Question
Do I need to extend PEP after being exposed midway through?
16 May 2022. Related: All topics, HIV transmission, PEP/PEPSE.
Hello Here are the sequence of events need guidance:
1. April 25th my condom slipped when I pulled out since I panicked, concerned my Doctor started me on PEP Truvada and Tivicay which was started in time (40 hours) on April 27th.
2. I have been on PEP for two good weeks and had a very similar incident, where the condom slipped again. I don’t know the person’s status is unknown. May 12th, this is quite a bizarre instance of occurring twice. I think I switched to a new condom brand.
I have two clarifications here:
1. Since I am on PEP and one of the medication Truvada is also used as PREP what are the risk here for me with given incident?
2. I am still taking PEP and have 15 more days of dosage left which will end on May 28th. So given that I am already on. The meds and the risk exposure of the issue should I just complete rest of my course and extend the PEP additional 2 weeks?
NOTE: I have been very careful and these unfortunate incidents happened twice.
Appreciate your guidance
Answer
Hi, how are you doing?
You do not need to extend your course of PEP. This is because, as you have mentioned your regimen of PEP contains the drug combination used in PrEP. For this reason PEP will have been acting as PrEP in your body and prevent further risky exposures while midway through the course.
You can finish your course of PEP when originally expected (when you get to the end of the next 15 days).
I understand that you have said this is a rare occurrence but have you considered PrEP? This would prevent any further panicking if you have any future problems with condoms.
Josh,.
Hi Farnk, as you are already on PEP you do not need to extend your course. PEP will prevent the risk of further exposures while you are taking it. You can finish PEP when initially planned.
As this woman has been on treatment since 2014 it is likely she is undetectable. This means that you would not need PEP as she would not be able to pass on HIV. This is called U=U: https://i-base.info/guides/testing/uu-undetectable-untransmittable
Helo am Frank, I have been having unprotected sex with a girl and I found out she has been on ARVs since 2014, I have been on PEP for 13days, will I need to extend the doze or I stop from the first
Hi Galukande, no you do not need to extend the course of PEP. As you are already on an established course, there will be enough PEP in your body to protect you from further exposures. This means that while you are taking PEP, you are protected from further exposures.
You can finish your course of PEP when originally planned.
Have been on pep for 26 days, on the 27th I had unprotected sex, should I go and get another doze or I just stop on the 28th
Hi Martin, only 2 days extra are required because this is how on-demand dosing works: https://i-base.info/guides/prep/real-life-examples-for-on-demand-dosing You can use this method because the PEP already in your body would have been acting as PrEP. If this was an exposure mid-way through the course you would not have needed to extend the course. You are only required to do so because this exposure was at the end of your PEP course.
If you feel more comfortable you can continue to take PEP for how long the doctor has suggested, but it will offer no additional benefit to your health.
As you told me to extend 2 days on pep it , but doctor say artist 7 t0 14 days to be safe should or I stop it because am making 5days extended days.
Hi Martin, while you have been on PEP, it can act as PrEP and prevent further exposures. As this was on your last day of PEP, if you can continue taking PEP for another 2 days it will be effective at preventing transmission. If you are unable to access another 2 days of PEP, the fact that you were on it when exposed will still greatly reduce the risk of transmission.
I was taking pep in 28days but I had unprotected sex at 28th day . What should I do now
Hi Van, there is no risk to your girlfriend. HIV cannot last long outside of the body – while on PEP your chances of transmission are VERY small. HIV will not last on your finger and after washing, it will not remain.
You have not put your girlfriend in danger. There is no reason to worry in this case.
Hi josh
I have started PEP around 60 hours after an exposure. Now, I had haemorrhoids before 1 year and because of that i have some rectal discharge that I always clean. Now 4-5 days in to PEP treatment, I fingered my girlfriend with one of the fingers I used to clean by butt earlier ( I usually clean my hand thoroughly with water and soap after cleaning my butt ) . There is more than 2 hours gap before I put my finger and I am really worried if maybe I put her in danger. Could you please advise me ?
Kind Regards,
Van