Q and A

Question

Can I use PrEP as PEP?

I recently had unprotected anal sex with an anonymous guy whose status I do not know. I am a gay male who bottoms and I am currently on PrEP. I was a little inconsistent with my PrEP before having sex with this guy. I decided to get on PEP just as a precaution, but I was unable to get the Tivicay until after the 72 hour period. I took the first Tivicay dose at about 90 hours after possible exposure. I am also experiencing anal bleeding which I believe is due to a haemorrhoid so I do now know if that was present at the time we had sex.

I wanted to know if my existing PrEP (Truvada) is going to cover me for the time I did not have Tivicay. I think I doubled on my Truvada right after having sex because I was a little panicked. I was taking 2 doses each day until I got the Tivicay and now I am just taking one Truvada and one Tivicay. I also wanted to know how long I should wait until I go to get tested before I get retested for HIV.

Answer

HI, how are you?

PrEP and PEP can contain the same medication. The difference is PrEP contains 2 and PEP uses 3. As there is a difference, there is no research to suggest you would have been covered for the delay in taking the full combination required for PEP. Though it is certainly a possibility that it did.

How inconsistent were you with PrEP before this exposure? If you took daily PrEP for the two days before you had sex, then you don’t need PEP. Or if you re on event-based (2:1:1) dosing and took the double dose the day before, you also don’t need PEP. In both thee case PrEP will cover you.

Do you have reason to believe this partner was HIV positive? This link will help to determine risk of transmission on the basis of the type of sex you had.

A test will be conclusive 6 weeks after finishing PEP. This will be a 4th generation antigen/antibody test and will be 99% conclusive. No test is 100%. Any test prior to this may give a false result due to the effects of PEP.

Josh.

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