[Question #4708] Can PEP be PREP?

80 months ago

I am a gay man and started PEP following unprotected anal with a guy who claimed he was already on PREP. I wasn't sure so I started the treatment on Dec. 4 within the 72 hour window and have not missed a dose of the Truvada/Tivicay combo. On Dec.15 I gave unprotected oral to a guy of unknown status who unexpectedly ejaculated into my mouth. Given what happened, should I extend my PEP regimen or was I protected from HIV due to the length of time I have been taking the medication? If so, how much longer should I go? I just want to be sure. Thank you.

H. Hunter Handsfield, MD

80 months ago

Welcome to the forum.

With apology for what will seem like a lecture, it was irresponsible of you to have sex at all while taking PEP in this situation. If you were concerned enough about catching HIV to take PEP, you should also have been concerned enough to take absolutely no risk whatever of exposing additional partners to your potential new infection.

OK, I got that off my chest. Oral sex is no risk -- there has never been a proved case of HIV transmission oral to penis. Your behavior was irresponsible because you didn't know that, but in fact you did not put that person at risk.

As for your own risk, since you were taking PEP, it was the same as taking PrEP -- so you were protected, in the event your more recent partner had HIV. I would advise you to just complete your current course of PEP and not worry about it.

HHH, MD

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80 months ago

Thanks, Dr. Handsfield, for your response and the reality check. I appreciate your perspective and will be more mindful going forward.

H. Hunter Handsfield, MD

80 months ago

Thanks for the thanks. I'm glad to have helped.---