Humiliated in A&E

50attemptaways

I wouldn't normally feel the need to ask for advice about much, but I'm really upset and confused about what to do next so here goes nothing, if a more suitable forum is appropriate please let me know.

I won't go into details for obvious reasons but long story short I had unprotected sex, with someone I know, I don't know the person that well however and we haven't been in contact since it happened.

I was thinking I might need to get the Post-Exposure Prophylaxis (something to prevent potential HIV I hadn't learned of till recently) to be on the safe side. This has been giving me alot of anxiety and I didn't sleep much at all. I finally decided to go to A&E and as I pretty much got nothing done and couldn't stop thinking about it.

Firstly this was pretty hard for me to do, as I felt ashamed I had found myself in this position, now I'm going to have to share a bunch of really sensitive sexual stuff with a bunch of strangers. I saw online they had these kits in A&E so I thought they might have a procedure around this, hopefully subtle.

I was there for a total of 6 hours (it is A&E after all). The drug has less potential to be effective as time goes on, once I learned I was in a less time critical queue I spoke about this to the triage nurses, though I finally seen to not that I was changed queue.

I was seen to by a GP, we initially shared the brief details of what happened, then the GP immediately stated I had come to the wrong place.
The GP said I needed to go to another clinic I had heard of, however this clinic was typically 9-5, and this was time sensitive.
I stated those places have limited opening hours, the GP replied this was not the case.
I then asked, are they 24hours? i.e. could I go in now?
The GP replied again with no, and I said so they are limited opening hours.
The GP because visibly angry at this and began shouting at me, saying not to be "getting smart".
At this stage I was pretty shocked, I used to work in a trade that involved speaking calmly with drunk people who often complained about no longer being served drink, so I know how to handle people shouting at me and usually take it quite well.
I calmly said (though I'll admit my voice was quivering at this stage), please stop shouting at me, its really unprofessional.
To which the GP ignored and continued to shout, stating this is a busy A&E and that I had already waited 2 days to seek help.

At this stage I asked for the GP's name as I wanted to report this, to which the GP refused, repeatedly.
I didn't really feel safe being treated by this GP anymore (obviously) so I left the room stating I wouldn't sit there and be shouted at while sharing sensitive information like this.
To which everyone in the patient waiting area, 15-20 people noted, and stared...
I talked to the nearest person a nurse, to please let me see someone else. The nurse would also not give me the GP's name.
The GP then suddenly lowered voice to a whisper while talking to the nurse and said I was very upset and to bring me back in the room (I was clearly crying at this stage and was visibly shaken)

To which the nurse ignored and brought me to a room away from the GP, I said I no longer felt safe around this person and would not be seen alone with the GP.
I then went on to explain what happened to the nurse and the nurse went away.
Soon after I had collected myself somewhat, the GP came back on their own and tried to close the door.

I attempted to exit, then another unknown staff member attempted to mediate between us. I noted the GP's ID badge after as this time the GP had forgotten to hide it.
The GP noticed that I had noted the name badge and immediately hid the ID badge with a clipboard, to this I exclaimed you must know you're in the wrong if your willing to hide your name.
The GP then flipped their badge over while I kept asking for the name, and stated how can I be treated by a GP and trust anyone, if they won't even give me their name.
The GP finally agreed to give me his name and I took note of it, we then entered the room with the mediator.
I explained that the GP became irate when I stated the suggested clinic had limited hours to which the GP stated never started shouting and that I had began "screaming", to which the GP said repeatedly.
I refused to shake hands as at this stage the GP had proved there was no credibility and is clearly willing to lie
The GP then suddenly had HIV preventative meds I needed and that here they were and I asked some basic questions about them.
After which the GP tried to then talked about the shouting and how I began "screaming".
I said theres no point in discussing this as we clearly won't agree to the real timeline of events, and that you have other patients to see.
To which I left after getting the basic details.
I could barely keep myself together at this stage, once I drove out of the hospital I began crying.

This kind of ****e is hard enough as it is without having to deal with this hassle, it has me stressed like **** with anxiety about the whole thing.
Am I being unreasonable here? Was this as ****ed up as it felt? Who can I complain about this to? I don't have alot of faith in the HSE to resolve this. This shouldn't happen to anyone else.

TLDR; Went to get HIV drugs, GP told me they didn't have any, got angry and began shouting at me, lied, then suddenly had the HIV drugs.

smelly sock

Hey sorry for your troubles.
My adivce is that this is stressful enough time in your life.

