[Question #5825] HIV Risk Assessment

19 months ago
Dear Doctors, 

Earlier today I went to the clinic and was tested for HIV (4th Gen Negative) and was started on PreP. I took the single Truvada pill and felt a little frisky and ended up having receptive anal sex with a man of unconfirmed status. He did say that he was negative but there was a little bit of a language barrier so I cannot be sure he understood. 

I preformed oral on him for a few mins and then I placed a condom on him so I know it was put on right. I did some addtional oral with the condom on (I believe this was a mistake) and then he inserted inside me and it lasted only 15-20 thrusts and he did not ejaculate. From what I could tell the condom was fine, I noticed no breakage. 

My questions are this. 

1.) The condom is what I'm relying on to insure that I didn't get HIV but because I'm a very nervous person I want a backup protection plan.  Do you think the Truvada alone would also work to insure I didn't acquire HIV even though I had only had the first dose a few hours earlier today? Obviously I'm going to continue it. 

2.) Should I go back and seek the addtional drug and be on PEP now?

3.) What would you do in my shoes? 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
18 months ago
1) Oral sex is very low risk for HIV, even without PrEP. Having taken Truvada, with a partner who almost certainly does not have HIV, there is no chance you were infected.

2) You should not take PEP on account of this event.

3) I would do nothing at this point.

This is your fifth question in a month about obviously zero to low risk events and you have been informed of the forum policy on repeated, anxiety driven questions. This will have to be your last one and there will be no opportunity for follow-up discussion on this one. 

HHH, MD
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