I started taking PEP around 27 hours after exposure due to fear that in my drunken state if there was any sex without condom although I don’t think there was

1. How effective is PEP when taken around 27 hours? 

2. I read online that certain vitamins and supplements can affect the effectiveness of PEP. I take zinc, finpecia, trazadone and took an erection pill one day but didn’t have sex. Is this true and would any of these affect my PEP use? I’m on day 10 of taking PEP. 

3. How accurate would a PCR test be 13 days after PEP completion?

I’m obviously experiencing a lot of fear and anxiety from this. 

Assuming you're in the US or other industrialized country, the chance a random women "met in a bar" has HIV is nearly zero -- in most areas of the country, under one chance in a thousand. When a woman has HIV, her male partner has an estimated HIV risk of once for every 2,500 vaginal sex exposures -- and that's unprotected, i.e. no condom. With a condom your risk was 100 times lower than that. Putting these numbers together, your risk of HIV was in the ballpark of one chance in 250 million. Even if your fears are true -- i.e. no condom -- your risk was around 1 in 2.5 million. Had you come to my clinic, we would have strongly advised against PEP.

To your specific questions:

1. Starting within 48 hours, PEP effectiveness is at least 90%, probably higher.

2. You read wrong. Neither these nor any other drugs or health problems would reduce the effectiveness of PEP.

3. Conclusive data are not available, but probably close to 100% certainty. 

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

I’ve had some itchiness in the groin and genital areas around day 13 and very slight sensitivity around the penis tip/urethra. This could en because I’m taking note of every little feeling. I’m currently at day 15 post exposure.  

1. What would the risk be for Herpes from the unprotected oral?

2. What would the symptoms for herpes be?

3. How noticeable would it be, would it be painful and how long would it take to show?

1. The chance of genital herpes from a single episode of unprotected oral sex is under one chance in many thousand. In addition, there's a good chance you have already had herpes simplex virus type 1 (well over half of South Africans have had it by age 20), in which case you are immune to a new HSV1 infection. (And HSV2 is rarely if ever transmitted by oral sex.)

That completes the two follow-up comments and replies included with each question and so ends this thread. Do you your best to move on without further worry. Follow your doctor or clinic's advice about follow-up HIV testing. For the reasons discussed above, you really should not be at all worried -- you had a near zero risk exposure, even if your partner had HIV. You definitely can expect negative test results. I hope the discussion has been helpful.