Forget about that doc and get on with taking the meds.

I presume you have taken a test etc.

Best of luck.

Tenigate

GPs have guidelines on when to offer pep. Unless you were with a person who definitely has hiv, or someone in a very high risk group, you will not be offered it. I'm sure the doc did his risk assessment and gave you your advice: pep is not for you. You're in the wrong place. Go to an sti clinic.

Sure his bedside manner sounds poor, but as you started arguing with him (in his view shouting), it sounds like you escalated matters considerably, culminating with the old chestnut "i don't feel safe"

I'd be fairly confident they gave you the pills to get rid of you.

notsoyoungwan

You waited two days to seek the PEP you thought you needed, then went to an emergency department and got annoyed when they didn't triage it as an emergency and you were in 'a less time critical queue' and then you got stroppy about being called out on turning up in an emergency department 48 hrs later instead of going to the STI clinic during their opening hours??? I can see why the doctor would be annoyed, tbh.

December2012

You probably should have gone to an STI clinic. There was no point in giving out to the staff that couldn’t treat you.

I hope you don’t get sick.

Are you focusing on this instead of worrying about having caught something? Hopefully you’ll be fine and can chalk this all up to experience.

Meauldsegosha

50attemptaways wrote: »

Am I being unreasonable here?

Yes.

50attemptaways wrote: »

Was this as ****ed up as it felt?

No.

50attemptaways wrote: »

Who can I complain about this to?

No one

You went to an A&E department which is already stretched with neither an accident or emergency when you should have gone to a STI clinic. You are part of the reason there is a 6 hour waiting time in A&E.

50attemptaways

Thanks for the reply everyone, its good to get some perspective on this.

Just to be clear it was a little over a day after the event not 48 hrs, as I was hoping to get more history on the persons sexual history, which I could not in the end, my mistake here was not just going straight to a clinic on the day.
As for attending A&E, I only did so on the advice of HIV Ireland, I thought this was far more normal than it clearly is.

I still take issue with the GP lying about me screaming, but at this stage I feel a lot better after a good nights sleep. Thanks again for the input everyone, lessons learned.

LLMMLL

Completely disagree with everyone here.

It's standard practice to get initial doses of PEP from an emergency department and then follow up with a clinic after if that clinic is out of hours.

Sure by waiting two days the OP didn't act in the most perfectly responsible manner but I think that's pretty understandable.

It's not clear whether the dr is misinformed and thinks PEP should only be issued by STI clinics, or if he did the proper assessment and judged that it was not right for the OP. Regardless he should have acted professionally.

Xterminator

Hi Op

I agree that your case was not best seen to in the A&E department.

In your own words you went in 'feeling ashamed' and in a bad frame of mind, and everything after just aggravated you. Could the doctor have handled things better - i think so. could you have handled things better - i think so.

Im not sure what redress you would like? Do you plan to offer an apology the the A&E dept for the time & resources used, to see you and the additional stress placed on the people working there, in an already stressful workplace?

of course not, nor would they expect this. Why would you think they should do so?


here is the A&E guidelines - from UK but still points are valid.

What counts as an emergency?

A&E departments are for patients with serious and life-threatening conditions.

If someone is obviously in danger – for example, they are experiencing chest pain, blacking out, bleeding, choking or the early symptoms of a stroke – they should be taken to hospital as quickly as possible.

Serious allergic reactions, severe burns, difficulty breathing or severe abdominal pain down one side are also all reasons to seek treatment at A&E and call an ambulance if necessary.

However, if it is not an emergency, consider one of the other options available to patients.

Should I call 999?

Patients unsure whether they should go to A&E should avoid calling the emergency services, but call the NHS non-emergency number, 111, instead.

never_mind

Personally speaking, I'd have gone to a local GP during the day and/or a 'Night Doc' to get a referral to A&E. Yes, PEP is administered at A&E and it is advised to take it urgently, but I think you panicked and then all logic went out the window. Doctor could have acted more appropriately and you could have acted more sensibly.

I'd draw a line and move on - no one was really at fault here - just a stressed person adding stress to already stressed doctors!

Tenigate

Xterminator wrote: »

here is the A&E guidelines - from UK but still points are valid.

Actually, the op was right to go to seek medical attention (although doc on call would be a better option than A&E). She didn't know whether she needed urgent care or not. That's why we use doctors.

