HEALTH CENTRE: Protecting Yourself From Getting Infected With HIV
HIV infection occurs when there’s an exchange of bodily fluids i.e. when infected bodily fluid makes contact with your mucous membrane (the lining of your mouth, eye lids, nostrils, anus, urethra, vagina etc) and or damaged skin. This contact could be during sex, needle use (intravenous drug users), accident victims rescue operations etc.
NOTE: Saliva is not part of these bodily fluids, so kissing is safe unless you’re the kind that engages in ferocious kissing practices or you both have oral lesions.
Abstinence/Celibacy remains the best form of prevention when it comes to HIV and other STIs. Unfortunately some people have serious beef with pleasuring themselves. In fact, some are repulsed by the act and would rather go out and get the real thing. (Shout-out to #TeamManuela)
Strict Monogamy is next in line. Unfortunately it demands 200% trust in your partner. In my opinion, both participants need to be highly paranoid about STIs for this to work. If one slips, na to inform the other person sharp-sharp and take necessary measures of preventing the infection (if any) from taking over the body.
Then there’s the proper use of condoms. Now the problem is that for condoms to be very effective, you have to use them during blow jobs and anal penetration, and as we all know, most of us don’t perform BJs on wrapped up dicks. Like seriously, Eeewww!
Fans of cunnilingus and anilingus are not left out. You need to wear a dental dam during such activities. Basically, what I’m trying to say here is that if you intend to continue having fun with multiple random sex partners, you should be well aware of the increased risk of STIs and the need for you to get vaccinated for HPV, Hepatitis and to also get on PrEP if necessary.
NOTE: The CDC and WHO recommends that sexually active folks get screened for STIs every 3 months, even if condoms, dental dams and PrEP are involved.
Pre-exposure Prophylaxis (PrEP) is, in a nut shell, a couple of anti-HIV drugs which you need to take on a daily basis to prevent getting infected with HIV. It has only been launched in a few first world countries, though the drug is readily available in all countries. The drug combination is called Truvada. If you have a serious problem with using condoms, please do yourself a favor and get on PrEP! (Yep! The protective effect of PrEP kicks in 7 days after you start it, and you’re expected to continue with it until one month after your last sexual contact)
PrEP only protects against HIV, so condom use is still very necessary to avoid exposure to other STIs.
There’s also Post-exposure Prophylaxis (PEP). This form of prevention is reserved for people who have been potentially exposed to HIV through needle pricks, splashes of bodily fluids, unprotected sexual intercourse, rape and etc. The goal of the therapy is to prevent the HIV from taking hostage of the body and turning into a proper HIV infection.
Depending on the level of risk exposure, candidates are placed on just 2 HIV drugs or 3 HIV drugs (HAART). Personally, irrespective of the type of risk exposure, I place patients on 3 drugs.
PEP must be initiated within the first 72 hours of exposure and must be adhered to for 28 days. Candidates are expected to run a HIV test before commencing the drug, 3 months after and 6 months after before they can be deemed HIV free.
Like I mentioned in my first entry, though it doesn’t appear in any guideline, I highly recommend PEP for any one getting a blood transfusion in this country.
HIV PREVENTION IS NOT FOR NEGATIVE FOLKS ONLY
If you’re HIV positive and you’re currently on antiretroviral drugs, you need to make an effort to cultivate the habit of using a condom, as there are different types and strains of HIV. Your CD4 count and viral load might look fabulous at the moment as the drugs are working just fine to suppress the infection, but if you were to get re-infected with a different strain/type of HIV, the drugs you’re currently on might become ineffective and trigger the need to switch medication.
Switching medications in Nigeria get as e be. If you’re switched and the new drug fails to work, your matter don enter voicemail be that oh. The Institute of Human Virology Nigeria used to conduct drug-resistance testing years back, but I’m not sure whether the US government still supports it.
Finally, please if you’re diagnosed as having HIV-2, make sure your doctor does not place you on Nevirapine or Efavirenz. These drugs have been found to be ineffective against HIV 2. Unfortunately some doctors don’t have the recent HIV treatment guidelines, and as such, they aren’t aware of this.
