[Question #13491] Looking for opinion on statistic possibility

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1 months ago
Looking for help on the following -
Unprotected insertive vaginal intercourse with female of unknown status.
Uncurcumsized male.
PEP started approx 25 hours post exposure.
What is the likelihood statistically of infection?
What is your suggested text regime once PEP completed?
Thank you.

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Edward W. Hook M.D.
1 months ago
Welcome back to the Forum.  Is this another exposure since your interactions with Dr. Handsfield two weeks ago.?

The risk of infection from this exposure was very low even before you opted to take PEP.  Having started PEP, you will now need to wait another 4-6 weeks AFTER completion of PEP before you will be able to reliably prove that you were not infected.  Less than 1% of women in North America have HIV and of those with infection, most are on treatment and non-infectious.  If your partner had untreated HIV, the risk of infection from a single episode of unprotected vaginal intercourse is les that 1 in 2500.  Thus, before starting PEP there was a more than 99.995% change you would NOT get HIV.  

You can test and expect conclusive results from a 4th generation HIV test 30-45 days AFTER completion of PEP.  

EWH
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1 months ago
Thanks for this.
Yes, new exposure.
Is non-circumcised the same 1/2500 statistic? I have seen various data on this.
With 1/2500 being the quoted stat, what would you say the statistical chances of positive test after PEP completion?
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Edward W. Hook M.D.
1 months ago
Being uncircumcised makes little meaningful difference.

See above.  As noted there is a more than 99.995% likelihood you will not be infected. EWH
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1 months ago
Thank you.
Can you speak to the effectiveness of PEP - how it works and why it may not work for a percentage of people?
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Edward W. Hook M.D.
1 months ago
As you know, this will be the final answer to your questions. HIV post exposure prophylaxis (PEP) works because it prevents the HIV virus from infecting the lymphocytes which are the source of continuing infection. This must occur before infection of lymphocytes occurs. PEP is estimated to reduce the likelihood of HIV infection about 90% when started within 48 to 72 hours after an exposure to a potentially infected partner. The longer the interval between the exposure and the beginning of pep, the more likely it is to fail.

This completes this thread. It appears to me that you were worrying more than you need to. I hope the information I have provided will help you to move forward without concern. There should be no need for follow up. EWH.
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