[Question #11690] Follow Up- Finished PEP
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12 months ago
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Hi Doctors- as a follow up I finished my 28 day PEP treatment today and tested negative, so below is my timeline:
Day 0- exposure
Day 1- started pep
Day 3- Neg RNA test
Day 10- Neg RNA test
Day 11- Neg 4th generation test
Day 18 or 19) - had sex with my regular partner, condom popped, potentially exposing him
Day 28- finished PEP, neg 4th generation test
The NP said that it is virtually impossible for me to have given my boyfriend HIV from having sex with him.
1. She said that there has never been a case in the medical literature where someone on PEP, had unprotected sex while on PEP, gave the other person HIV, and never got HIV themselves, and I won’t be the first. Given your experience is this true?
2. I also read and many doctors would not recommend my boyfriend take PEP from this incident. Citing that me being on PEP makes his chances of getting HIV 0. If this is the case why does the CDC say “never have unprotected sex while taking PEP”?
3. Is it possible that my viral load could have quickly spiked to infectious levels day 10 of PEP, then disappeared by today, day 28, leaving me with a negative 4th generation result?
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Edward W. Hook M.D.
12 months ago
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Welcome to the Forum. Thanks for your questions. I'll be glad to comment. You appear to misunderstand how HIV PEP works. Successful HIV PEP prevents the virus from ever entering a person's body and establishing infection. Persons taking PEP never have virus circulating in their body or bloodstream. As a result, persons successfully taking HIV PEP cannot infect others with HIV because they have never had infectious virus in their body which could be transmitted to others. Your multiple negative tests prove that you have not had the HOV virus in your body. The NP you spoke with was absolutely correct.
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Thus in response to your questions:
1. She said that there has never been a case in the medical literature where someone on PEP, had unprotected sex while on PEP, gave the other person HIV, and never got HIV themselves, and I won’t be the first. Given your experience is this true?
Yes, this is correct
2. I also read and many doctors would not recommend my boyfriend take PEP from this incident. Citing that me being on PEP makes his chances of getting HIV 0. If this is the case why does the CDC say “never have unprotected sex while taking PEP”?
Correct, your BF certainly does NOT need to take PEP because of the encounter you describe. The CDC is being overly cautious and is concerned about the (theoretically only) possibility of you becoming infected while taking PEP, not because they have any concern that you would infect someone else.
3. Is it possible that my viral load could have quickly spiked to infectious levels day 10 of PEP, then disappeared by today, day 28, leaving me with a negative 4th generation result?
No, this is scientifically impossible
I hope this information is helpful. EWH
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Edward W. Hook M.D.
12 months ago
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I only just realized that this is a repetitive question which was answered 4 days ago. Why are you repeating the question. Can you tell me where you got the misinformation that persons taking successful PEP can infect others? EWH---
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12 months ago
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Thank you doctor. I will now put this all behind me.
I got misinformation from Reddit forums where people were telling me a bunch of information about how I can still be infectious even though I’m on PEP and am testing negative. I think I need to stay off of Reddit.
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Edward W. Hook M.D.
12 months ago
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I agree. Take care. Reddit may be referring to the tiny proportion of persons who fail PEP. There is no evidence that you failed PEP. Please don't worry. EWH---