I’ve been abstaining from sex for about 3 years now and had been doing well but unfortunately this past Sunday had a potential incident. I never gave consent for sex or penetration however the young man I was with was consistently trying to insert his penis into my vagina while fingering me. I know fingering is not a risk, however at moments it would hurt and with his attempts I became concerned that maybe he succeeded and inserted his penis inside of my vagina. (I know I should be able to tell but at that point I was sore and it’s been 3 years so honestly I couldn’t.) if he did insert his penis it can’t have been for more than a minute. 

As a result of this uncertainty I went ahead and took my first dose of PEP the following afternoon (less than 24 hours after the incident occurred) 

If he did insert his penis into my vagina for a minute unprotected, what would my risk be with consistent usage of my PEP medication?

Will 6 weeks post my final dosage of PEP provide a conclusive result? 

Thank you. 

Statistically, if your partner did penetrate your vagina, the risk of acquiring HIV is vanishingly low, less than 1 chance of infection in more than 100,000 such episodes.  This estimate is based on the facts that less than 1% of heterosexually active men in the U.S. have HIV and that even if your partner had untreated infection, the likelihood of your acquiring infection from a single exposure is substantially less than 1 in 1000.  Hsd you approached me requesting post-exposure prophylaxis (PEP),  I would have declined to provide it has the risks, small  they are, that way a potential benefits.  

If you were in my position would you continue? Initially my plan was to get on it until he showed me his (hopefully negative) HIV results but he seems unwilling to test and the meds are leaving me with a constant stomachache. 

Would taking PEP for a week or two instead of the intended 4 weeks still reduce the risk of infection? 

You said the risk was 1 in one thousand but with the addition of PEP in less than 24 hours what would the risk be?

Thank you. 

Precisely how much PEP reduces the risk for acquisition of HIV is unclear because transmission is so uncommon that to determine this figure accurately would require thousands and thousands of patients. General estimates are that the PEP would reduce your risk for acquisition of infection at least an additional 90%.

There are no data on the potential benefits of taking PEP for two weeks rather than the 30 day period that has been studied. 

Finally, While decisions about taking PEP are a personal decision, were in your situation, I would not have started pet PEP  and, if I had started it and decided that I did not want to continue, I would have no concerns about stopping.  Personally, I believe that your risk of infection is minuscule. 

I hope this additional perspective is helpful to you. EWH

I guess specifically I’d like to know the odds of infection from this potential incident with the taking of PEP as well. 

Also how accurate are RNA tests after taking PEP? Could I take one 2 weeks post PEP for reassurance or should 6 week 4th gen be the only one I take? (Money is not a problem for me in this situation) 

Thank you. 

A 2 week RNA test would be quite reassuring but experts would still recommend a combination HIV antigen/antibody test at six weeks to be entirely conclusive.

As you know, we provide up to three responses to each client’s questions.  This is my 3rd response and therefore the thread will be closed shortly without further responses.  Please don’t worry. EWH 

I think I will continue on with PEP just to be on the safe side and the nausea side effects have started to die down. Hopefully with the low odds plus additional protection of PEP, my tests will come back negative. 

Thank you. 

As I said, your decision to take PEP is a personal choice.  I am confident you will find that you did not acquire HIV.

End of thread.  EWH