on PEP because I scared myself by getting so drunk that I was raped in the first place. My friend said to me the next day that I was the worst she has ever seen me from drinking. It made me seriously consider why I was drinking like that. I will now be alcohol free for a month all being well and I will use this time to think about my drinking.

Having taken my first dose of PEP at midnight I was unsure what to expect. I have been put on 2 tablets, Truvada and Raltegravir. I had to work again today and it was a full 12 and a half hours again and my god was it awful! I had diaorrhea all day long. I must have gone to the toilet around 12 times. It’s been nearly uncontrollable cause my stomach has been cramping and I’ve had stabbing pains and for the entire day there has always been a background feeling of nausea. Not like I actually felt I was going to be sick but just always there and in the very pit of my stomach. I couldn’t face eating a single thing for most of the day and the only thing I managed to force myself to eat was a plate of chips at lunch and considering I normally eat non stop and I have had a 17 hour day from getting up for work to going to bed that’s not a lot! All of these symptoms I have read about online and are said to be very common.

I had to grab my bag whilst at work and sneak off to take my pill at lunchtime because as my PEP took so long to arrive at A&E my tablet times are midnight and midday which is far from ideal. One bonus of tablets being at bedtime though is that you can go straight to sleep and miss most of the side effects as you are asleep (unless like me you end up waking up in the night with horrendous stomach pain and diaorrhea that won’t stop).

I had to go back to work today. I had a 12 and a half hour day to get through, all the time feeling sick to my stomach with stress, worry and anxiety. I hadn’t told anyone about the sexual assault. On my break I decided I needed advice so I called 2 organisations I knew would point me in the right direction. Firstly, I called Terence Higgins Trust and explained the situation. They are a fantastic HIV charity and their phone adviser suggested I leave work immediately and attend a clinic to get PEP. I explained that this wouldn’t be possible but they encouraged me and gave me various clinic numbers nearby. Then I called my local sexual health clinic who also suggested that I needed to go straight to the clinic to get PEP.

I felt torn cause I am a nurse and I have responsibility to the patients I am looking after so I decided not to leave work and instead to go to A&E after work. I knew time was of the essence but work was short staffed and I was working 3 days in a row so it was A&E or nothing. Now, I feel I must say that going to A&E for your PEP is far from ideal. Only clinics and A&E can give PEP but where possible always go to a clinic. Accident and emergency departments are already pushed enough with people needing life saving treatment so anything that can be done to take extra pressure and work load off them is always better and it also means from a more selfish view point that if you attend A&E you will have to wait for hours to get your medication as well as having to explain to more people the reason why you need PEP.

I finished work and quickly went home and showered and changed (I really didnt want to sit in A&E in my nursing uniform) and then I went and sat in A&E. From the time I arrived to getting my medication and leaving was roughly 3 hours which wasn’t bad for a busy accident and emergency department on a Monday night. First I had to be triaged by a nurse and had to tell him the whole ordeal of the sexual assault and then I had to retell the whole thing to a doctor as well as waiting to have blood tests. All the staff were lovely (although I knew the doctor briefly from a previous area I had worked which was quite embarrassing) but having to tell the story twice was upsetting.

When I woke up the day after the incident which was a Sunday I was so shocked by what had happened. I almost thought it was a nightmare but as certain things came flooding back to me I knew that it had all been very real. I was very sore all over. I initially tried to forget the assault and had a long hot bath. However as the day went on I started to worry and I remembered that I had felt he wasn’t wearing a condom when I forced him out of me. Where I live has a high prevalence of HIV and I knew that I had to consider what I was going to do about this. I decided I would allow myself this one day to be alone and think about my next move.

The story of how I ended up needing to be on PEP in the first place is one that I honestly never expected to be telling. Don’t get me wrong, in the past I have been no angel & I admit to that but the reason I am on PEP for the first time in my 32 years on this planet is because I was sexually assaulted on a night out. Now, I know that many people will find it very strange that a 32 year old man who is 6 ft tall and fairly well built can have been raped on a night out but that’s what happened to me.

My friend was having a Halloween party and I had been looking forward to it for weeks! All my friends who I hardly ever get to go out or party with were going to be there. I had the whole weekend booked off work & I was planning my costume and really looking forward to it. I work as a nurse and I had been working non stop and it just needed to have some fun and blow off some steam with my mates. I took around a litre of vodka with me to the party and a bottle of shots and I was to share the vodka with whoever wanted it and the shots were for everyone. The party was great fun and I know almost everyone and the drinks were flowing and a couple of hours in I realised I had basically finished the litre of vodka off but mainly to myself!! and the bottle of shots was gone of which I had around 6 or 7. My friends decided to go out. I don’t remember leaving my friends house. I have the briefest flash back of standing in the first bar we went but only a seconds worth. Then we headed onto another bar I was later told. I don’t remember leaving or how we got there. Once at the second bar my friend said she went to the toilet and that I just disappeared. All I can imagine is that I felt unwell and realised how much I had drank and had left to try to get home. I must have tried to walk but I have no idea what happened as I had completely blacked out for the past few hours by this point.

My next memory is waking up somewhere along the seafront lying on the floor and a man was raping me anally. He was on top of me and I had just come to and I pushed him off me but he grabbed at me and forced himself back into me and continued until I managed to gain the strength to push him off me and run. I was so confused. It was almost pitch black and I had no idea how I had ended up there. I could feel when I pushed him out of me that he wasn’t wearing a condom however at the time I was so shell shocked by what happened that I couldn’t think about it. I headed home and went straight to bed unable to process what had just happened and I passed out.

First things first....