The op states "we initially shared the brief details of what happened, then the GP immediately stated I had come to the wrong place".. end of consultation, 5 minutes max, right?

Instead, the op insisted on a prescription which she learned about from Dr Google, started complaining to an overworked GP about the opening hours of the clinic... in the end the op wasted the time of the doctors, nurses, a "mediator" (i.e. another staff member), and 15-20 people who were sitting in the A&E waiting their turn to use the hospital staff.

I'm not trying to pour salt in the op's wounds. Just stating a fact. Op can't control the GP's behaviour but she can control her own.

LLMMLL

It is advised to go to A and E for our of hours PEP. I've never seen it recommended to look for an out of hours GP first. It's a very time sensitive matter. I don't know if an out of hours doc would even have access to the initial doses needed.

Everyone knows that docs have a stressful job but if that doc puts someone off taking PEP who really needs it through his dismissive attitude then that's a major problem.

never_mind

LLMMLL wrote: »

It is advised to go to A and E for our of hours PEP. I've never seen it recommended to look for an out of hours GP first. It's a very time sensitive matter. I don't know if an out of hours doc would even have access to the initial doses needed.

Everyone knows that docs have a stressful job but if that doc puts someone off taking PEP who really needs it through his dismissive attitude then that's a major problem.

The usual scenario for A&E in non-emergencies is going to an out of hours GP and get referred to it. While this can be seen as an 'emergency' you could say a lot of medication is time-sensitive. If something isn't hanging off you, you are better off going to a GP first and take on their advice before going to overcrowded A&Es.

The OP made a bad decision then waited 2 days to go into an A&E. They should have gone to a GP first.

Whatever the case, I wonder if PEP should be administered by pharmacists much like the pill.

gctest50

LLMMLL wrote: »

..........

Everyone knows that docs have a stressful job.......

So aircraft mechanics, pilots , atc an so on

853 passengers in an a380

nilescraneo

I've been told by STI docs in GMHS to attend A+E for pep within 48 hours (it's also in all HSE STI prevention literature) if you think you have been at risk of an exposure to HIV. So not sure why everyone is criticising OP for doing so.

I think the reason a pharmacist can't dispense it is due to the meds high cost and side effects of the drugs, so docs need to assess if patient really needs it.

Tenigate

gctest50 wrote: »

So aircraft mechanics, pilots , atc an so on

853 passengers in an a380

imagine if passengers started banging on the cockpit door because they weren't happy with the speed or altitude because they learned otherwise from google or flight simulator..... they'd probably be restrained and arrested on landing.

never_mind

nilescraneo wrote: »

I've been told by STI docs in GMHS to attend A+E for pep within 48 hours (it's also in all HSE STI prevention literature) if you think you have been at risk of an exposure to HIV. So not sure why everyone is criticising OP for doing so.

I think the reason a pharmacist can't dispense it is due to the meds high cost and side effects of the drugs, so docs need to assess if patient really needs it.

Yep, I know the GMHS tell people this but really if you have had unprotected sex you can make it to a GP in 48hours to be referred to an A&E - this will also mean not paying the 100 euro fee for presenting without a referral.

LLMMLL

Tenigate wrote: »

imagine if passengers started banging on the cockpit door because they weren't happy with the speed or altitude because they learned otherwise from google or flight simulator..... they'd probably be restrained and arrested on landing.

You can make up all the dodgy analogies you like and compare it to other medical situations but the fact remains that the standard advice given by STI clinics in Ireland is to attend A and E for PEP if it's outside clinic operating hours. The OP did nothing wrong by attending.

Mr. Incognito

I'm sorry but this is ridiculous.

You had unprotected sex with someone.

Then you freaked out that you had HIV.

Then you went to an emergency department without a referral from a GP.

Then you demanded emergency HIV meds which are very expensive.

Then you threw a strop when the doctor, quite rightly told you not to waste their time and go to an STI clinic.

Then you threw what appears to be the mother of all hissy fits until they gave you the meds to go away.

You sound like a ridiculous dose of drama.

Please use protection the next time because you really seem to think that emergency services exist to service your needs and not genuine emergencies.

Neyite

50attemptaways wrote: »

Thanks for the reply everyone, its good to get some perspective on this.

