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 Nick, to clarify you have had PrEP on day 1 (sex), day 2, day 4 (sex) and day 5. You have only used single doses and you were not already taking PrEP before day 1?
As your partner did return with an HIV positive result starting PEP would be recommended. This is because on-demand PrEP requires an initial double dose on day 1 and you missed a dose on day 3. This can provide some protection and lower the risk but it cannot be said how much.
To help with this PEP can be used. PrEP uses some of the same drugs as PEP and can help account for starting PEP a little later than recommended.
For more information about PEP please see here: https://i-base.info/qa/factsheets/pep-faq
How safe is it to take prep 1 pill of truvada then sex after an hour , following Day I took prep but no sex ,3rd no prep , 4th day prep then sex after 4hours , 5th day Prep then I tested the woman and the results came positive for her….. Question is Can I switch to PEP?….and how protected was I from prep
Hi Drake, did you still have 2 doses left of PEP after this exposure? If you continued with PEP for a further 2 days you would have been protected as PEP will have worked like PrEP.
If you did not have any PEP left after this exposure and it has now been 2 days since, it would be recommended to restart a course of PEP.
PEP: https://i-base.info/qa/factsheets/pep-faq
Hi. Am Drake. I got exposed two days to the end of pep dose. Do i continue with new dose?
Hi Kimberly, PrEP contains some of the same drugs as PEP. For this reason, there can be some benefit to using PrEP as a course of PEP.
Was this a high risk exposure? e.g., do you know the status of your partner, how long did you not have a condom on, was it rough sex?
Taking PrEP for 10 days after in lieu of PEP would not offer much help. If you were to continue it as a course of PEP e.g., for 28 days, it would be more effective. You can also try and access PEP now and switch from PrEP to PEP as the drugs are similar and changing between the two will still have the course of treatment be effective.
PEP: https://i-base.info/qa/factsheets/pep-faq
Good day Josh
I had completed my pep course and a day after that I had an exposure due to condom bursting , I couldn’t access the pep , the clinics where closed on Sunday and Monday and Tuesday where public holidays as well , I couldn’t access pep for those days , but immediately after condom failure I took prep , I’ve been on prep for those three days , and I’m still on it , I decided that since pep is taken within 72 hours , I shouldn’t go and take them
Is this a good idea to continue prep for ten days since only a day has elapsed since my last pep med and the beginning of my prep journey or should I go get pep , will it make a difference
Hi Ralph, while on PEP you are protected from further exposures. PEP will work like PrEP in this case. You do not need to be worried.
PEP: https://i-base.info/qa/factsheets/pep-faq
Hello! I need some advice.
I went through something very similar. Condom slipped during MSM Sex on December 7, I was the top, and I started the Biktarvy PEP Pill (50mg bictegravir, 100mg emtricitabina, 25mg tenofovir alafenamida) December 8.
December 23, the same thing happened. I was topping and the condom broke. I still have 14 days left to finish my PEP cycle.
The second bottom communicated to me with proof that he is taking PReP.
Should I be worried?
Hi Jose, you do not need to extend the course of PEP. As you have mentioned it will work like PrEP when taken daily.
PEP: https://i-base.info/qa/factsheets/pep-faq
Hi,Josh. Have a good day.
I have msm behaviour on 22nd November with condom, but I don’t know that guys hiv status, so I ask for PEP medication in Hospital and take the PEP on 23 November at 9:45 am. I take the Biktarvy as pep(In china some hospital use this for pep.)And then I have another sex on 29th November at 21:am(I have already take 7 pills but 6 days 11hours) without condom ,though we use the hiv kit mainfest both of us are negative. And today I am taking the 22nd pills , and do I require to extend my pep for another 7days,or I should only complete the 28 days PEP? The PEP can work as PREP daily when I have my second exposure ? Thank you for your explain.