Q and A

Question

Can I test while I am on PEP?

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.

Please see this link for more information about PEP:
https://i-base.info/qa/factsheets/pep-faq

If you have any further questions please get in touch.

Josh.

102 comments

  1. Josh Peasegood

    Hi Peter, there is no risk of transmission. Please see here for more information: https://i-base.info/qa/factsheets/hiv-transmission-and-testing

  2. Peter

    my girl friend tested negative, I also tested negative ( first test) but am not sure of my girl friends status. we had protected sex unfortunately the condom got broken. what should I do

  3. Josh Peasegood

    Hi Sylprg, for a 4th generation test to be conclusive it needs to be done 42 days after the last dose of PEP.

    Testing negative at 40 days is very reassuring and is more than 95% accurate. But for certainty you are required to take a second follow-up test.

    For more information about testing please see here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing

  4. sylprg

    I had protected vaginal sex for 2 mins and started on Pep the next day and compketed the course on 28 days
    My baseline test was negative before starting the Pep
    My test after pep completion was also negative
    40 days after pep completion, my 4th gen test is non reactive(0.13)
    Is the last result conclusive?

  5. Josh Peasegood

    Hi Nurse, no drug is ever given to a patient without explaining what it is for.

    PEP: https://i-base.info/qa/factsheets/pep-faq

  6. Nurse

    I will like to asked a question my partner his using PEP .I just find inside his bag ,by accident,so I asked about it and told me that the Doctor just give him without telling him is for what. Do you give people PEP without telling him about it or testing them? Then the following day I went to the doctor to test for HIV .I tested negative.

  7. Josh Peasegood

    Hi Lev, as you had used a rubber there is no risk of transmission. You do not need to be using PEP.

    PEP is usually 3 drugs but 2 when needed can be suitable. A 3rd drug is often added for completion rather than being scientifically backed as a requirement. You can continue with PEP as a course of 2 drugs if you would feel more comfortable doing so. Starting PEP within 72 hours like yourself is effective.

    PEP: https://i-base.info/qa/factsheets/pep-faq

  8. Lev

    I have a question, I was in a risky situation when I’m “Doing it”, Before we do anything I put on a rubber before continuing orally then penetration.

    The thing is, I don’t know my partner condition since it’s a one night stand, I’m concerned and I want to take PEP, but my healthcare giver only gave me Truvada (as far as I know it contain TDF & FTC).

    From what I know, PEP should contain more than that (?) Side note, I did take it after 65 hours.
    2 pills in one go.

  9. Josh Peasegood

    Hi RT, a test will be conclusive 6 weeks after the last exposure using a 4th generation test.

  10. RT

    The girl i have sex with tested positive, and i tested negative before window period, show i wait for how long to be tested again because i went to Laboratory after 22 days of exposure results are negative.