Questions and contributions as always are welcome.
Written by Francis
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69 Comments
Mandy
February 09, 05:07‘It has only been launched in a few first world countries, though the drug is readily available in all countries.’
What does that mean exactly?
Francis
February 09, 08:38@Mandy: I mean the drug is available worldwide but only a few countries have introduced it into their guidelines for managing the HIV epidemic.
Some doctors choose to work with their country’s guideline while others choose to work with that of other countries as long as no harm comes to the patient. The Nigerian guideline on HIV is a bit slow sha but we are approaching full WHO standards.
Getting PREP in Naija is easy if you’re close to a medical doctor that can help you forge records. ?
Max 2.1
February 09, 08:48I heard PReP costs a fortune, so don’t even bother @Mandy..
Francis
February 09, 08:59@Max costs a fortune if he lives in obodo oyibo. For Naija here na free thanks to US tax payers.
Max 2.1
February 09, 09:02???
Max 2.1
February 09, 07:20@Francis, your paranoia has no end.. Tueh. I’ve never heard of HIV infection through Bj though, unless you have cuts/wound in your mouth and someone jizzed inside, I don’t think its as bad as you make it out to be(your own paranoia for sex is something else). I like your last paragraph, a lot of people don’t know about it, so it’s good you shared it.
Advice from a concerned fellow- Go out there and have some fun, the world isnt as gloomy as you make it out to be ☺☺..
#Chestnut
February 09, 07:50Max…YOU? #BloodOfJesus!
Max 2.1
February 09, 08:24Ummm, hello!!. I’m no saint.. Haven’t you been tracking his comments since he started commenting here? Dude is clearly paranoid AF.. Doesnt wanna get heart broken(fear of rejection), doesn’t wanna meet anyone for fear of kito, doesn’t wanna show anyone his dick let alone have sex.. He actively avoids people in general and I’m worried.. Paranoia is Good, saves your life more than you know it, but “too much” paranoia just limits you and leaves you in a cage, unable to be free and enjoy life.
Francis
February 09, 08:57????????? Max I’m making small effort to meet pipul now na. I can’t make the switch from introvert to extrovert overnight. I still have a lot of baggage to offload and hopefully the few people wey I don meet go understand.
Baby steps man. ?
Francis
February 09, 08:49@Max: Precum dey tied to BJs and HIV has been isolated in Precum so……. I’m not trying to make sex look bad. Just saying it as it is so everyone is aware of the possible risks invoked. Sugar coating some things just worsens the situation.
For some of us, our sexual behaviours (can’t think of a better word now) aren’t medically acceptable and behaviours can be quite difficult to change for some people. I can’t goan be giving myself unnecessary palpitation each time I engage in hot casual sex. My last experience was exhausting enough.
I’ve been doing just fine with my hands ?
bryannn
February 09, 08:32Nice one Dr. Francis, how do i get in touch with you???
Francis
February 09, 08:58@Bryannn you can get my email from PP.
Cerio
February 09, 09:07Good information you’ve given.Please how can someone get the HPV vaccine in this country?@Francis.Thanks
Francis
February 09, 09:11@Cerio no idea man. I’ll have to ask the consultants I work with when I resume work soon
simba
February 09, 09:15Hi Francis awesome work continue…IHVN still carry out the resistance test,but only in their research clients…we do get the results with attached possible switch…. I love what u doing,continue dear… as per HPV vaccine, tricky as per supposed to be given before sexual exposure,but there is a protocol ongoing to twist it ,if it’s gonna be effective in sexually exposed individuals as non exposed..
Francis
February 09, 09:22@Simba Thanks man. Just my small contribution to the community.
Looks like you work closely with IHVN. I still miss dem. MSH came and took over and started dulling person small small.
You seem to have better info on this HPV ish. Come do small post for us na. I’d like to know more about it.
simba
February 09, 09:51My dear @Francis… we can privately exchange ideas. I ‘ll leave the writing to u,cus am not that good lol. Yah,currently I work with them,in an MSM based project.. we can synergies and help the community, I have helped some here done CD4 and VL free in the clinic.. theses are small things we can offer.. PP can give u my phone number
Francis
February 09, 10:02Thanks man. I’ll do that ?
