Question
Late with the after sex on-demand PrEP dose.
5 March 2022. Related: Adherence, All topics, PrEP.
Hello for all. I started 2-1-1 prep, took 2 pills 3 hours before sex. Then I took second pill after 24 hours after sex, not 24 hours after the first 2 pills – I have delayed the second pill by 3 hours. I’m still continuing taking PrEP every day because I have sex but I am just worrying is it ok to delay the second dose by 3 hours? Thank you for reply.
Answer
Hi, how are you doing?
Being 3 hours late on the second dose is not likely to cause a problem. The initial double dose will have increased the drug levels within your body more than a single dose anyway. These drugs tend to remain at the required drug level within the body for more than 24 hours.
While it is best to take the medication as routinely as you can, being late by 3 hours is unlikely to cause you any problem. As you have now continued with daily dosing, PrEP will have remained at effective level within your body.
There is no reason to be concerned after this event,
Josh.
Hi John, as you had started with a double dose it allows PrEP to remain active in the body for slightly longer.
This will help to reduce the risk and keep it low. You do not need to be worried. It is still a good idea to test (as with anyone). The earliest to test after an exposure for a conclusive result is 6 weeks after the exposure.
More information about transmission can be found here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Hi Josh,
I had anal sex and bareback and he came inside to me.
However I missed my final dose.
Day 1 @ 7.30am – 2 dose
Day 2 @ 7.30am – 1 dose
Day 3 – Missed
Day 4 @ 9.00am – 1 dose
Day 5 @ 7.39 am – dose
Am I risk? I have been worried and get sick lately.. status this unknown..
What’s the chance to catch HIV if he is positive?
I’m planning to take HIV test next few weeks..
Thanks
John
Hi Phil, for more information about transmission please see here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Do you know if your partner had HIV and/or was on treatment? Did you use a condom?
Being late by 20 hours with the last dose is unlikely to impact how effective PrEP is. On-demand dosing means you have a higher level of PrEP in your body than normal and can account for being late.
I had anal sex both ways but never came inside or anything.
I did the on demand dose of prep but forgot to take my final dose on time but I eventually took it about 20 hours later.
Am I at risk?
Hi Kelynch,
1. PrEP should be taken at the same time each day from the time you take the initial dose.
2. PrEP is extended by continuing for 2 days after the last exposure.
3. Yes you can restart PrEP the day after you finish. You can extend on-demand dosing into daily dosing.
Hello Josh, regarding taking PrEP may I please raise my concerns!
1. If i take prep at 3 pm and have sex at 5 or 6 pm today, what time should i take prep tomorrow and after tomorrow? Does it have to be 24h after the first two doses?
2. If i am willing to have sex tomorrow again (not sure with the time) but after the first sex (first two doses today), how do I extend my prep?
3. As the first case, if my two doses in on Monday and I finish the last two on Wednesday (2-1-1) done. But on Thursday, i am planning to have sex again. Should i take just one pill of prep of can i restart my prep course as the first one has been finished? It concerns me as Thursday is the next day after finishing the last 1 (2-1-1).
I hope you get my point and thank you for your explanation.
Hi Daniel, no you are not at risk. Even without PrEP oral sex carries little to no risk of transmission – there has never been transmission via oral sex. Saliva contains antiviral properties that kills HIV before transmission.
You can finish PrEP the scheduled 2 days after exposure.
More information about transmission can be found here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Hello there,
I have a concern and looking for advice as I am taking Prep on demand only and had oral sex with a partner whose status I am not sure.
He ejaculated my mouth and on my face, the problem is I do have bleeding gums, but no other sores or wounds.
I took 2 pills of prep on Thursday at 9 and I had sex at 23:30, I took the following Friday at 21:00 one pill and then I missed my last dose on Saturday and took one on Sunday at 20:30, which is 48 hours late on my last dose.
Am I at risk? I am continuing to take prep today (Monday) on the scheduled time and will do a few more days if requested
Thank you
Daniel