[Question #11656] Does my boyfriend need PEP too

Avatar photo
13 months ago
Hi doctors - I am currently on PEP after a low risk exposure with another male (oral sex and he tried inserting in me but stopped). Now, I am 3.5 weeks into PEP and had sex with my boyfriend. However, the condom broke.

Does my boyfriend need to get on PEP now? I read on HIV-base that he wouldn’t need to because my viral load (if PEP is failing) would be so low that he won’t get infected. 

One thing I want to add- I have tested using 4th gen tests every week while on PEP and they all are negative 
Avatar photo
Edward W. Hook M.D.
13 months ago
Welcome to the Forum.  Thanks for your questions.  The short answer is that your BF does not need PEP..  If your encounter did not involve penetration, you probably did not need PEP from a scientific perspective .  More importantly, your negative 4th generation tests indicate that you were almost certainly not infected.  In the absence of a positive test there is almost no chance that you were viremic and therefore 
, there is no risk of you infecting him despite the broken condom. 

Please don’t worry.  EWH
---
Avatar photo
13 months ago
Thanks for the quick reply doctor! 2  more questions
1. let’s just say for arguments sake that my initial exposure was high risk, would that then change your answer about my boyfriend getting on PEP? 

2. Should I continue to get an HIV test every week while I’m on PEP? 


Avatar photo
Edward W. Hook M.D.
13 months ago
The answer would be the same no matter what the exposure was.  Given your negative tests, your BF is not at risk.

Personally I think weekly testing is not necessary.  It’s a personal choice however.  EWH
---
Avatar photo
13 months ago
thanks doctor. To wrap up this thread I have a few last questions:

1. I forgot to mention that I took an RNA/DNA test a week before I had sex with my boyfriend. The test was negative. Is it likely that my viral load could have increased this week (week 3 on PEP)? I read something about viral load blips 

2. Is the RNA test more accurate than the 4th generation one? Do you recommend I get another RNA test? 

3. I saw a previous posts where you said that those on PEP DO NOT  transmit the virus. Is this because the PEP medication is strong enough to make a viral load so low that the person can’t infect others? Does the PEP medicine in this case act as hiv treatment medication?  
Avatar photo
Edward W. Hook M.D.
13 months ago
1.  You are negative HIV RNA/DNA test is further proof that you were not infectious. I would have no concerns.

2. HIVRNA/DNA test become positive before fourth generation combination HIV antigen/antibody test. As I said, your risk of infection is very very low and I would not be worried at all. You should speak with with the healthcare provider who prescribed your PEP to determine what follow up or she would recommend.

3.  PEP entirely prevents HIV infection. There is no circulating virus at all. The idea that there are low levels of circulating HIV virus present in person taking PEP is an Internet based myth.

Once again, let me emphasize that even without PIP your risk for acquisition of HIV was virtually zero. I think you are more concerned than you need to be. Please don’t worry. EWH.
---
Avatar photo
13 months ago
Thank you for your advise doctor. Unfortunately, I do not have a PEP counselor since I got my PEP from an online site. 

I will do my best to put this behind me and reassure myself that there is no way I could have infected my boyfriend since I am still testing negative. 

Regarding your last point. Are you saying that there would be no HIV in my system when we had sex while I was on day 21 of PEP? 
Avatar photo
Edward W. Hook M.D.
13 months ago
Correct!

End of thread.  EWH
---