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 Ken, neither of what you mentions reduces how effective PEP is. Being in a sauna or drinking alcohol will not reduce how well it works. As you have been taking it everyday, you have done nothing that will change how well PEP works.
Thank you Doctor,lastly on my social life,
1. I’ve been GOING to a health club for sauna and steam bath while on PEP,clarify if this induced heat in the body by the sauna doesn’t affect the amount of drug in body which might compromise with efficacy of the drug .
2. Drinking beer and whisky while am on PEP doesn’t affect efficacy of the drug but I have never missed a dose of my TLD PEP course.
Hi, your results are conclusive. You are HIV negative. You do not need any further testing. Please follow this link for more information: https://i-base.info/guides/testing/hiv-testing-feelings-of-fear-anxiety-and-guilt
Hello, I started pep treatment after a suspicious intercourse at the 39th hour. While receiving Pep therapy, the HIV combo test was negative on the 12th day. I continued the PCR RNA 226(positive) drug. On day 20, HIV RNA negative HIV Duo ultra negative and HIV confirmatory test negative during pep therapy. On the 30th day, the drug was finished and on the next 5th day, HIV RNA was negative. HIV Duo ultra-negative 1 month after the drug ended. My HIV test came back negative on the 90th day after the medication was finished. I think I had it done at the hospital for 3 generations. Eliza test was negative 5 months after the drug ended, that is 6 months after the contact.
Hi Ken, PEP is not used for more than 30 days because there is no longer benefit to doing so. Increasing the duration of PEP does not increase how effective it is. Most studies for PEP show that from 21 days PEP will have worked or not. PEP is currently given for 28 days more likely as an ease of adherence rather than increasing the effectiveness of the drug.
If PEP can delay a possible infection,why not then prescribe it for a duration of more than 28-30 days such that all probable chances of infection are ruled out.Am currently on PEP day 30 but I would wish to continue PEP for extra 10days to eliminate anxiety and build confidence.How beneficial can this approach of extended medication be in eliminating probable infections? Thanks
Hi Ulan, while on PEP you are unaware of your status. While very unlikely, it is possible. This is why when on PEP it is recommended to either not have sex or use a condom until you are sure of your status.
Can I transmit hiv to a partner when am on pep?
Hi Ken – PEP protects from all risks from having sex. Kissing is not a risk though whether you are on PEP or not.
Hello, If I have abrasions inside the inner parts of my mouth and I kiss a partner who is HIV positive much as she has no bleeding gums.Is there a risk of me being infected am currently on PEP.