[Question #6081] Post-Exposure Prophylaxis for HIV

16 months ago
I am a 37 year old healthy male, no STD's from recent test. My ex-Girlfriend was also negative from tests. She had unprotected sex with a man 7 days ago, and we had unprotected sex 24 hours ago. When I asked her details, she states that the mans penis had no lesions and he was not ill. Also stated that she was not bleeding at the time.  She has had no flu like symptoms or feeling ill. No known lymphatic enlargement. When we had sex, she was not bleeding. Should I start Post-Exposure Prophylaxis for HIV now?
Edward W. Hook M.D.
Edward W. Hook M.D.
16 months ago
Welcome to our Forum.  Thanks for your question.  If I were you, I would not seek PEP in this situation.  Your risk of HIV would reflect the likelihood that your Ex-GF's partner a week ago had HIV (low I presume), the likelihood that  he transmitted infection to her (less than 1 infection per 1000 acts of unprotected intercourse), that she was now infectious (not all infected persons have circulating virus in their blood one week after acquisition of infection), and the likelihood that she transmitted infection to you (again, chance of this occurring, statistically is less than 1 in 1000).  It is improbable that all of these things would have happened.  Thus, while PEP is highly effective, he likelihood that you were exposed is so low that I would not recommend it.  (I should add that PEP can be expensive and some persons who take it experience uncomfortable, mostly GI, side effects).

I hope this information is helpful to you.  EWH
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16 months ago
Thank you for the response.

So, if she is telling me the truth- now she states she had sex with this man she doesn't really know twice starting about 14 days ago (may be more often than twice). While I had sex with her once 24 hours ago. What would be the probability of me actually getting HIV (I see from other questions it is 1/2500 kind of thing?). Also, can you please comment on Hepatitis C and probability?

Very much appreciate your response!
Edward W. Hook M.D.
Edward W. Hook M.D.
16 months ago
Many of our clients go through a mathematical exercise, multiplying the various probabilities, and exercise that I personally find a bit silly.  that is particularly true in the situation you describe where you know so little about the male who is the starting point of the exercise.  It is safe to say that your risk is less than 1 in 100,000 and probably far lower but this is a game I chose not to play.

As far as hepatitis C is concerned,  it is not transmitted with any meaningful frequency through penile-vaginal or oral intercourse.  From what you say there is no reason to worry about sexual acquisition of hepatitis C from the encounter you describe.  EWH
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16 months ago
Dr. Hook,

Your services here, especially on a weekend are priceless. I cannot express to you how much it means to me that I was able to get peace of mind so fast. I hope you know how important your services are on this site, especially given the stigma of STD's.


Edward W. Hook M.D.
Edward W. Hook M.D.
16 months ago
Thanks for your kind words.  I'm pleased that my comments were helpful.  EWH---