Question
Can I test while I am on PEP?
9 January 2022. Related: All topics, CD4 and viral load, HIV testing, HIV transmission, PEP/PEPSE, Side effects.
I had an exposure through an unprotected sexual encounter at which I was the insertive (top), lots of lubricants were used, and there were no ejaculations nor blood. My partner was informed that he tested positive on the second day and later knew that his viral load is less than 20,000 copies/mL. I started PEP on Thursday night (8 pm) with only Truvada (39 hours later) then started having Tivicay as well from Friday night (8 pm). I had a strong headache for a couple of days, and a fluctuating low-grade fever throughout the day. Furthermore, I am generally sleepy and I do sleep from 8 to 12 hours every day since I started PEP.
I tested for HIV AG/AB on Sunday’s night (December 26th, 2021), and the results were negative, I know it does not indicate anything relevant to the exposure but did it as baseline information. Now after 15 days the low-grade fever is back, so far maximum 37.5C, and commonly some hours (3 or 4) after taking my pills, and I can feel a lymph node under my jaw on the left side. Am I seroconverting?
I am too stressed and I cannot do anything apart from worry. Are there any tests I can do at the moment to know my status? I know I should be following up with a doctor but where I live there is a high stigma against homosexuality and HIV so I don’t dare to follow up with a doctor. Your support will be highly appreciated, as I am totally by myself in all of this.
Answer
Hi M,
How are you doing? Starting PEP as early as you did means you are within the time frame for it to be most effective. Also, being the ‘top’ further reduces your risk, as does not ejaculating and there being no presence of blood. Using lubrication further reduces risk as it reduces the risk of abrasion from friction. These factors means it is very unlikely you will test positive for HIV.
As you have mentioned, a test while on PEP is not accurate. This is because PEP can ‘mask’ HIV and will not give a true representation of your status. To be sure you will need to wait 6 weeks until after your course to know your status. In the meantime, this guide discusses feelings of fear and anxiety while awaiting results.
The symptoms you have mentioned are possible signs of seroconversion. Also they are signs of many other infections. Due to how non-specific symptoms are for HIV, it is impossible to say if you are seroconverting. If these symptoms are in association with the time you take PEP, it is more likely a side effect of the medication.
I am sorry to hear that you are in this alone. Do you have any family/friends that you are able to discuss this with? The Terrance Higgin’s Trust in the UK offer an email service that may be suitable in this instance. It is unfortunate to hear about the lack of support you are having from your doctors, but if you become increasingly concerned with your health you need to make sure you speak to them. This is the only way you can be sure of your current state of health.
If you have any further questions please get in touch,
Josh.
Hi Nanny, you are correct. PEP can delay the body making antibodies. This is why at home tests that use antibodies can only be used from 90 days. This ensures anyone who is positive will test positive. Some people may test positive earlier using this test, but everyone is unique for how long it takes to produce antibodies. This is why the recommended minimum time to use these tests is 90 days.
Good morning
Here I have last Question to ask.. I have read something same if you diagnosed positive to hiv u can be come undetectable when on treatment, So when u take hiv antibody test the results will remain positive right.My Question is why we count 90 days window period from last day of PEP if u were taking. Is PEP going to delay antibody test?
Hi Nanny, condoms are effective barriers for preventing HIV transmission.
Thank you somuch, may God hear my prayer I had condom break which I have notice after few minutes nd I started pep after 5 hours, he ddnt ejaculated nd before this exposure we were using latex condom.. But do to stress I doubt if condom can prevent infections, so I’m still worried of the days we used condom
Hi Nanny, it is possible to test this early. These tests look for antibodies. The body makes antibodies in response to infection. For HIV this can start as early as 23 days after exposure but it can take as long as 90 days for the body to start making them. This is why it is suggested the test be done 90 days or more after exposure. But for this reason, it is possible to test positive earlier using these.
Sorry more Questions
I have read something here on internet saying hiv rapid home antibody test can detect infection from day 23 to 90.does this mean that its possible to test positive at day +23 after exposure or I’m confused?
Hi Nanny, for this type of test to be accurate you will need to wait 90 days after PEP. It is a good sign that you have already tested negative and this would indicate you are much more likely to remain negative. Do you have access to a health clinic? The clinic may have facilities to confirm your status at an earlier date. In the meantime you can follow this link about anxiety while waiting: https://i-base.info/guides/testing/hiv-testing-feelings-of-fear-anxiety-and-guilt
Thank u for your quick respond, the test I used it’s a home rapid test hiv 1/2 antibody test which display result after 20 min. I am so worried becouse my partner tested positive. So how do I count window period, from exposure or from the day I finshed PEP
Hi Nanny, do you know what type of rapid test you took? Some tests require a different amount of time to be sure. If it was a 4th generation Ab/Ag test, this would be conclusive. You can follow this link for when you can test for HIV: https://i-base.info/guides/testing/what-is-the-window-period
Good day your information will help alot, I was on PEP from 6 of October nd I have tested nagative today 18 January using antibody rapid test. Is my result accurate or when is the write time to test in order for Good Result.