Just to be clear it was a little over a day after the event not 48 hrs, as I was hoping to get more history on the persons sexual history, which I could not in the end, my mistake here was not just going straight to a clinic on the day.
As for attending A&E, I only did so on the advice of HIV Ireland, I thought this was far more normal than it clearly is.

I still take issue with the GP lying about me screaming, but at this stage I feel a lot better after a good nights sleep. Thanks again for the input everyone, lessons learned.

This sounds like it's advice to be taken when someone has actually been exposed to HIV. You have no proof that the person you had sex with has any STI. You panicked and you went to the wrong clinic.

However, the conduct of the doctor in A&E does sound unusual and unprofessional so if you wanted, you could contact the HSE or the hospital's complaints department to ask them to review the incident in line with their policies for staff & patient interaction. Part of the A&E job is dealing with the folk who are there for non-emergencies and being time-wasters and if this doctor cannot communicate that to those folk without shouting then tbh, he should not be near vulnerable patients.

TallGlass

Just out of interest. Does a doctor or nurse have to give you there name if requested?

I don't think either party's let alone a doctor should be shouting at either other in an A&E. Regardless of the situation. Its not exactly professional. There are actual critically ill patients after all there so a bit of respect from both parties wouldn't go a miss.

LLMMLL

Neyite wrote: »

This sounds like it's advice to be taken when someone has actually been exposed to HIV. You have no proof that the person you had sex with has any STI. You panicked and you went to the wrong clinic.

Sorry but that's not correct. You're more likely to get PEP if you don't know you've been exposed to HIV. It would be extremely rare to be exposed to HIV and know about it. If a person is aware they have HIV they'll be on meds to reduce their viral load and would be very unlikely to pass it on to another person. You would usually be given PEP for certain kinds of unprotected sex where you have no knowledge of the HIV status of the person you've slept with.

Can we just out this to bed now? Apart from waiting 2 days to attend A and E the OP did nothing wrong by attending there and followed the advice of STI clinics themselves. It's getting ridiculous at this point.

gctest50

Mr. Incognito wrote: »

.......

Please use protection the next time because you really seem to think that emergency services exist to service your needs and not genuine emergencies.

Not getting AIDS is a bit of an emergency

Small window of time for medication

How long does it actually take to sort out and administer said PEP ?

Would she have got better service if she showed up with " Hi, I'm 3 months pregnant and I think I felt something weird ... "

never_mind

LLMMLL wrote: »

Can we just out this to bed now? Apart from waiting 2 days to attend A and E the OP did nothing wrong by attending there and followed the advice of STI clinics themselves. It's getting ridiculous at this point.

Sorry but this is an advice forum and the OP came here looking for perspective - this is what posters are giving.

The OP should have gone to a GP and/or clinic first before attending A&E in my view - this is what PI is all about!

LLMMLL

never_mind wrote: »

Sorry but this is an advice forum and the OP came here looking for perspective - this is what posters are giving.

The OP should have gone to a GP and/or clinic first before attending A&E in my view - this is what PI is all about!

But your opinion directly contradicts professional advice. The OP is looking for advice about an interpersonal issue he/she found embarrassing. Peoples incorrect opinions on whether they should have attended A and E are ridiculous.

njs030

gctest50 wrote: »

Not getting AIDS is a bit of an emergency

Small window of time for medication

How long does it actually take to sort out and administer said PEP ?

Would she have got better service if she showed up with " Hi, I'm 3 months pregnant and I think I felt something weird ... "

No a medical emergency is a heart attack, stroke, suspected appendicitis and so on.
A window of 48 hours to attend a GP or sti clinic is not an emergency to present yourself at A&E and demand to be seen faster!
It's similar to going to A&E for the emergency contraceptive pill to avoid pregnancy because it's time sensitive.


And yes a pregnant woman gets seen fast because it's a MEDICAL EMERGENCY!!

Did I miss where op stated they were female?

Neyite

LLMMLL wrote: »

Sorry but that's not correct. You're more likely to get PEP if you don't know you've been exposed to HIV. It would be extremely rare to be exposed to HIV and know about it. If a person is aware they have HIV they'll be on meds to reduce their viral load and would be very unlikely to pass it on to another person. You would usually be given PEP for certain kinds of unprotected sex where you have no knowledge of the HIV status of the person you've slept with.

Can we just out this to bed now? Apart from waiting 2 days to attend A and E the OP did nothing wrong by attending there and followed the advice of STI clinics themselves. It's getting ridiculous at this point.

