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 Mntu, yes it will still be effective. PEP will work to prevent further exposures while you are taking the treatment.
PEP: https://i-base.info/qa/factsheets/pep-faq
Hi ,I had an exposure on day 2 after starting on pep ,will pep still be effective?
Hi Shasre, even though the drugs used in PrEP and PEP have different names they largely work in the same way.
You only need to continue PrEP for 2 days after an exposure. You do not need to extend a course of PEP for a full duration.
Any exposure you have on PEP you are protected from. PEP will only work as PEP for the first exposure you have which is why it can be completed at 28 days and you are still protected from all further exposures for the duration of the course.
Hello Josh ,very sorry to keep asking
So , basically tenofovir and lamivudine are the two drugs in my med (my pep med) and dilutogivir or something like that , I read on a prep it contains tenofovir and emtricibine something like that…..
So taking this into reality , pep after seven days is like prep? , and if you don’t stop taking pep since I had an exposure day 26 , and continued taking the med for another 28 days, for those addition 28 days , would pep still be acting like prep or does pep stop working after 28 days and taking further pep pills will not help ?
Thank you so much for your response!
Hi Shasre, yes PEP will have continued to work like PrEP.
As the third exposure you have mentioned was on day 26, the following 2 days of PEP will have been long enough to complete a course of on-demand PrEP.
You were protected from this exposure even with him ejaculating inside of you. An additional 28 day course of PEP was not needed.
PEP: https://i-base.info/qa/factsheets/pep-faq
Good morning Josh
I just read about pep working for everyone as prep for the middle two weeks only
I’m a woman and now I’m worried as my second and third exposures was on the 4th and 5th day of taking pep , I am so stressed now I don’t know if it was working well or I became infected , in all these cases he never ejaculated inside me
Also if they said for the middle two weeks only , I had another exposure on the 26 where I was drunk and he came inside me , so I continued taking my pep pills for the remaining 2 days and even continued for further 28 days
My question is , as I never stopped taking pep , will it continue working as prep for those other 28 days since I never stop taking the pills
Hi Daniel, if this is high risk please speak with your prescribing doctor and start another course of PEP.
I think it’s a high risk and the person is HIV positive… although I don’t know his viral load
Hi Daniel, was this a high risk exposure? Do you know the status of this person? You can work out the risk of exposure here: https://i-base.info/guides/testing/risks-for-transmission
It is safe to take 2 course of PEP back to back. Being on PEP for 60 days is not going to cause any problems. It will delay when you can take a test. The earliest you can now confirm your status (from both exposures) will be 6 weeks after the last dose of the second course. This will be using a 4th generation test.
PEP: https://i-base.info/qa/factsheets/pep-faq
Hi guys…I just finished taking PEP on Saturday….so I had another exposure on Sunday and Monday so I now started taking PEP all over again on Monday because the person i had sex with is HIV positive…..I just want to no if I took the right decision….so currently am on PEP..please did I take the right decision…Thanks