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 Sam, yes it can act as PrEP while you are taking PEP. PEP: https://i-base.info/qa/factsheets/pep-faq
Oral sex carries little to no risk of transmission. There has been no documented of case HIV transmission via oral sex.
Hi Doctor,
If I am taking TLD for PEP, can it act as PrEP in a situation where I get another exposure while 18 days on PEP?
And what are the chances of contracting HIV through oral sex especially sucking the dick and taking in semens of an HIV positive partner?
Kindly advise me because I am really worried.
Sam
Hi Samson, no you do not need to extend your course of PEP. While taking PEP you are protected from further exposures. In these cases PEP will act as PrEP. Also, oral sex carries little to no risk of HIV transmission. Continuing with PEP for the next 14 days is suitable to prevent transmission.
For more information about PEP please see here: https://i-base.info/qa/factsheets/pep-faq
I am 16 days on PEP, yet I have got another exposure. I and my partner had protected anal sex where the condoms didn’t break. However, we had a blow job and I sucked his dick where I took in my mouth his precum. We tested later on for HIV using determine testing kits and he tested positive for HIV but I was negative.
I am really worried about whether I am safe and I am not sure whether the remaining tablets of PEP for 14 days will suppress the new infection if any. I am also confused whether I should extend my PEP for another 16 days after this course is done! Please advise me because I’m dying. Thank you!
Samson
Hi Joshua, yes while on PEP you are protected from further exposures. This is because you are continuing with the course for a longer amount of time. There is still enough time after exposure for it to be suitable as PEP within the 28 day course.
I took pep for 3 days already since my first exposure. Am I protected if I have unprotected sex now? You mentioned pep works as prep too. But it takes prep at least 7 days to reach maximum protection. (7 days is the time for the medicine to reach to mucous membranes for protection) . Is it true
Hi Bash, as you had completed your first course and this was not a midway exposure, you will need to restart a course of PEP.
Hi
I would like to know if should I restart my course? I got exposure after 5 days I finished my course. I finished on Tues and got exposure on Sunday.
H Cristian, Acriptega has a short half life. This means that most of the drug is out of the body within 24 hours. This is why the medication is needed to be taken daily. 21 days is not enough time for long term side effects to develop.
Hi Cristian, even when taking PEP correctly you are still unsure of your status. For this reason it is recommended that you either do not have sex or you use a condom. This is because there is potentially some risk of transmission even though this is very unlikely.
More information about PEP can be found here: https://i-base.info/qa/factsheets/pep-faq