HIV Ireland and STI clinics recommending that people ask for a service that A&E do not provide? They are basically saying that everyone who has unprotected sex and is potentially exposed to an STI should go to A&E? Really?

The morning after pill for women is also extremely time sensitive. And a few years ago before it was an over-the-counter medication, that meant we had to wait for an appointment with our GP, go and pay for it, get the prescription and pay for that, to get our medications. A&E would also have told any woman presenting for the MAP that they were in the wrong clinic, and to leave.

This is not much different.

LLMMLL

Neyite wrote: »

HIV Ireland and STI clinics recommending that people ask for a service that A&E do not provide? They are basically saying that everyone who has unprotected sex and is potentially exposed to an STI should go to A&E? Really?

.

For a gay man who has unprotected sex absolutely.

amtc

Just for the sake of being nosy I googled STI clinics and there are some open till 9pm and Saturdays. Much more efficient use of time.

Neyite

gctest50 wrote: »

Not getting AIDS is a bit of an emergency

Small window of time for medication

How long does it actually take to sort out and administer said PEP ?

Would she have got better service if she showed up with " Hi, I'm 3 months pregnant and I think I felt something weird ... "

She would get triaged, like the OP did, talk to a doctor, like the OP did, and if there was no immediate danger, (like in the OP's case) she would be referred to the early pregnancy unit that opens 9-5, Monday to Friday.

gctest50

notjustsweet wrote: »

No a medical emergency is a heart attack, stroke, suspected appendicitis and so on.
A window of 48 hours to attend a GP or sti clinic is not an emergency to present yourself at A&E and demand to be seen faster!
It's similar to going to A&E for the emergency contraceptive pill to avoid pregnancy because it's time sensitive.


And yes a pregnant woman gets seen fast because it's a MEDICAL EMERGENCY!!

Did I miss where op stated they were female?

your capslock is stuck

anyway CUH have this :

If a patient presents to ED Triage for PEP Mon‐Fri 9am-4.30pm, the triage nurse should contact ID CNS (087 XXXXX272) or ID SpR (bleep X03).   Outside of these hours this protocol should be used to assess the need for a HIV-PEP starter pack which should be dispensed and administered to patient if warranted. 
Follow-up with Infectious Diseases is extremely important and should be arranged as detailed below prior to the patient leaving the Department. 

Neyite

LLMMLL wrote: »

For a gay man who has unprotected sex absolutely.

It's medication that should be taken within 48 hrs.

The op states that it was a little over a day since exposure.

He (might be a she, the OP didn't state sex, so you shouldn't assume it's a gay guy) waited an additional 6 hrs and complained that they weren't in a more urgent triage queue.

He (or She!) had plenty of time to go to an STI clinic and get the medication in time. That's why the doctor referred them elsewhere.

njs030

gctest50 wrote: »

your capslock is stuck

anyway CUH have this :

Making smart comments doesn't make your point any better.

A pregnant woman with pain is a medical emergency yes.
A person with a 48 or 72 hour window for medication isn't.

Mr. Incognito

https://www.hse.ie/eng/health/az/H/HIV-and-AIDS/What-are-the-treatment-options-.html

t is sometimes possible to halt the development of HIV in the first 72 hours after exposure. This is known as post exposure prophylaxis (PEP). PEP involves taking anti-HIV medicines for four weeks.

PEP is often used when a person knows they have been exposed to HIV. This could be because they had sex with someone who they knew had HIV and the condom broke, or they were accidentally stabbed with an HIV-infected needle.

PEP is not guaranteed to work and the medicines that are used cause some unpleasant side effects, such as nausea, vomiting, diarrhoea and headaches.

If you are concerned that you have been exposed to HIV, immediately contact your local accident and emergency department or GUM (genitourinary) or sexual health clinic.

From the HSE Website. The do recommend going to A & E in fairness.

LLMMLL

Neyite wrote: »

It's medication that should be taken within 48 hrs.

The op states that it was a little over a day since exposure.

He (might be a she, the OP didn't state sex, so you shouldn't assume it's a gay guy) waited an additional 6 hrs and complained that they weren't in a more urgent triage queue.

He (or She!) had plenty of time to go to an STI clinic and get the medication in time. That's why the doctor referred them elsewhere.

Its effectiveness decreases with time. It's not a case of taking it anytime between 0-48 hrs guaranteed to work but taking it at 49 hrs guatanteed not to work. It's recommended to get it as early as possible with best results if taken within 48 hrs.

