Question
I didn’t double dose for on-demand PrEP…
13 August 2022. Related: Adherence, All topics, PrEP.
Since I took PrEP on-demand by using the method 1:1:1 instead of 2:1:1 did it give me a bit of protection, or not at all?
I took the first pill around 1 pm, I had sex around 10 pm and then I took 1 pill the day after and another one after two days..
Answer
Hi, how are you doing?
Yes, taking the 1 pill instead of 2 is still going to provide you with some protection. It is always better to have something rather than nothing.
There are also other factors of sex that will change the risk.
Is there a reason you only took one pill on the first day?
Josh.
hello Kristian and thank you for your question.
If I understand correctly you took 3 tablets the first day, then no tablets for 1,5 – 2 days, then 1 dose the day after sex and one more dose after that.
The newest evidence say that if you have taken at least 4 days of prep in a week, that offers protection.
Sounds like you have. Apologies if I misunderstood.
Please see the link bellow for more dosing information:
https://i-base.info/uk-guide-to-prep-february-2024/
https://i-base.info/guides/prep/real-life-examples-for-on-demand-dosing
Hi I-base,
I decided to take on demand prep, I took double dose of prep and additionally within that time period a single dose of prep, 36-40 hours before sex, slightly concerned, level of protection. I did take another 1 dose of prep again 24 hours after and 24 hours again.
Hi Dewny, is there a reason you do not follow the 2-1-1 schedule?
Do you know if your partner is HIV positive and/or on treatment?
As you have only taken one dose of PrEP prior to sex the same level of protection cannot be guaranteed as if you had taken a double dose. However some PrEP is always better than no PrEP and can still provide some protection.
The need for PEP is based on this being high risk e.g., known HIV positive partner not no treatment, rough sex, long duration of sex, use of drugs etc…
More information about transmission risk can be found here: https://i-base.info/guides/testing/risks-for-transmission
Dear ibase team.
my situation is I use on-demand prep, but just take one pill at the start instead of two pills like the schedule.
After I took that one pill correctly 5 hours I started having unprotected sex with my partner. And he ejaculation inside my anus, after his ejaculation i immediately go to the toilet and try to push the perm out of my anus at least 25 times.
That means I use a 1-1-1 schedule instead of a 2-1-1 schedule.
I am so worried and confusing that should i take the PEP immediately or not because i still in my 72hours.
is 5 hours is enough for the body absorb enough elements to protect me form exposure to hiv.
Please help me to answer these questions as quickly as you can i really need some advice at the time.
Thank you all for listen to my problem, I’m so grateful for that
Hi Onyinye, it is good yo used condoms but they can sometimes break. The risk is likely to be very low though if you noticed in time and your partner did not ejaculate.
Although using tenofovir might help, taking meds after a risk usually has to include three meds.
This is called PEP and there is more info ar this link:
https://i-base.info/qa/factsheets/pep-faq
I had unprotected sex and the condom broke, but he did not ejaculate inside me. I bought tenofovir 300 mg pills. How long can I take them?
Hi Minesoung, as your partner has always used condoms and his previous partner was a long time before taking the test, he is negative. For this reason there is no risk to yourself.
1-1-1 dosing is still going to provide some protection but it will not be as effective as 2-1-1. It is good that you took it.5 hours prior – this allows time foe PrEP to be absorbed by the body and work.
Dear Josh,
Thank you so much for you reply. I am, once again, really grateful to you.
I took one pill of on-demand PrEP prior to sex (5 hours prior), instead of taking 2 Therefore, I am not sure if enough dosage of PrEP is built in my system. I used Tenof-Em pills that contains 200 mg of emtricitabine and 300 mg of tenofovir disoproxil fumarate. My partner had tested last month with “Anti HIV 1/2” test, which I assume is the antibody test. He said that he has’t had sex with him for the last one year. And he always used condoms with the other people in that last year. I am just worried if the one dosage of PrEP hadn’t built enough protection in my body. So I did 1-1-1 instead of 2-1-1.
Thank you so much for your reply. I am really really grateful for this website.
Hi Minseoung, did you take any PrEP prior to sex? If you did not, PrEP will not have effect if you continue with it after sex.
As you used condoms there is no risk of exposure with anal sex. When did your parter last have sex with his ex-partner? If it was 6 weeks before taking the test, his result will be accurate if he has had no more exposures.
Oral sex is not considered a high risk exposure – in the UK oral sex is not an exposure that requires PEP. This is because saliva has anti-viral properties making HIV transmission through saliva very unlikely.
Dear i-base team,
I also forgot to take the one of the two initial dose of on-demand Teno-Em (Generic Truvada) before 5 hours prior to the sexual intercourse. I took it after 6 hours of the intercourse when I remembered that I forgot. I am still continuing taking them. We used condoms during anal sex and no ejaculation happened. My partner has a negative test result from the last month but he said that he found out that his ex-boyfriend is HIV+. We performed oral-sex without condoms and my gum health is not the best (wound in mouth), and as far as I remember there was pre-cum. Should I be worried of HIV? I have 2 leftover PEP pills that are remainder from 30 pills. Should I take them? I live in a country that does not provide PEP pills. Was the one dose of prep pill any effective or it wasn’t enough?
Sorry If I make the question complex. I am very anxious and my english is not that good. I am very grateful for this website.