Law
February 09, 09:30The HPV vaccine is quite expensive but its importance cannot be overemphasized. I did mine last october. there are two injection doses spread within a few months
Francis
February 09, 09:36@Law bros well done. More info pls. Like actual cost, location … Any info wort having. The thing dey fear me somehow as e no even need sexual contact to spread
Max 2.1
February 09, 09:52Francis ?????. tufia
Khaleesi
February 09, 11:14thanks so much Dr. Francis!! this is highly useful info …
Francis
February 09, 12:48@Khaleesi you’re welcome
Jamie
February 09, 12:24Thank you, Francis.
So, is it true that the partner of a HIV man who’s on drugs does not really need PrEP anymore like someone told me months back? I am paranoid about just condoms, cos they break; I would wear them even if I was on PrEP anyway…but I need anything like a vaccine…a protection. At the end of the day after my request, I was made to look like the one discriminating and asking for too much.
Jamie
February 09, 12:26*I intended to write ”HIV Positive”, not HIV man. I dunno how the plus got lost…
Francis
February 09, 12:48@Jamie: You still need PREP my dear. Just because he’s on drugs doesn’t mean the drug is actually working and his viral load is down.
Even when one’s viral load is down, there’s still a risk of getting infected from that person thus the need to continue using a condom (if you can) and staying on PREP.
That said I’ve encountered several couples that don’t use PREP or condoms and the uninfected partner is still negative months/years after. Those ones are probably immune to HIV.
Max 2.1
February 09, 13:18Chances of being immune to HIv is pretty low and the subset of people who have been discovered to be immune to it aren’t even in Africa. The viral load greatly affects chances of infection..
simba
February 09, 13:30Max dear… there are it’s just about a single gene… even in my clinic…most Clients have being found never likely to be infected….it’s time we don’t be biased cus of some foreign textbooks who never conducted effective researches in Africa..
Francis
February 09, 13:48Lol. Conducting research for Naija na wahala talkless of submitting the report of that data to the international community
Max 2.1
February 09, 17:35You don’t say…@ Simba..
Francis
February 09, 13:46@Max : Just like my physiology lecturer taught us, beware of chopping what the textbooks feed you hook line and sinker. What you see in real life is sometimes contrary to what you read in books.
Dickson Clement
February 09, 14:32The CCR5 receptor mutation has been reported in some part of Africa too. In addition to some parts of Europe. I can’t remember which east African country this mutation was found but this CCR5 or CD195 is a transmembrane protein and it is what the HIV virus needs to get into the cells! So people with this mutation are resistant to HIV 1, and have slower progression to AIDS. The HPV Vaccine is called cervarix ( that’s the one I’ve seen), and in my centre it was used for WOMEN alone. Gardasil is another one but it’s in literature. I am yet to see it. I won’t bother about getting that vaccine personally because HPV has over 40 strains and the vaccine was only targeted against the strains implicated in cervical cancer. I don’t have a cervix.
Francis
February 09, 14:35????? @ I don’t have a cervix.
My wahala with the HPV is catching the one that causes cancer or the one that leads to warts all over. I saw a pic of one victim on LIB and fear catch me one time.
Dickson Clement
February 09, 14:50@ Francis! Good job!! If there is a vaccination I recommend for men, it will be Hepatitis vaccine (HBV vaccine) , it’s around 5k in Enugu. Go to old UNTH, that one is available there. It’s about 3 injections, 6months apart. Liver disease is on the rise and I can confidently say that during this my service year, I see about 3 new cases of hepatitis infection weekly. I really wish I had Internet on my system, I’d have loved to talk about hepatitis. It’s becoming something serious. Any derangement in liver function, the patient is placed on antiretrovirals, interferon alpha costs over 100k for a week. treatment. So, I am yet to see a guy with anal cancer, so HPV for guys is nothing but warts worry!!
Francis
February 09, 14:57Tah! Find time abeg. If your laptop no get internet access, just type the post in word, copy to ya phone and then send to PP. Problem solved. ???
