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 Keir, wearing gloves would mean this is not a second exposure.
Regalrdess, while on PEP you do not need to be concerned about subsequent exposures for the duration of the course. This is because while you are taking PEP, the treatment will also work like PrEP. For this reason you are protected from further exposures while on PEP. You do not need more treatment and you can complete you course when originally planned.
Hi,
I had a needle prick about 13 days ago and started on Acriptega on the same day. I was just wondering what should be done if a second exposure were to happen while taking the medication (had an HIV positive patient today with a bleeding wound which I had to deal with – I was wearing gloves but got paranoid about the potential of micro cuts on my hands).
Hi Shekinah, no this is not ‘too high a risk’ for PEP to handle.
While on PEP, your treatment will work like PrEP. This means you are protected from further exposures for the duration of the course of PEP.
As you have been adhering to PEP you have protected yourself from subsequent exposures. You can complete your course of PEP as expected without extending the duration.
PEP: https://i-base.info/qa/factsheets/pep-faq
Good evening , I need help and advice please
I have been on pep for 22 days when I had another exposure where the hiv positive person ejaculated inside me , I am a female by the way …..the person is not on treatment too , is this risk too high for pep to handle now
Please help me , I don’t know if now I will be infected , maybe pep can’t help with that exposure ….
Is there a great chance that pep was working well as it is supposed to , I have been adhering to my treatment, I was very careful , help
Thank you for your response doc
Hi Joakim, do you mean you used a condom during this exposure? If this is the case there is no risk of transmission and you would not need a course of PEP.
If you did not use a condom, do you know if this was a ‘risky’ exposure? What is the status of your partner? do you know if they are on treatment if they are HIV positive? what type of sex did you have?
You can use this link to determine if this was high-risk exposure that would require PEP: https://i-base.info/guides/testing/risks-for-transmission
Have you considered PrEP if you are considering a second course of PEP? PrEP is a tablet used before an exposure to prevent transmission and is more effective at prevention than PEP.
PrEP: https://i-base.info/guides/prep
Just took pep for 28 days then after a week have in protective sex again is it advisable to take pep for another 28 days?
Hi Jay, no you were not exposed to HIV again. As you had taken two following doses of PEP on days 29 and 30 after an exposure on the 28th, your PEP will have worked like PrEP.
For testing to be accurate, you will need to wait a minimum of 6 weeks after the last dose of PEP. For this to be accurate you will need to use a 4th generation test. This is because PEP can delay the effects of HIV causing tests to be inaccurate.
PEP: https://i-base.info/qa/factsheets/pep-faq
Hello team ,
I had second exposure on 28 day( was on viraday pep) and I took two more tablets(29 and 30th day ). The second and first exposure was condom slippage. Post completion of pep, doctor asked me to take tests again and I was hiv negative. Do I need to repeat test. Also am I exposed to hiv again.
Hi David, no you do not need to extend the course of PEP. As you had already been on treatment, PEP will have worked like PrEP and there is no risk of exposure to you from this event.
PEP and HIV treatment are often the same drugs. Usually it is a drug called TLD. TLD can be used as both PEP and treatment for HIV.
PEP: https://i-base.info/qa/factsheets/pep-faq
Hi, Good evening…My name is David….I had an exposure on the 24th of dis month while on PEP, although my friend (male) is undetectable… And secondly when we had the unprotected sex ,he did not cum inside me…Am bottom while he is top…his viral load is 19 as at April dis year but I don’t no if he is still undetectable, because around July he could not take his drugs for five days because it took time for them to deliver it to us..but since then he has been consistent with his drugs…..so my question is :
1)should I extend my course of PEP
2) Secondly the PEP am using is the normal drug that HIV people take(It comes in different colours and it’s kinda big in size) I think you will know it….I hope I am safe with it, because am scared right now….Thanks … please I would love to see your response.