[Question #11358] PEP Question
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15 months ago
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Hi Doctors - you guys have helped me through some tough times and expect I know the answers you will provide but I guess asking more for reassurance. Last week I was with a man who I gave Oral sex and was the receiver in anal sex; first time since I quite using PREP last year. When I asked for him to use a condom, he was already in process of putting the condom on. We had sex for a few minutes and then he stopped without ejaculating. I did not see if the condom had broken or not; I thought maybe it had as he stopped. As I was unsure, I was put on Stribild and took my first dose 12 hours later and have been diligent taking with +-1 hour everyday; they also tested me for HIV, Syphillis, and bunch of other stuff and expectedly, I was negative.. I will get tested anally and orally for STDS this week by PCR swabs at 6.5 days post even. What has me a little worried - I came down with a bad cold 3 days post event that I am still battling it.
1. I am assuming worst case scenario - he had HIV and condom broke that with PEP and no ejaculation that my risk is exceedingly low. Can you confirm?
2. I looked up Stribild and looks like a really good PEP drug. Have you had much experience with it.
3. I will get my other STI tests this week and if negative, assuming no worries there.
4. How long after I finish PEP can I get an HIV RNA test to confirm that PEP worked? I know the 4th generation Antigen test is a month later but if I wanted to know sooner.
5. Would be having a cold impact getting HIV?
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15 months ago
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Please delete my name. Sorry.
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Edward W. Hook M.D.
15 months ago
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Welcome back to our Forum. Thanks for your continued confidence in our service. Having glanced at our multiple earlier interactions, like you, I suspect that you do already know the imformation I anm about to share. Straight to your questions:
1. I am assuming worst case scenario - he had HIV and condom broke that with PEP and no ejaculation that my risk is exceedingly low. Can you confirm?
Lots of assumptions here. If he had untreated HIV (the majority of persons with HIV are currently on treatment) and if the condom broke, the risk fo acquiring HIV from a single act of receptive rectal intercourse is less than 1% even before we consider that you have started PEP which would further reduce your risk fr infection more than 90%
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2. I looked up Stribild and looks like a really good PEP drug. Have you had much experience with it.
Stribild is a well tolerated, highly effective anti-HIV drug. I would have confidence in it.
3. I will get my other STI tests this week and if negative, assuming no worries there.
Your tests for gonorrhea and chlamydia will be conclusive later this week, tests for syphilis are not conclusive until about 6 weeks following a potential exposure.
4. How long after I finish PEP can I get an HIV RNA test to confirm that PEP worked? I know the 4th generation Antigen test is a month later but if I wanted to know sooner.
The experience in following up PEP using HIV RNA PCR tests is limited however, for diagnostic purposes, PCR results are conclusive when taken more than 11 days following an exposure. I would have confdence that you were not infected based on a negative PCR about 11 days after completing PEP although, as I said, solid scientific data are not available.
5. Would be having a cold impact getting HIV?
Absolutely not
I hope this helps. Your name on this thread is the same as in your multiple other interactions over the past 3 years. I would not worry about your confidentiality EWH
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15 months ago
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Doctor Hook - thanks for reply. So worst case scenario is 10% of 1%; .001% so probably not worth worrying. Thanks for info on pcr rna test at 11 days post pep (that will shorten worry time). I meant that I said Thanks with my name in the question itself. Have a great day and will update you later.
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15 months ago
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Dr Hook - my anal and oral tests were negative for gonorrhea and chlamydia. Quick question - would having the HIV PCR RNA test on day. 10 after prep completion make a big difference from day 11?
Lastly - my name is in the actual original question text. Please remove. Thanks
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Edward W. Hook M.D.
15 months ago
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Please contact the site administrator to try to change the name.
The data regarding when HIV RNA PCR tests become conclusive are for 11 or more days. I would think that 10 day data would be strong but not entirely conclusive evidence that you were not infected, there just are not good data however. EWH
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