Today at 3:30 AM Í had intercourse with an unknown status HIV female partner. She performed oral sex without protection, then during the intercourse the first condom broke (I was inside of her) but I noticed inmediately and used a different condom. Then she performed oral sex again using the second condom and we kept the intercourse. After the act I did check the second condom and had a puncture close to the tip when I did the metod with the water sink to check holes.

Do I need to take PEP? Today is Sunday and my only option is going to an ER right away to get this prescribed. She said that she is clean but is not possible for me to check that fact. Time is running and tomorrow will be the second day. Please address my ris and if I really need to incur in the cost that means adquire the PEP.

Thank you.

We do not give specific medical advice for or against PEP after sexual exposures. Most likely it isn't necessary, but that decision must be made by in-person care with a provider who understands the local risks and frequency of HIV. Even if your partner has HIV, the chance you were infected probably was very low, given the brief time of unprotected vaginal exposure; and oral sex almost never transmits HIV. The large majority of sexually active women do not have HIV; and most women who say they have been tested recently and not infected are telling the truth. However, a local HIV clinic or emergency department might know more than I do (or than you do) about the statistical chance a partner like yours has HIV.

Therefore my advice is that you visit the ER or other source of expert care and discuss the details with them -- including everything you know about your partner -- and make a decision together whether to take PEP. Most likely it isn't necessary, but better safe than sorry.

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

HHH, MD

Yesterday I went to the ER. I explained that I want to be evaluated for PEP  and basically they said that is very unlikely that if the other person showed any symptoms of immunosupresion or being very sick then I should be in the good (explained by the head nurse that was in charge), they only gave me antibiotics for Chlamydia and prescribed Doxycicline, the head nurse that helped me during that night stated that they do not prescribe PEP which is weird considering that I went to a big hospital in a large city (I live in the US).

 I was expecting to get the PEP but I could not get it in the ER. Would you recommend me to do a 4th gen HIV test at 6 weeks? Should I look today for a different alternative (like telehealth) to get the PEP since I am still within the timeframe? I would really appreciate some clarity.

Thank you.