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,.
Another question, if I started my treatment 48 hours after exposure, with PEP, thinking positively that the LTD ACRIPTEGA pills have done their job 100%, if I have sex with my partner who is 100% healthy, has some risk of contracting HIV?
Hello, can you tell me how long ACRIPTEGA lasts in the body after taking it for 21 days? Is there any negative effect that beer has on the drug?
Hi Coxy, yes you would need to restart your course. As you had completed your course you would not have remained protected for the following days.
Hi,I recently ended my pep and after 28 days on the 30th day I got exposed again,should I start another course of pep?
Hi Tracy, as you are on day 27, you can extend your course by 1 day (29) and this will act as on-demand PrEP. This will be suitable to provide protection from HIV transmission.
Hey I’m Tracy
I had an exposure then decided to use pep. On my course of pep I had another exposure on day 27 of my course and now I’m scared that I might be exposed to HIV as I don’t know my partner’s status. What should I do? Should I just finish the course or extend it ?
Urgent
Hi Nic, having sex while on PEP does not make PEP less effective. it is recommended to not have sex while on PEP as there is the potential for transmission as you are unaware of your own status. It does also mean that if you do have sex, you are protected from further exposures. While on PEP, the treatment will act as PrEP and prevent other risks. PEP: https://i-base.info/qa/factsheets/pep-faq
PEP is not a substitute for PrEP. It is recommended that when you complete PEP, you have a test and immediately switch onto PrEP. PEP and PrEP are similar but PrEP contains fewer drugs making it more suitable to be taken for prevention. PrEP can be taken either on-demand or on a daily basis: https://i-base.info/guides/prep/how-to-take-prep. 2 days is required after the last sexual encounter before PrEP can be stopped.
If you do test HIV positive, taking Descovy would not significantly risk resistance. Resistance is rare and is more commonly caused by poor compliance rather than a treatment with fewer drugs. Descovy can be used in the treatment of HIV. After testing positive a third drug would be added to make the treatment more suitable.
Hi, I just finished my 29-day PEP (Biktarvy) course (my bad that I miscounted the days). I did have some exposure on day 4 and day 25 while on PEP. I was wondering how much protection (on a scale 1 to 100%) I had for the exposures during the course? Why is it that one health care provider told me that I was protected during PEP and the other told me not to have sex as it would make PEP less effective? Does PEP really work as PrEP or not (and how many days after taking PEP to make it work as PrEP if ever)?
I am starting my PrEP (Descovy) course straight after. How much protection will I get if I have condomless sex now? How long should I wait until the protection reaches 99%? And if I decide to stop having condomless sex, how much longer should I continue taking PrEP from the last exposure?
Lastly, if I was hiv positive (let’s say recent tests were done too early to detect the virus), would taking Descovy build up drug resistance for the future actual hiv treatment?
Thank you.
Hi Derrick, as you had already started PEP you do not need to extend your current course of PEP. PEP will act as PrEP for the duration of the course. You can complete your course of PEP when originally planned. Please see here for more information: https://i-base.info/qa/factsheets/pep-faq
Hello,
I started Pep and Prep 3-1-23 and on day 6 I was exposed to HIV through insertive anal. What are the chances I get HIV ? Should I extend my pep ? I don’t know what to do. Please help