[Question #11898] Please Help

11 months ago

Hi Doctors, I have been a nervous reck and would love your professional input. Last year I, bisexual male, met up with a guy I met online, we messed around. He rubbed his penis against my anus, but I am honestly not sure if he inserted himself in me. We also exchanged oral sex. The very next day I got on PEP. However, here is the issue- before I completed my PEP I had unprotected sex with my regular partner. I subsequently finished PEP and have been tested several times in the last 12 months and have always been negative.

1. Is it possible that I could have gave my regular partner HIV when I had sex with her while I was still taking PEP?

2. I consulted with the clinic that gave me pep and all they said was “don’t worry about it. However, in the future never have unprotected sex while on PEP again”. This did not give me reassurance at all. Does them saying don’t worry about it mean that I couldn’t have given my girlfriend hiv while taking PEP?

3. Is it possible that PEP could have cured the HIV out of my system after I transmitted it to her?

H. Hunter Handsfield, MD

11 months ago

Welcome and thanks for your confidence in our services.

No worries at all. First, you had a near zero risk exposure, probably under one chance in thousands (or millions) against HIV from such and vent. (I would have advised against PEP in this situation.) Second, HIV is not transmissible sooner than a few days (probably 5-8 days) after catching it: the virus needs time to grow to reach high numbers in blood or semen. Third, your multiple negative HIV tests prove for sure you were not infected. Those comments answer your questions, but to be explicit:

1. No, not possible.

2. The clinic's "don't worry about it statement" was exactly right. (It's common sense to not have sex while on PEP, until assured infection didn't happen. But in your case it was not unsafe at all.)

3. No, this doesn't happen.

So all is well. Please stop testing -- and stop worrying about this! Let me know if anything isn't clear.

HHH, MD

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11 months ago

Thank you for your quick reply doctor. That has made me feel a lot better. I have a few follow up questions:

1. I looked at the calendar and realized that I had sex with my regular partner while I was on day 24 of taking PEP. Is it safe to say that I couldnt have transmitted HIV to her while I had that much PEP in my system?

2. I saw a previous post on here from the other doctor that said “those taking PEP cannot transmit the virus while on PEP. It is scientifically impossible” why is this the case?

H. Hunter Handsfield, MD

11 months ago

1. Your test results prove you were not infected -- probably not even exposed to HIV, although it is conceivable that you were and infection was prevented by PEP. Either way, you never were infected with HIV and could not have transmitted the virus to anyone else.

2. It's impossible to transmit while on PEP because the drugs prevent the virus from surviving in the body. If there is no virus, of course there is no chance of transmission.

Your mind is working overtime thinking up impossible scenarios. Just accept the straightforward science. You've probably heard this repeatedly from your own doctors, and now my expertise. Accept it or not, I don't care -- but this isn't a debate! You simply are flat out wrong in your worries and assumptions.

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11 months ago

Thank you doctor. I will try my best to put this all behind me and believe the countless professionals who told me that there is no way that I could give my partner HIV from having sex with her while I was taking PEP. Last questions to wrap up my thread:

1. In your response you said - “It's common sense to not have sex while on PEP, until assured infection didn't happen. But in your case it was not unsafe at all.”- why was it not u safe in my case? Is it because I have tested negative well past the window period?

2. I forgot to mention that a week before I had sex with my regular partner I took an RNA test that came back “not detected.” Is this further proof that I was not infectious when I had sex with her?

H. Hunter Handsfield, MD

11 months ago

1. It's because there was no chance you were infected from the exposure described. And in theory to protect agains the rare circumstance when someone was infected with an HPV strain resistant to the PEP drugs.

2. Yes the negative RNA test was further proof you were not infectious.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful.

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