[Question #7011] Window period of PREVIOUS exposures BEFORE HIV PEP (question for Dr. Handsfield

60 months ago

Dear Dr. Handsfield,

I took Triumeq PEP after one exposure and have tested negative on both combo and RT PCR at 6 months after the last dose of PEP.

Here are my two questions:

(1) Will PEP affect the window period of PREVIOUS exposures?

41 days, 21 days, and 4 days before the exposure for which I took the PEP, I had other sex exposures. I don’t know how to test for these exposures. I am afraid the PEP I took later would affect the window period of these exposures that happened earlier than the one to which PEP was prescribed by less than three months. In other words, I am afraid the window period of these previous exposures would be affected or prolonged because the Triumeq PEP came into play later.

So, doctor, please tell me how to test for the previous exposures?

Will the Triumeq PEP affect the window period of PREVIOUS (41 days, 21 days, and 4 days earlier) exposures?

(My English is limited. Dear doctor, did I express myself clear enough for you to understand my questions? If not, sorry and please let me know.)

(2) Will medications for mental issues(panic and depression) affect test result of HIV combo or RT PCT testing? (Or should I list the names of the medicine?)

I have been on medications for mental issues(panic/depression) and I don’t know whether the medications would make HIV test results any less accurate and invalid.

Dear doctor, thank you, please kindly answer my questions.

Thank you.

H. Hunter Handsfield, MD

60 months ago

Welcome back, but sorry you found it necessary. This question is very similar to your previous ones and the answers to them should be pretty obvious. Your wrritten English is fine; your questions are clear.

1) No, your previous PEP has no efect on window period for testing after your most recent sexual experiences.

2) As answered in reply to your question about 6 months ago, there are NO medications of any kind that have any effect on HIV test performance, reliability, or window period.

I have to wonder why you continue to use PEP instead of PrEP. If you have frequent potentially risky sex, PrEP would be best. If your sexual exposures are not frequent enough to warrant continuous PrEP, look into "PrEP on demand". Instead of continuous anti-HIV meds (PrEP) or PEP for a month after every exposure, PrEP on demand is very simple: 2 Truvada pills up to 24 hours before an exposure, then 1 pill twice in the 24 hours afterward. That's all. It is equally effective as standard PrEP or PEP in preventing HIV. Discuss it with your doctor or clinic.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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60 months ago

Dear Dr. Handsfield,

Thank you.

Sorry, I don’t quite understand your answer to my first question because of my English.

To put the question another way,

I know a negative combo test result at six months after Triumeq PEP can be considered conclusive for the exposure concerned. After the exposure until now, I have had no exposures.

But what I am asking about is the PREVIOUS exposures and their window periods, instead of the most recent exposure the Triumeq PEP was prescribed for.

43 days before PEP,

I had sex

23 days before PEP,

I had sex

6 days before PEP,

I had sex

The most recent sex and

I took Triumeq PEP 40 hours later.

Six months after the PEP last dose, the combo test and RT PCR are negative.

43 days, 23 days, and 6 days, respectively, before I took PEP for the most recent exposure, I had sexual exposures. (Maybe there were other exposures happening within 3 months before I took the PEP, but I can’t remember clearly.)

For each of these PREVIOUS exposures, I would have thought their respective window period would be three months after the exposure if I had not taken the PEP later. But with the later PEP, I am worried the previous exposures’ window periods would become obscure and elusive.

More specifically, If I was infected by any of these exposures happening within 3 months before I took the Triumeq PEP, whether the PEP would affect my antibody responses to these PREVIOUS exposures, thus making their window periods more than three months?

If I was infected by any of these previous exposures, when can I test for conclusive results?

Can the negative test results at six months after the last dose of Triumeq PEP prove I am not infected by ANY PREVIOUS exposures?

Doctor Handsfield, please kindly help. Thank you!

H. Hunter Handsfield, MD

60 months ago

You are being argumetnative. I'm happy to help as best I can, but this ins't a debate. I understood your question exactly, that you were asking about your previous exposures. The PEP after those earlier exposures has had no effect on your HIV test results. You have had conclusive results.

And by the way, the internet "shouting" (capitsl letters, boldface) are not helpful. Please stop using them on the forum.

Finally, do not keep asking questions that have already been answered.

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60 months ago

Dear Dr. Handsfield,

Sorry, I didn’t mean to shout. I was worried and afraid I couldn’t express complex concepts clearly in English.

And I am really not sure I understand your answers exactly.

In your reply, you mentioned:

“The PEP after those earlier exposures has had no effect on your HIV test results. You have had conclusive results.”

Dr. Handsfield, do you mean:

1. The PEP after those earlier exposures had no effect on those earlier exposures’ window periods?

Each of those earlier exposures’ window periods is still three months even though there were PEP coming at play later?

2. The negative combo and RT PCR test results at six months after the last dose of PEP are conclusive.

And it is safe to say I am not infected with HIV by any previous, earlier exposure and the latest exposure?

Dr. are the two points above right? Do I understand you correctly?

Dr. I have a new question:

Will the repeated use of PEP in the past generate long-lasting effects on my antibody responses to afterward, new sex exposures, like, blunting antibody responses and prolonging window periods? (I have taken PEP course twice in total. The first one was a full 28-day course. The second one was a 6-day-7-pill Triumeq incomplete course. It has been more than six months since the last dose of PEP last time and I haven't had sex after the PEP.)

Dr, Handsfield, thank you for suggesting the use of "PrEP on demand."

I know this is my last post in the question thread. May I ask for answers written in simpler grammar and a little detailed manner because I am afraid I can't fully understand your answers?

Thank you for your kind help!

H. Hunter Handsfield, MD

60 months ago

The answers to 1 and 2 are yes and yes; you correctly understand.

No, repeated use of PEP will have no effect on HIV tests done following later exposures.

I repeat my main advice above: Consider using PrEP on demand instead of PEP after potential high risk epxosures.

This should be your last question like this on this forum. Repeated questons on the same topic are not permitted, and this is your third asking pretty much the same questions. It doesn't count as a different topic just because of a new exposure similar to the others, or to repeat similar questions about HIV testing. Repeated questions, especially when anxiety driven, are subject to being deleted without reply and without refund of the posting fee. This policy is intended to discourage questions with obvious answers. In addition, such questions have little educational value for other readers, one of the main goals of the forum. Thank you for your understanding. Best wishes and stay safe.

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