Hello,

My second question is: Can a wart on a finger be transmitted to the genitals or anus? After having intercourse with a regular sex partner, I noticed he had what looked like a wart on his finger. If it was a wart, should I be worried about the fact that he had his hands on my penis and also fingered my anus? Im not sure if type of warts that infect the hand can be transmitted to the genitals 

Welcome to the Forum.  I'll apologize in advance for what may seem like a complex and nuanced response.  The issue of when PrEP is maximally effective is still debated and is likely affected by a number of variables.  Drugs get to and accumulate in different tissues in the body (the rectum, the vaginal elsewhere) at different rates; in addition, different sorts of sex acts carry a different risk for infection if exposed.  The CDC, which tends to be conservative in its advice, states that PrEP, taken as directed, becomes maximally effective for prevention of HIV acquisition due to receptive rectal intercourse (the highest risk activity for HIV acquisition) at 7 days but states that PrEP is maximally effective for prevention of HIV acquired through receptive vaginal sex at as long as three weeks.  These ESTIMATES are based on drug levels measured at the site of infection, data on the relative site to site variation in risk for infection, and clinical trial data.  That said they are only estimates.  We do however also know the so-called PrEP on demand, taken just the day before a risky sexual exposure is almost as effective as PrEP taken regularly and long-term.  With PrEP on demand, the drug is started just hours before a potentially risky exposure and then for 48 hours thereafter .  Thus there is a difference between when PrEP begins to be effective in reducing risk for HIV acquisition and when it is maximally effective.  Further, as you may have noticed, while there are estimated for the effectiveness of PrEP for reactive rectal intercourse and receptive vaginal intercourse, there are simply no good data on insertive sex, in part because these exposures, on the risk continuum are somewhat lower risk, making it hard to determine firm effectiveness levers other than to say it works.  Bottom line- virtually any PrEP is helpful but, particularly for person often at risk, regular PrEP is the way to go.---

Thank you, Dr Hook!

Really quick clarification: 

Your summary is about right.  Remember however that HIV and STI transmission is probabilistic and involves, among other things, the biological "efficiency" of the potential exposure.  By this i mean that being the insertive partner in rectal intercourse is less likely to result in infection than being the receptive partner if your partner happens to have HIV.  PrEP however greatly reduces risk irrespective of the sort of exposure but, if failures were to occur, all things being equal, bottoming would be more likely to be one of the very rare PrEP failures than topping.  You are correct that, becasue failures are less common, the data on failures for insertive partners is also less.  EWH---