[Question #10438] Hiv exposure and pep
22 months ago
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had protected sex with a high class massage girl.she was coming off her period.and blood got on my lower penis skin which apparently wasn’t covered by the condom.my penis head was covered throughout. she saw me nervous after and said to not worry as she gets tested every 3 months and she’s clean.but idk this girl.. also she wouldn’t give me a bj unprotected before sex.so I guess that’s a good sign.. because im an anxious idiot I applied for pep today. My exposure was Thursday afternoon..so I would have to take the medication by tomorrow at 1:20pm.the below was prescribed: emtricitabine-tenofovir disoproxil fumarate oral 200 mg-300 mg tablet and Tivicay 50 mg tablet.is this Even necessary?
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H. Hunter Handsfield, MD
22 months ago
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Welcome back. As for your previous several questions, this was another low risk exposure with almost no chance of HIV infection. Even testing for HIV is optional and if I were your doctor, I would not recommend PEP in this situation. And don't forget an important downside of PEP: if you take it, from a lab test standpoint the time to conclusive testing to be certain you were not infected will be 3-4 months from now, instead of 4-6 weeks. Are you prepared for that delay? In any case, we are not a health care or emergency services website. We do not advise for or against PEP.
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That said, IF you are going to take it, it is really dumb to delay a decision until a reply from this forum. Every hour of delay increases the chance that PEP will not be effective. Continue your discussion with the provider who prescribed it.
HHH, MD
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22 months ago
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Thank you.. low risk in the sense that I have nothing to worry about? And can I continue sex based on this exposure? I actually did take the first dose today just to be safe before I saw this message. Was anxious and wanted to do all I can about it
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H. Hunter Handsfield, MD
22 months ago
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See my opening comment above about this being a near zero risk of HIV. As in your most recent previous thread, you tend to overestimate the chance of sexual transmission of the virus. This was low enough risk that you didn't even need HIV testing, let alone PEP. I would estimate the chance you caught HIV at somewhere around one chance in 25 million. (I'll be happy to explain that calculation if you would like.) To me, that certainly is low enough that you "have nothing to worry about" and can safely continue sex with your regular partner.
Perhaps you also would like to know that in the 20 years of this and our preceding forum, with thousands of questions from people worried about possible exposure to HIV, nobody has yet reported that they tested positive. You will not be the first. If and when it finally happens, undoubtedly it will be a genuinely high risk exposure. (Think unprotected sex with a known infected partner.)
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Still, as I said above, PEP decisions are between the exposed person and his or her doctor if he has sought PEP; having started, I am not advising you to stop, but to either make your own decision or contact the doctor or clinic where it was prescribed and discuss it with them.
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22 months ago
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Understood.. and yes I’m just trying to ease my mind.. if anyone I trust this forums opinion.. due to credentials and being the head of the CDC.. so I guess this exposure would be similar to unprotected oral sex.. also one last thing.. call doc made the prescription for this.. not an actual intake doc but online service. I took one dose today only.. iam getting stomach symptoms from the medicine already. if I stop the doses going forward I still would need 12 weeks for a conclusive test result?
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H. Hunter Handsfield, MD
22 months ago
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No, a few doses would have no effect on time to conclusive test results. If you stop now, you can have an accurate PCR (RNA test) at two weeks and an AgAb (4th generation) test at 6 weeks.
That completes the two follow-up Q&As included with each question and so ends this thread. I hope the discussion has been helpful.
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