[Question #8360] Follow up to Question #8235

45 months ago

Dr Hook,

I appreciated your previous advice and my tests for gonorrhea and chlamydia were negative. I finished taking stribild over 2 weeks ago and maintained the strict regiment by taking every day between 8 pm and 9 p,m. Just over 2 weeks after finishing the stribild for PEP, I came down with what I think is a cold; haven’t had one in a long time as always wearing a mask but a family member had a cold as well. I took a COVID test to rule that out, My symptoms the first day was a sore throat and then progressed to congestion in my nose and sinuses. No fever or rash. I am assuming this is far more indicative of the common cold than primary hiv infection. Wanted to ask your option as probably just the worst time to get it with timing of completing pep. Lastly, the man I was with gets his normal testing done next week with his doctor for his prep check up. That would be almost 7 weeks (6 weeks and 6 days) after we were together. He has offered to share his result with me. If his results are negative, can I move on and put this incident behind me? Thanks

H. Hunter Handsfield, MD

45 months ago

Welcome back. I'll be taking this question, but I have reviewed your previous discussions with Dr. Hook, especially the most recent one and agree with all he said.

I agree you have a cold, not HIV: symptoms of acute retroviral syndrome (ARS, i.e. initial HIV infection) generally do not include nasal congestion. Indeed you can "move on and put this incident behind [you]", even without your partner's anticipated negative HIV test. Certainly you should do so when you learn his negative test result. I'll be happy to comment further if you would like to add a follow-up comment when that result is available.

In the meantime, do your best to not worry. Let me know if anything isn't clear.

HHH, MD

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45 months ago

I really apologize if I misunderstood something. But you state Indeed you can "move on and put this incident behind [you]", even without your partner's anticipated negative HIV test.

I am unsure how I can put this behind me until he tests negative. What I have read is I need to test negative 6 weeks post pep completion. If he has a negative test 7 weeks post incident, that is sooner than my 10 weeks post incident.

Are you saying I have nothing to worry since I started pep 3 hours post exposure and maintained the regiment religiously.

Once again, I am sorry if I am misinterpreting.

H. Hunter Handsfield, MD

45 months ago

My interpretation of your exposure, as you described it in your previous thread and as Dr. Hook agreed, is that your partner almost certainly does not have HIV. In addition, you took a highly effective PEP regimen that was started early. Those facts work out to an extremely low chance you have HIV, without knowing your partner's new HIV test result. Of course that anticipated result will make it certain you were not exposed and therefore could not have HIV, but you can be very confident his test result will be negative.

As you know, each question comes with two follow-up exchanges, so you have one more coming. Also, this being your second question about the same exposure, it should be your last. So I suggest we hold off on further discussion until you know your partner's test result.---
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45 months ago

Dr Handsfield - I really appreciate your replies. This is my last post and questions. My friend gets his test results tomorrow as part of his PREP testing. I am concerned as he showed me his PREP pills and they were a drug called Dovato (SV 137) which i researched and said it was an HIV treatment pill. It never said it was approved for PREP. When he shows me his results, what test should I look for? I would not imagine they would run a viral load test (RNA) on him unless he had HIV. Wouldnt they use a 4th generation? I am concerned he has lied to me about being on PREP when he is really on HIV treatment. I get a 4th gen test next week which would be 33 days after completing PREP. If that is negative, can I put this behind me or do I need to test again. Lastly, I am assuming even if he was on HIV treatment (not PREP) then I couldnt get HIV. Thanks

H. Hunter Handsfield, MD

45 months ago

You're still focused on irrelevancies. You took highly effective PEP. And your closing "assumption" is correct: of course any effective treatment for established HIV would also be effective as PrEP! Official approval as PrEP means only that the manufacturer submitted data to FDA showing effectiveness. It doesn't mean that non-approved treatments don't work.

You do not have HIV and your upcoming test will be negative. When it is, move on without worry.

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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