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 Kel, no this will not change how effective your course of PEP was. As you had more than 2 doses of PEP after these exposures it would have acted like on-demand PrEP. These will not risk transmission.
Hi Josh I have another question, so during my PEP which i was taking i took for 28 days and i finished my all doses with good adherence and i even took two extra drugs from the bottle, it was TLD that i was taking so today 4 October was the last day of taking the 30th dose. I tested today using Bioline it came out negative, now my worry is this i had two exposure on my 22 and 23 day of my course will this affect the effectiveness? Or there is a need of my to extend the days again?
Hi Kelvin, no you do not need to extend your course of PEP. You can finish this course when originally expected.
Please see here for more information: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Am on day 23 of pep do I need to extend the day when I got second exposed on 23 day?
Hi John, if this was a high risk exposure it would be recommended to take a second course of PEP. Taking 2 courses in a row is not going to change how effective PEP is.
Am John i completed my 28days of taking pep on 9th and on 17th I was exposed again. After 50 hour’s i started taking pep again. My question is “is the decision of starting again taking pep the right decision or i should stop taking it” please advise.
Hi Samson, these symptoms are not suggestive of seroconversion. Have you spoken with your doctor about possible causes for these symptoms?
As you had been on PEP and your second exposure was protected (by condom and PEP) it means that HIV is a very unlikely reason for your symptoms. The symptoms you are not experiencing are not uncommon and many illnesses and if they continue/get worse please speak to a doctor.
Hey Josh,
I finished my PEP on 03rd/09/2023 that’s last Sunday. However, I got another exposure midway of PEP and you advised that I don’t extend the PEP since it acted as PrEP for any would be infection. Just to remind you; the anal sex in the second exposure was safe and condoms didn’t break but we’d oral sex where I took in my partner’s semens yet he tested positive for HIV.
I am experiencing stomach upset characterized by diarrhea, skin rash, headaches and fever. Should I say that I am seroconverting? What are the chances that I will turn HIV positive?
Please talk to me. Thank you
Hi Samson, the symptoms you are experiencing are not caused by HIV. You are not seroconverting. While taking PEP you would not experience symptoms.
The symptoms you have mentioned can all be caused by stress. Have you been able to speak with anyone about how you are feeling?
You do not need to extend your course of PEP.
Hi Josh,
This is my 26th day on PEP. I had another exposure while on PEP for 18 days. You asked me to continue with this course and not to extend it by any days ahead since it worked as PrEP against the would be infection.
Remember my partner in the second exposure tested positive for HIV. Now I have sores in my mouth and most important, the fatigue and stress.
Should I be convinced that everything will be well with me and I won’t seroconvert?
Please speak to me because I’m getting wasted on my inside. Thank you