I am here to ask regarding a different case, for context I started to take Descovy (PrEP) on 12/17/25 - Since then I've been having an active sexual life using condoms plus PrEP and I am really having a good adherence to it (no missed doses). I had some condom breakages (I think I will change the brand that I'm using) but since they were briefly and I'm taking PrEP I did not have anxiety or anything else that made me think anything wrong. Except the encounter that i will mention below:

On Saturday 02/07/26 (at 12 AM) I had an encounter with a lady that I met (friend - american), during the act my condom broke and I did not notice after 3 minutes and besides that her period was starting (she did not know) so I got a little bit of blood on my glans and part of my member. When i noticed I washed thoroughly and put another one and did not have more breakages on that night.

My questions about this are the following: 

1) I am aware that PrEP is designed to protect in cases where the condom fails (it happens to me a lot), but what if we add to the equation the menstrual blood which was very unlucky and unexpected? Would that increase my risk?

2) Should i consider asking my provider for PEP considering the blood involved?

3) In case that I do not need PEP and this is considered a negligible risk since I am taking Descovy, can I continue with my regular sexual life?

Please consider that I don't know her status and we both are not drug users, so basically the only risk that I have been incurring lately is protected sex (not counting the breakages).  I am sorry to come back but I am not well versed in the PrEP world and I just want to avoid any risks.

Thank you,

E.

I’m sorry to hear of your condom break.  This occurs about 1% of the time condoms are used.  As for your specific questions.

1.  Your partner sounds to be low risk.  Few women have HIV.  Even if she she does, this was virtually no risk.  Even without PrEP your risk of infection is less than 1 in 2000 and PeEP lowers that risk to close to zero.  The presence of blood does not change that.  Blood and genital secretions contain about the same concentration of HIV.  You certainly do not need PEP.

2.  Absolutely not 

3.  I encourage you to not worry and to continue with your normal sexual activities.

EWH

Thank you for your response. Since I am not an expert this information is very useful for me. I still do have the following questions/doubts regarding the PrEP (Descovy):

1) What kind of exposure would trigger the use of PEP while using PrEP (Descovy?

2)How many doses do I need to miss to be considered that I am unprotected again? Does taking a dose for 5-6 hours after your regular time be considered a missed dose?

3) What is considered a high risk exposure while I am on PrEP?

4) I am a straight male. Since I only have sex with women (no sexual workers) and I am adherent to the PrEP, am I considered a low risk person to get infected with HIV?

Thank you again Doctor,

E.

1.  On PrEP, as long as you were taking the medication, there is almost no reason to need.PEP.

2.  More than two doses of missed medication would increase your risk of infection somewhat until you had taken your medication for another 3 to 4 days.

3.  The highest risk exposure would be receptive rectal intercourse, but even in that situation, the medication should do its job.

4.  Yes

EWH

Thank you again for your answers. They are giving me reassurance and I decided not to call the provider today for PEP so I will wait until I have to do my follow up labs (every 3 months) as the PrEP guidelines state.

I do have one last question, since I did take my dose on Saturday after the even 5 hours later than I supposed to be (It should be at 5 PM but I arrived home late and I ended taking it at 10 PM) would it impact my protection for the mentioned encounter.?

I will keep protecting myself with PrEP and condoms. I hope everything goes fine and the medicine does it's effect. I will keep you posted if something bad happens considering everything that I mentioned.

Thanks,
E.

I agree with your decision not to not seek PEP.  It is not needed and I would not prescribe it.

A five hour deli in taking a dose will not reduce the effectiveness of your PrEP.

You are going to be fine.  Please don’t worry.  End of thread.  EWH