So no, the doctor absolutely should not have referred them onwards based on that criteria. There may have been other reasons why they did so but sounds more like he's an ignoramus.

Neyite

Mr. Incognito wrote: »

https://www.hse.ie/eng/health/az/H/HIV-and-AIDS/What-are-the-treatment-options-.html



From the HSE Website. The do recommend going to A & E in fairness.

They do, AND they also suggest you contact your local GUM.

They also state in their triage system that you can get referred elsewhere:

Patients are assessed by the Triage Nurse and given a priority rating which will determine the urgency with which they are seen. The Triage Categories are outlined below.

• Category 1 – immediate attention
• Category 2 – very urgent treatment
• Category 3 – early full assessment
• Category 4 – needs to be seen but can wait
• Category 5 – can be seen elsewhere

The OP states that just a day had passed since exposure. That's what, 12 or 24 hrs at the most. They were triaged as a category 4 most likely by the triage nurse. Being 12 hrs into a 72 hr window is NOT urgent.

Then the OP complained that they weren't in a more urgent queue. That was unreasonable of them. They were not an urgent case. Time sensitive certainly, but not urgent by A&E criteria.

When the doctor assessed the patient he likely downgraded the patient to a category 5. This is all correct procedure. They are not going to hand out scarce and expensive medications to people who have time to get it prescribed elsewhere. Because that means that the next patient coming in the door needing the same and who does NOT have the time the OP did, can get it right away.

What was not normal procedure was the way the staff handled the OP.But I suspect that the OP already had their card marked by insisting they were more urgent than those that were actually urgent. T

LLMMLL

Posting general a and E guidelines isn't helpful at all. The doctor Should not have referred them onwards based on the time limit. We don't know what the decision was based on but your suggestion that as long as it's within 48 hrs it's fine is downright dangerous if someone uneducated on the matter reads it.

Neyite

LLMMLL wrote: »

Its effectiveness decreases with time. It's not a case of taking it anytime between 0-48 hrs guaranteed to work but taking it at 49 hrs guatanteed not to work. It's recommended to get it as early as possible with best results if taken within 48 hrs.

So no, the doctor absolutely should not have referred them onwards based on that criteria. There may have been other reasons why they did so but sounds more like he's an ignoramus.

No, according to the link Mr Incognito posted the window is 72 hrs. Not 48. And if you've evidence that it is guaranteed not to work in hour 49 then you should get onto the HSE pronto to get them to change their website.

The OP's exposure was 12-24 hrs max. They had time to get to the GUM clinic.

retro:electro

Mr. Incognito wrote: »

https://www.hse.ie/eng/health/az/H/HIV-and-AIDS/What-are-the-treatment-options-.html



From the HSE Website. The do recommend going to A & E in fairness.

They advocate you go if you know you've been infected. The OP didn't know, and was only speculating about infection due to having unprotected sex.
It sounds like there was a pair of them in it. A particularly narky and pressurised consultant coupled with a hysterical patient is a recipe for disaster.

LLMMLL

Neyite wrote: »

No, according to the link Mr Incognito posted the window is 72 hrs. Not 48. And if you've evidence that it is guaranteed not to work in hour 49 then you should get onto the HSE pronto to get them to change their website.

The OP's exposure was 12-24 hrs max. They had time to get to the GUM clinic.

I'm not trying to be pedantic Neyite. I know quite a bit about PEP. You are just wrong on this factual matter.

The window is 72 hrs but far less effective 48-72. Then within 48 hrs the earlier you take it the more effective it is. The wait for a clinic to open could be the difference between becoming positive or staying negative.

njs030

LLMMLL wrote: »

I'm not trying to be pedantic Neyite. I know quite a bit about PEP. You are just wrong on this factual matter.

The window is 72 hrs but far less effective 48-72. Then within 48 hrs the earlier you take it the more effective it is. The wait for a clinic to open could be the difference between becoming positive or staying negative.

As already stated it's the same as the emergency contraceptive so could women land in to A&E for it?

48 hours is quite a long time to find a sti clinic rather than overloading an already struggling emergency department.

nilescraneo

Mr. Incognito wrote: »

I'm sorry but this is ridiculous.

You had unprotected sex with someone.

Then you freaked out that you had HIV.

Then you went to an emergency department without a referral from a GP.

Then you demanded emergency HIV meds which are very expensive.

