Dear Doctor

I am male 39 years old taking Prep ( generic truvada) for hiv prevention from 14th july after testing hiv negative on combo test after 4 months of previous exposure , all kidney and liver test are perfect  ............i have taken 8 pills till 21st july and had exposure on 21st july 4 hours after taking my pill( not risky only condom protected blowjob ) and i continue my daily pill ......

 I want to ask on 23rd july i accidently take 2 pill in a gap of 40 minutes...........my questions

1. Do taking 2 pill on 10th day effect my liver or kidney as I have already taken 9 pills ........i dont have any side effect only litlle stomachache .

2. Do 2 pills in a gap of 40 minutes effect efficacy of prep for my 21st july exposure or it increase protection .........i have taken single pill today and continue to do that.

3. Am i safe if i engage in risky behaviour on 25th july as i have already taken 11 pills till now in 10 days . I mean 2 pills on 10th day don't effect absorption of drug

4. Every where it says 2 pills dont effect my health as prep on demand includes 2 pills at same time 

Welcome to the Forum.  Thanks for your questions.  Congratulations on taking PrEP as well- it is safe and highly effective for preventing HIV

1. Do taking 2 pill on 10th day effect my liver or kidney as I have already taken 9 pills ........i dont have any side effect only litlle stomachache .

No, there is no reason to think that taking 2 pills close together will have any adverse side effected

2. Do 2 pills in a gap of 40 minutes effect efficacy of prep for my 21st july exposure or it increase protection .........i have taken single pill today and continue to do that.

No, taking 2 pills will no reduce the efficacy of PrEP for HIV prevention.

3. Am i safe if i engage in risky behaviour on 25th july as i have already taken 11 pills till now in 10 days . I mean 2 pills on 10th day don't effect absorption of drug

Yes, you are safe to pursue what otherwise might be risky behavior for HIV acquistion at this time.

4. Every where it says 2 pills dont effect my health as prep on demand includes 2 pills at same time 

I agree

I hope these reassurances are helpful.  EWH

1.  See above.  Even considering the multiple “ what if” factors you mention, there is no risk.

2. It does not resemble a needle stick in any way.

3.  No

4.  You should not worry about the events you describe.  I would not even call it an exposure.

EWH

Thank you for your answers . I am much relieved from anxiety now .

1. Do Daily Prep ( 12 doses before exposure) will completely protected me from blood exposure to cut on tongue  from earring back ( if it happens hypothetical) . Can you explain it biological reason if possible .?

I have read an article do you think it is related https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6170970/

2. I have been checking my tongue for last 24 hours and there is no cut mark or puncture . No pain etc . I think I will feel pain if there is puncture also it will be difficult to puncture tongue by earring back which is rounded but not pointed . What do you think doctor ?

3. I have also check earring of my partner at home it is not possible that ear ring back can cut her neck ............only it can touch neck when you are sleeping...........large force is required to puncture neck skin .

Beside this girl is 100 percent hiv negative as she don't do sex only massage body to body ..Also she told me she is hiv negative and it an very high end parlour .

Am I thinking right doctor ?

I know from inside I am safe .

Sorry for asking anxiety driven repeated questions . I will move forward after reading your replies 

Thanks again doctor

1.  PrEP prevents infection from becoming established if you were exposed, not that there is any indication that you were.

2.  There is no evidence that a puncture occurred 

3.  Correct, you are not at risk 

This completes this thread.  There should be no reason for you to return to the forum.  Please don’t worry.  EWH