[Question #9711] HIV PreP and Risk Assessment
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29 months ago
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Hi Doctors.
After my recent HIV scare I have tried being extra careful and I decided to use PEP. I had been having sex with only an hiv negative girlfriend for a month. We tested with a 4th gen lab test 47 days after we met and only had sex after the tests. From that day, I have been taking Adco-Emtevir(Emtricitabine and Tenofovir) as PreP. This is because I cannot completely trust her yet.
2 days ago I had protected intercourse with a differrent girl of unknown status. This is while I had been taking the pills as described. Taking a single pill each day. I continued taking the pills the next day and now I'm wondering if I need to continue with the pills for at least another month.
My question is that if at all I could have been exposed to hiv from the described last encounter, would I need to take the pills for another month as PEP or the PreP I was taking would be sufficient.
Technically maybe what I'm asking is, if I was exposed 28 days into taking PreP, can I stop at day 30 or i will need to take more pills for another 30 days?
Also, while on the PreP, I have been taking alcohol. Would this lower the effectiveness of the PreP?
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Edward W. Hook M.D.
29 months ago
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Welcome back to our forum. And I’ll be glad to comment. You were encounter two days ago with a new, casual partner was a no risk event. Condom protected sex is safe sex and PrEP makes even unprotected exposures virtually no risk. Between the two preventative measures that you have used you are no risk whatsoever for HIV. If you choose to discontinue your PrEP at 30 days, the medication that you were taking at the time of your encounter with you or casual partner would be fully protective.
Drinking alcohol while taking PrEP does not reduce its efficiency or effectiveness.
I hope the information I provided has been helpful to you. I encourage you to move forward without continuing concerns. EWH.
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29 months ago
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Thanks a lot Dr Hook.
Just to clarify. If one is on PreP, for how long should they take the pills before they become fully protective? And, for how long after an exposure should they take them to be protected?
I'm asking because PEP is for a month after an exposure.
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29 months ago
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Also, If you can just confirm:
1. ARS symptoms show up at least 10days post exposure and can't show up after 3 weeks?
2. ARS symptoms do not include
Coughing, runny nose and diarrhea?
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Edward W. Hook M.D.
29 months ago
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Recent data show that drugs against HIV will effectively prevent infection when taken starting as little as a day or two before exposure to an infected person. This is now called PrEP on demand.
1. The ARS typically begins more than a7-10 days following an exposure and does not occur more than 30 days following an exposure.
2. Cough and runny nose are not part of the ARS. Diarrhea does rarely occur as part of the syndrome.
You are worrying unnecessarily. EWH
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