Seriously though, pls write about this hepatitis thing since you already have first hand experience. The ones I see in the clinic, I refer to the gastroenterologist to tackle. The management get as e be.
Dickson Clement
February 09, 14:57@ Francis, before someone can have fulminant warts like that, there will be an underlying immunosuppression- say the person is starving, or not eating a healthy diet, or has HIV, or diabetes, or other chronic diseases. For emphasis, if you have had sex at all, there is 90percent change u have HPV infection already. The other question is – which strain? Over 80percent of sexually active persons have the infection. Even children do present with flat warts sometimes when they have fever. It clears out with time
Francis
February 09, 15:07Hmmmm, this your data scary die. Reminds me of when I thought I had a wart under my arm. I summoned courage to block the dermatologist months later and she said it was just a skin tag. Phew!
Pink Panther
February 10, 00:41Lol. Max is right. You have a serious case of paranioasis. 😀
Francis
February 10, 00:50@PP: Every man with him own disease ??
Francis
February 09, 14:59For some reason I keep postponing going to get that hepatitis vaccine …. Just like I play with the one for meningitis. ??
KingBey
February 09, 17:05Good to see a medical Dr who is conscious about safe sex and not a hoe. The ones I know are unrepentant hoes and don’t even care about slipping on a CD during sex. I was beginning to wonder maybe being in the medical profession gives an immunity against sexual infections. Biko, what’s the difference between HIV 1 and 2 and which one is prevalent in Africa?
Francis
February 09, 17:11Serious shading. Lol. You guys seem to forget that we are human beings first then doctors. ?
HIV 1 is global and HIV 2 is predominantly in West Africa
KingBey
February 09, 17:24Okay. Thank you Doc. No shade o. Just my experiences with Doctors I have met.
Geeluv
February 09, 18:03I quite agree with Max… Oga Francis please enlighten us more about the mouth stuff advance microbiology teaches something different “that the virus can’t be contracted through the Oral route”… please more on this Ooo. I love Bj ?…
Francis
February 09, 18:10Like Max said, you don’t have to worry much about precum unless you have sores in your mouth. The risk of transmission is low if you don’t have sores.
goldd1st
February 09, 18:48Hi Dr Francis…interesting topic ….but mi question goes like dis……a vry close frnd of mine is hiv+ n he is gay bt nt having sex again…before that he found out that his throat is always bitter…now he is taking d drug…n still yet…he always complain that the throat is still bitter….I told him to meet his doctor and the shot me out…..anyway does d drug give dis type of side effect or his just anoda disease?….and again can u pls explain this HIV2 tin….thanks
Francis
February 09, 22:35@Goldd1st: He needs to have his doctor or an ENT specialist check out his throat. He could be having a chronic throat infection. That’s all I can think of right now. HIV comes with so many complications that’s why we always manage patients with the help of other specialists.
With regards to more info on HIV2, being on HIV drugs doesn’t mean you are covered. There’s need for monitoring to make sure the drug is working or failing. Unfortunately most patients don’t have access to that kind of monitoring. Some centers just give you drugs and send you on your way. Due to genetic make up and other factors some HIV drugs just don’t work for certain types of HIV and that’s what I was trying to explain in the last section of this post.
Instead of relying on monitoring services, just make sure you are not placed on Nevirapine or Efavirenz if you have HIV-2. There’s nothing as painful as popping pills for nothing ?
How does one know what type of HIV he has? Well some labs always specify it in the results and some don’t. So if you’re lucky and yours does, just take note.
Hope that answers your question.
ELI
February 09, 19:40A medical series on this blog is long overdue. there is so much info that we need to protect ourselves. There is very health info for gay men in our part of the world. i applaud your efforts Francis. #DR-FRANCIS!
Francis
February 09, 22:38@Eli Thanks ?
tarter
February 09, 21:38how do i get prep drugs ?
Francis
February 10, 00:38@Tarter: Like I said to Mandy, getting PREP in Naija is easy if you’re close to a medical doctor that can help you forge records. It involves faking you have HIV and making sure you’re placed on a particular drug regimen.
