I sincerely apologize for asking another question, but there is a slight development from my previous question and would like your opinion on PEP. I have since learned that there was another woman (CSW) that I was with that night t(verified by the place I was staying at) that I have virtually no recollection of given my inebriation. I am quite sure I slept with this woman, as I now vaguely remember her, but cannot confirm that a condom was used for her, although I assume we would have made sure to use -- I just cannot remember. I got back to the states within the 72 hour window period for pep and was able to secure a one day courtesy supply to ensure I started in the window so that I can have a follow up consultation later today for the full prescription (took at around the 69/70 hour mark - I know somewhat late). I know it is ultimately my decision, but my concern here is more so "what ifs" given I just can't verify whether protection was used, and given her line of work and the locale (Dominican Republic). Given the unkown factors and potential risk - which I assume still puts the odds in my favor, do you believe it is worth proceeding with Pep for additional assurance and peace of mind? I am concerned with taking such a strong medication(s) for 30 days that could have side effects, but at the same time, I want to make sure I am doing the right thing to ensure safety. Again, I apologize for the having to write in again.

That you had sex wig a CSW in the DR only slightly increases the risk for infection.  Most CSWs do not have HIV and in all likelihood, your contact with her was likely only a single exposure.  As you point out, the decision regarding PEP is yours.  The major side effects of PEP are GI discomfort ugh almost any medicine can do almost anything on rare occasions.  Most people who take PEP have few problems or lasting side effects other than to their bank account (it is expensive).  I think the real question has to do with your peace of mind.  As you point out, the odds are very much in your favor.  Personally, were I in your situation, I would probably not pursue further PEP but might get early testing (at two weeks) with an RNA PCR test, again, just for peace of mind.

I hope this perspective is useful.  As you know, I'm happy to address follow-up questions if you wish if there are further questions or I've been unclear.  EWH

My last (I promise!) inquiry here then is on effects of a 28 day duration of pep on the body, especially considering it most likely was not needed. I'm not concerned with any short term effects and I really haven't had any real noticeable side effects after a week or so. I have read on here and elsewhere that long term side effects (e.g. kidney, liver) or toxity for a 28 day duration is rare. Would you agree with that given the strength of the medication? What about hypothetically if there was indeed some small degree of pre-existing kidney or liver impairment, is 4 weeks just too short a time frame for most people to be concerned with hypothetical/damage to the body, organs? Are there any medications or foods you suggest staying away from while taking this? They mentioned not to take within an hour or two of drinking alcohol, not sure if there is anything else I should possibly consider to play it safe.

This will be the final response to this thread.  Forum guidelines provide up to three responses to each question.  We are beyond this.

In answer to your questions, every prescription for medication should reflect a balance between potential adverse effects and the benefit of the drug.  For PEP, in most instances, this is a largely personal decision guided by recommendations.  In general PEP is well tolerated and does not cause lasting side effects even in those who experience adverse effects.  As to specific foods or medications  to avoid, any major medications to avoid would be listed on the prescription and should be able to be considered by your pharmacist (the number of likelihood of potential drug interactions are huge- pharmacists track such possibilities).  Beyond that I really would not worry.

As far as whether or not 28 days of therapy is needed, there are no high quality scientific studies to determine whether or not shorter courses of therapy might be equally effective.  My advice is, having started the treatment, to complete it.

Hope this helps.  Take care. EWH