Q and A

Question

Can I assume my symptoms while on PEP are seroconversion?

23 May 2022. Related: All topics, HIV testing, HIV transmission, PEP/PEPSE.

Hi, I’ve taken PEP due to the fact our condoms broke. I didn’t know the status of the lady. I took the Ranega (TLD) as PEP, after a week after I finished PEP I had flu and sore throat. Now we are in the 4th week and my body is itching and I can start seeing a rash.

Can I assume this is a seroconversion status? I haven’t taken any test yet because I’m waiting for a total of 6 weeks then I can go do a test.

Answer

Answer: Josh Peasegood

Hi, how are you doing?

No. This is not likely seroconversion. These are too few and too general symptoms to be considered seroconversion.

The flu and the sore throat are common. Regardless of being on PEP it does not stop the flu being common. Do you still have these symptoms?

It is possible that this rash is a side effect of Ranega. Have you spoken to a doctor about this? A rash should be seen by a doctor from when you notice it.

Have you been able to speak to your partner about their status? There are a number of factors other than the use of a condom that can alter the risk of a transmission.

You are right that a test is conclusive after 6 weeks after PEP. But you can take a test at 4 weeks to help with stress. This test will be 95% accurate and the test at 6 weeks will be conclusive. This is a guide about dealing with test anxiety. 

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

Josh.

137 comments

  1. KT •

    Hi…its been about 3 days now and this fever is still low grade around 37.2 degrees celsius. It keeps fluctuating from normal and low grade. Could it be that the hiv is in a weakened state due to pep but my immune system still detected a weakened virus? Hence the low grade fever? I am anxious about this

  2. Josh Peasegood •

    Hi KT, no this is not a serocovnersion and as you had taken PrEP beforehand along with this course of PEP you are not at risk for HIV.

    For more information about transmission risk please see here:
    https://i-base.info/guides/testing/risks-for-transmission

  3. KT •

    Hi, I took 11 dose of PreP before sleeping with a female escort. (Double dose on day of exposure) I took PEP 18 hrs (20 hrs to be exact as it takes 2hrs for meds tobe absorbed) after exposure, as when she was wiping my penis. She wiped it near my urethra with tissue along with the used condom….

    I am on my 10th day of PEP now. I currently feel weak and likely abit feverish. Is it seroconversion? What are my risk of hiv infection in the first place?

  4. Josh Peasegood •

    Hi Joey,

    For more information about transmission please see here:
    https://i-base.info/guides/testing

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

    1. Each time you insert is not considered a new exposure.
    2. PEP is 80% or more effective at any hour started within 72 hours.
    3. Truvada alone will be suitable as PEP before being able to access the third drug.
    4. HIV infects CD4 cells. Sleep cells are considered later on in the process of HIV. This does not effect how PEP works.
    5. No this does not mean your risk is higher.

  5. Joey •

    Hi. I had a high risk encounter 8 days ago on Monday, April 29th. I was the incentive top and we did not use a condom. Apparently he had an anal tissue that started to bleed and not only did it get in contact with me genitally, it also got in my mouth.

    I went to the clinic within 3 hours and got on pep and took my first dose at 4 hours though it was on Truvada as the third drug wouldn’t come in until the next day (I took that drug and another dose of Truvada at hour 20).

    I have lots of questions:

    1. I read about the risk percentage for a top but was wondering if when changing positions during sex, does each insertion act as a second encounter that would increase the risk of infection? Meaning, fully taking it out and penetrate again would be like a second encounter risk?

    2. I read that PEP is 80% effective if taken within 72hrs. Does that mean it’s 80% effective even at hour one all the way to hour 72 or is it higher at 99% at hour 1 and decreased to 80% at 72hr? What is the rate of decrease per hour?

    3. If I took only the Truvada pill at hour 4, is pep.not effective until I took the third medicine at hour 20?

    4. Will HIV infect the sleeper CD4 cells at the same time it’s infecting the other active CD4 cells? Is that why PEP not 100% effective as there is a 20% chance that it infected the sleeper CD4 cells cresting a latent virus reservoir?

    5. Is my risk even higher because I accidentally got a drop of blood in my mouth from rimming him?

  6. Simon Collins •

    Hi Mark, this page has info on PEP:
    https://i-base.info/qa/factsheets/pep-faq

  7. Mark •

    Hi I slept with hiv positive lady, this is the forth week, am still on pep but I have severe ears pains, neck pains,burning sensation, thigh pains,

  8. Josh Peasegood •

    Hi Maaviz, what you have described are not risks for HIV transmission.

    The symptoms you have described are not suggestive of HIV and have presented too early to be a sign of seroconversion.

    Please see here for more information about testing and transmission:
    https://i-base.info/qa/factsheets/hiv-transmission-and-testing

  9. Maaviz •

    Hi i hope you are doing well. thank you very much for the things you guys do on this website. I have a few questions. I have been very stressed over this.

    I encountered a possible exposure on the 22nd of December 2023. I received protected oral sex from someone who might be HIV positive twice with protection. was it a risk factor if the condom tore?
    the 2nd was 30 days ago, The female sat on my genitals, I was naked but she was wearing a thin legging or some sort of pajama? It was very elastic.. My provider put me on PEP right after that, Thing is, I finished PEP course a few days ago and I have been feeling Body aches, Joint pain and overall pain in my bones for the past 2 weeks even after ending PEP. is this suggestive of HIV? Please let me know.

    I tested right after ending PEP and it was negative.

  10. Josh Peasegood •

    Hi John, no your partner is not at risk. You are still advised to use a condom as you are unsure of your status however there is no risk of transmission.

    While on PEP, it will either work and there is no HIV to transmit, or in the rare case that it fails PEP suppresses HIV so much that it cannot be passed on while you are taking it.

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