NOTE: PREP is not beans. If you are not good at popping pills on a daily basis, it is to be avoided completely.
grass
February 09, 21:43doc Francis, i have lil blisters and bumps on my glans and penis,it goes and comes back..itchy sometimes n reddish
Francis
February 10, 00:32@Grass: You have a see a doctor in person for proper diagnosis. It could be anything like say Herpes etc
the second francis
February 09, 22:59Thanks for the education….how can I contact u? @ francis and simba..reaLly wana know about dis HPV…is it related to swollen nodes all over…
Francis
February 10, 00:48@Francis: You’re welcome. Simba and Dickson are your guys as they seem to know quite a lot about HPV than I do. With the little I know, I wouldn’t relate generalized lymph node swelling with HPV. HIV and Lymphoma would be the first thing that comes to mind, if I were to come across such a case like yours.
P.S: Could you pick another Name for your comments to avoid confusion? Thanks ?
Canis VY Majoris
February 09, 23:21Insightful post. I have a few “hypothetical” questions.
So, there’s this dude who’s been with his bf for a year and half now, and a few months ago they mutually agreed to ditch the condoms for whatever reasons. But here’s the comma (,) the said bf is “bisexual” with an obvious gf who he plans to marry, or so he says. However, the said bf has more than once assured this dude that he still uses condoms with his hag, but the dude is still worried as there’s a “3rd party” involved and apparently there are more than 1 ways to acquire STIs and STDs sexually.
So hypothetically, should this dude just go on PReP anyways to replace the condoms?
Francis
February 10, 00:29@Canis: He’s better off keeping the condom IMHO. I don’t see a need for PREP now as par there’s no serious visible threat in sight…..plus taking PREP no be small decision.
If he succumbs and decides to ditch the condoms for le boo, then PREP is a MUST! At least he will be covered against one STD
Francis
February 10, 00:30P.S: Bros the use of that word hag get as e be na .
Wayfaring Stranger
February 10, 01:33** chuckles**
Dickson Clement
February 10, 10:55If people can learn that trust is a risky semantic in this concern. I wouldn’t advise you to go off the condom for any reason. Unless u are willing to risk everything for this guy! If not, don’t do it.
Max 2.1
February 10, 12:26Using condom is a must, you could get urinary tract infection which is painful as hell and you’ll be passing out blood in your urine(I’ve experienced this) and you’ll be wishing and praying for it to go away, but it won’t.. And then you’ll do the walk of shame to the doctor’s office where he’ll query you about your sex life.
Please condom is a must, HIV isnt the only reason to wear it. Before you start diving in Without wearing anything, make sure you two are married, then have taken dozens of tests for all STI’s for like a year, make sure you’re both faithful to each other and take anti-biotics to kill the bacteria in your rectum (E-coli I think) that causes UTI.
Enigma
May 17, 07:57I have a friend that is HIV positive and has HPV. (Warts) he told me he has started taking medics for like 2months now but he’s still got the warts and he’s shy to tell the female doctor. When he finally told the Dr, d woman said its not a serious issue that the guy has to come to d clinic so she could see it but you know its really embarrassing showing ur cake to a female doctor.. Lol.. The question is, could the wart go since he’s been taking his medics, he’s been abstaining and d viral load is possibly reducing?
Francis
May 17, 09:20The warts won’t go on their own. He needs to have them taken care of either by freezing them off or burning them off. He should see his doctor and i really don’t see any wahala there in seeing a female doctor.
It’s not like female patients enjoy exposing their body parts to male doctors especially in obstetrics and gynaecology
INDIGENE.
May 17, 19:00Francis.. lost your mail Address… need it please
Francis
May 17, 19:30Just ask PP for it
Lyon
October 27, 14:22Dear Francis, how can I get some private online chat with you? I’d like us to talk about stuff.
Francis
October 27, 14:29Send me your email address via the admin and I’ll buzz you on HangoutsI app Android. Make sure you have the app installed.
Calmly
March 05, 16:39Dear Francis, how can I get some private online chat with you? I’d like us to talk about stuff.
Francis
March 05, 17:32No online chat oh. Just email which you can get from Pink Panther