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

Answer: Josh Peasegood

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.

Please see the link for more information about PrEP:
https://i-base.info/guides/prep

Please see this link for more information about PEP:
https://i-base.info/qa/factsheets/pep-faq

Josh.

136 comments

  1. Josh Peasegood •

    Hi Sean, yes PEP does work as PrEP. You do not need to extend the course of your treatment by 7 days.

    More information about PEP can be found here: https://i-base.info/qa/factsheets/pep-faq

  2. Sean •

    Hello Sir Josh! These are in my PEP, Lamivudine, Fumarate de Tenofovir, Disoproxil Comprimes!
    My question is during PEP if i have another Exposure, does PEP work as PrEP and help prevent infection? Should I extend my PEP course? Thank you

  3. Josh Peasegood •

    Hi AJ, PEP would not be recommended in this case. It is still considered low risk even if your parter was HIV positive and not on treatment. Rubbing your penis’ together is not a significant risk.

    More information about transmission can be found here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing

  4. AJ •

    Hi Josh,

    If you’re foreplaying and you’re rubbing your penis with another penis, can you catch HIV thay way.. Let’s say the person is hiv positive and hant taken any medication. Would I need pep just in case.

  5. Josh Peasegood •

    Hi AJ, as a single occasion being later than normal is unlikely to risk your treatment is not working.

    Are you able to take PEP to work with you as to avoid being late again?

  6. AJ •

    Thank you Josh Peasegood. Yesterday I was an hour late due to work, so I took my.medication at 6:45pm an hour an a half later than usual. I’m still good right?

  7. Josh Peasegood •

    Hi AJ, no you do not need to be concerned. Being half an hour late with your medication is not going to have any impact on how well it works.

    As with most treatments taken at a specific time it is okay to take it within an hour of it’s normal time e.g., between 5:00pm and 6:00pm.

  8. AJ •

    Hi, I have one more question. I’m on Pep and I take my medication every day around 5:30pm or so. Today, I took the medication at 6:00pm, 1/2 hr late. Should I be concern about taking the medication a half an hour later than when I normally take them?

  9. Josh Peasegood •

    Hi Aj, no you do not need to extend your course of PEP.

    While on PEP, the treatment will also work like PrEP. You are protected from further exposures for the duration of the course. You can complete your course of PEP when originally planned.

    For more information about PEP please see here: https://i-base.info/qa/factsheets/pep-faq

  10. AJ •

    Hi all, Happy New Years

    So I started taking Pep on January 2nd from a potential January 1st exposure. I’m taking emtricit-tenof- disop and truvada. Today, January 11th, like an idiot, I may have had another exposure. I am a bottom BTW.

    My question is, should I extend my pep medicine after the 28 days, or am I ok. I’m asking any medical professional on this field.