Then you threw a strop when the doctor, quite rightly told you not to waste their time and go to an STI clinic.

Then you threw what appears to be the mother of all hissy fits until they gave you the meds to go away.

You sound like a ridiculous dose of drama.

Please use protection the next time because you really seem to think that emergency services exist to service your needs and not genuine emergencies.

Such an ignorant post. HSE STI clinics ADVISE you to attend an A+E department for PEP if you are worried you have been exposed to HIV. OP did nothing wrong. Inform yourself before making such OTT statements.

Also the cost of a 1 month dose of antiretroviral meds (PEP) is far less than treating someone with HIV for life, which could be someone who read your 'advice' and didn't go to a+e to be assessed for PEP.

The statements you make about unprotected sex are none of your business and judgemental also imo.

Neyite

LLMMLL wrote: »

I'm not trying to be pedantic Neyite. I know quite a bit about PEP. You are just wrong on this factual matter.

The window is 72 hrs but far less effective 48-72. Then within 48 hrs the earlier you take it the more effective it is. The wait for a clinic to open could be the difference between becoming positive or staying negative.

All of that applies to the morning after pill in all the years I required it when it was prescription only. We still trotted off to our GP and hoped for the best because we would have been turned away empty handed with a telling off if we tried to clog up the A&E.

That aside, the doctor who saw the patient, referred them to the GUM. Because the OP was still in that 48 hrs window. The op themselves say it was "less than a day since unprotected sex." The OP had between 24 and 36 hrs to get to a clinic and still be within the 48hr window.

What you are saying is that everyone who has unprotected sex should present at A&E within 48hrs and get the drug, and that's not workable. I'll take you at your word that you know a lot about the drug so you know it's given to those who are knowingly exposed to HIV. The OP says they have no idea whether or not the partner they shagged had any STI. They also didn't state whether it was hetro or gay sex they had, we don't know if the OP was male or female. We don't know if it was a weekend or week night when they went to A&E. But the doctor who examined them knew all of those variables that determines exposure risks and made the medical diagnosis to refer the patient out of A&E, presumably because he knew that the OP had time in the morning to go to the GUM and take the medication.

lifeandtimes

Mr. Incognito wrote: »

https://www.hse.ie/eng/health/az/H/HIV-and-AIDS/What-are-the-treatment-options-.html



From the HSE Website. The do recommend going to A & E in fairness.

They say contact them, not arrive up unannounced

LLMMLL

Neyite wrote: »

All of that applies to the morning after pill in all the years I required it when it was prescription only. We still trotted off to our GP and hoped for the best because we would have been turned away empty handed with a telling off if we tried to clog up the A&E.

That aside, the doctor who saw the patient, referred them to the GUM. Because the OP was still in that 48 hrs window. The op themselves say it was "less than a day since unprotected sex." The OP had between 24 and 36 hrs to get to a clinic and still be within the 48hr window.

What you are saying is that everyone who has unprotected sex should present at A&E within 48hrs and get the drug, and that's not workable. I'll take you at your word that you know a lot about the drug so you know it's given to those who are knowingly exposed to HIV. The OP says they have no idea whether or not the partner they shagged had any STI. They also didn't state whether it was hetro or gay sex they had, we don't know if the OP was male or female. We don't know if it was a weekend or week night when they went to A&E. But the doctor who examined them knew all of those variables that determines exposure risks and made the medical diagnosis to refer the patient out of A&E, presumably because he knew that the OP had time in the morning to go to the GUM and take the medication.

It's possible the OP was assessed as not needing PEP in which case he/she wouldn't have got it at the clinic the next day.

However if the OP was assessed as needing PEP the doctor should not have referred him to wait until the clinic opened.

Il completely mystified as to how you don't get this. pEP is not 100% effective. Is more effective if you take it working 48 hrs. Even more if you take it within 24 even more if you take it within 12 etc.

Why do you think the STI clinics advise going to a and E at all? They don't say "only go on the weekends". The time frame matters hugely.

I don't have any opinion on why women couldn't get the emergency pill In a and E. That's nothing to do with what I'm saying.

The advice for gay men who have unprotected sex is to go to a and E if the clinic is closed. They may be refused PEP overall but they shouldn't be referred to a later time if they do actually qualify.

njs030

LLMMLL wrote: »

It's possible the OP was assessed as not needing PEP in which case he/she wouldn't have got it at the clinic the next day.

