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 Max, no you do not need to extend the course of your PEP. Your combination of PEP includes PrEP (Truvada).
This means you are protected from further exposures for the duration of your course. You can finish PEP in 5 days.
Sorry to hear that you are feeling anxious. This is why efavirenz is not recommended as PEP. It will still work but because of the side effects other drugs are preferred.
I am taking Truvada and Efavirenz for PEP for 28 days. I was exposed to a possible exposure on the 23rd day. Should I extend my course? Efavirenz has been making me extremely anxious.
Hi Lilly, yes this is a good sign. At home tests will be conclusive 12 weeks after the date of exposure. For this type of test you will need to wait 5 more weeks.
You can have a conclusive result now if you use a 4th generation test. This are accurate from 6 weeks after exposure. These can usually be done at local health clinics.
More information about testing can be found here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Good day Josh
I don’t know if it is the right questions to ask here but I really do hope you give feed back if you can thank you
So I have been exposed to hiv 7 weeks ago , I am so worried I knew nothing about pep , or prep ,
I took an at home hiv text now at 7 weeks and 4 days it came back negative , please can I know If this is a good sign that I might not be infected. Please help if you can , although I will do a follow up test but is there a chance that the test will not turn positive , I have no symptoms too , please help
Hi Jk, as you had 2 doses of PEP following your exposure you do not need to restart/extend PEP.
This is because PEP will have worked like on-demand PrEP. You can stop PEP on the 30th day.
PEP: https://i-base.info/qa/factsheets/pep-faq
Hello I had an second exposure on 28th day of pep and I took the remaining two pills on 29th and 30th day. Should I restart pep again or this is fine
Hi Daniel, you do not need to extend your course of PEP.
As your friend is undetectable, even though their last test was 6 months ago there is still no reason to think their viral load will have increased. This means there was no risk of transmission.
Also as you had already been on PEP it will have worked like PrEP. This means that even if there was risk of transmission from this exposure, your current treatment will have protected you.
PEP: https://i-base.info/qa/factsheets/pep-faq
Hi ,Good afternoon….I had an exposure on my 21st day while on PEP, although my friend was undetectable when he did his last test last six months but I don’t know for now if he his still undetectable so my question is should I extend my course of PEP or stick to the stipulated time.
HI Sashre, taking PEP within an hour of when it is normally taken is fine. While it is best to take it at the same time everyday, there is some leeway to be early/late with treatment and it will work.
PEP: https://i-base.info/qa/factsheets/pep-faq
Hi
And please help, I have been taking pep everyday , but for those days I was not taking it acxactly at 24 hours , some days I’d be thirty mins to hour late than the usual time some days I’d be like thirty mins to an hour early , please what are my chances that the pep will not be effective as I was not taking it axactly at 24 hours