However if the OP was assessed as needing PEP the doctor should not have referred him to wait until the clinic opened.

Il completely mystified as to how you don't get this. pEP is not 100% effective. Is more effective if you take it working 48 hrs. Even more if you take it within 24 even more if you take it within 12 etc.

Why do you think the STI clinics advise going to a and E at all? They don't say "only go on the weekends". The time frame matters hugely.

I don't have any opinion on why women couldn't get the emergency pill In a and E. That's nothing to do with what I'm saying.

The advice for gay men who have unprotected sex is to go to a and E if the clinic is closed. They may be refused PEP overall but they shouldn't be referred to a later time if they do actually qualify.

Then op should have gone the first day instead of hanging around until the clinic closed and demanding to be seen ahead of actual emergencies.
You seem to be missing this point

LLMMLL

notjustsweet wrote: »

Then op should have gone the first day instead of hanging around until the clinic closed and demanding to be seen ahead of actual emergencies.
You seem to be missing this point

People do not always act in the objectively best way when in stressful circunstances.

Would you have any understanding for a closeted gay man attending a small regional hospital for this?

And how does it contribute to the OPs issue. Does everyone who acts imperfectly in a stressful medical situation deserve to be treated in a horrible manner by the medical staff?

And I'm sure if you had the risk of contracting HIV you'd think of it as an emergency. And the HSE does too. That's why PEP is available in a and E departments.

Neyite

LLMMLL wrote: »

The advice for gay men who have unprotected sex is to go to a and E if the clinic is closed. They may be refused PEP overall but they shouldn't be referred to a later time if they do actually qualify.

Where does the OP say they are a) male and b) gay?

They don't even state the sex of the person they had sex with.

All we know is that a person had sex with a person less than a day before the A&E encounter. That's literally all the facts we have.

In the end, despite a doctor diagnosing outpatient care, the OP got given the drugs in order to leave and stop creating a disturbance.

What would you say if that hospital had no stocks of PEP for the next patient, say, a Garda getting stabbed by a HIV+ needle or a gay guy who was unable to access healthcare for a genuine reason and was close to 48hrs since known exposure because someone with little or no risk factors stropped in order to get the meds they technically didn't need?

LLMMLL

Neyite wrote: »

Where does the OP say they are a) male and b) gay?

They don't even state the sex of the person they had sex with.

All we know is that a person had sex with a person less than a day before the A&E encounter. That's literally all the facts we have.

In the end, despite a doctor diagnosing outpatient care, the OP got given the drugs in order to leave and stop creating a disturbance.

What would you say if that hospital had no stocks of PEP for the next patient, say, a Garda getting stabbed by a HIV+ needle or a gay guy who was unable to access healthcare for a genuine reason and was close to 48hrs since known exposure because someone with little or no risk factors stropped in order to get the meds they technically didn't need?

It's absolutely possible the OP was in a category that does not qualify for PEP.

Bit your argument was based on it being ok to wait even if they did qualify which is what I was arguing against.

Either way the doctor behaved terribly

njs030

LLMMLL wrote: »

People do not always act in the objectively best way when in stressful circunstances.

Would you have any understanding for a closeted gay man attending a small regional hospital for this?

And how does it contribute to the OPs issue. Does everyone who acts imperfectly in a stressful medical situation deserve to be treated in a horrible manner by the medical staff?

And I'm sure if you had the risk of contracting HIV you'd think of it as an emergency. And the HSE does too. That's why PEP is available in a and E departments.

It's available for times when it's not possible to get to an sti clinic or for situations as described above like the gardai etc.
Not for someone who has spoken to a doctor and been told to attend a clinic the following day. The doctor knew the full story (which we don't) and made a medical decision that the op wasn't in a high risk category.

Again, no one knows the ops gender. Please stop making assumptions.

Neyite

LLMMLL wrote: »

It's absolutely possible the OP was in a category that does not qualify for PEP.

Bit your argument was based on it being ok to wait even if they did qualify which is what I was arguing against.

Either way the doctor behaved terribly

My argument was that only the doctor that examined the patient can determine the treatment based on the risk factors that were told to him and not to us.

We don't know that the doctor was negligent in this. If the OP feels that he was, then the best course of action is to write down a timeline (with specific timings) of events as detailed as possible while it's still fresh in their mind, and writing to the head of the A&E they attended to conduct a review of the doctor in question.