Question

Is my partner at risk when I am on PEP – or afterwards?

20 December 2022. Related: All topics, HIV testing, HIV transmission, PEP/PEPSE.

I had sex with a random person and the condom broke few minutes before he came. We went for an Elisa Test and his results were positive. I started taking pep 28 hours after exposure and I have been taking it for 20 days now.

During this 20 days, I have been having sex with my boyfriend since day one because I couldn’t find a reason to give for not having live intercourse as saying the truth could have costed me the relationship. Could he be sick? Could I have infected him?

Answer

Answer: Simon Collins

Hi there

How is your random casual partner doing?

How did they react to finding out they are HIV positive?

Do they have support including access to treatment?

Although you are worrying about a small chance of being positive, this person is dealing with this for real. i-Base is a service for people living with HIV so I worry about them.

Having said this, it is really good that you started PEP. This will dramatically reduce the risk that you become positive. PEP will protect your boyfriend while you are taking it, even if you are unlucky and do become HIV positive.

This is because PEP often delays seroconversion in the rare cases when it doesn’t work. It is also why you need to wait for 6 weeks after the last PEP dose to take an HIV test.

This will give you more time to decide what to do when the PEP is finished.

This is because your boyfriend will be at risk if you have sex without condoms if you do become HIV positive. Here are a few options.

1. You could either make up reasons why you do not want to have sex, or make up reasons to use condoms. This could include that you don’t feel like penetrative sex, have other types of sex instead, or say you have a fungal infection (this is not an STI). None of these explanations are likely to sound convincing if you are normally used to having sex without condoms.
2. Another option is to find a way to talk about what really happened. This is also not easy, even though it should be. Sometimes this can end a relationship or raise issues of trust just because of one small incident that is not otherwise important.
3. The third option, also common and perhaps the thing most people do, is to say nothing and hope everything will be ok. In most cases it will be. If you pick this last option, try to reduce the times you have sex until you get the test results.

Whatever you decide to do, I hope everything works out well.

In reading the answer, please remember that HIV is not an easy virus to catch. Even though it only takes one exposure, the risk from a single exposure is usually much lower than 1%. This compares to much higher risks if you have another STI where the risk of transmission might be more than 80%.

If you are unlucky though and do become HIV positive, then your boyfriend will be at much higher risk during the first few months when viral load is very high. Getting an undetectable viral load on HIV treatment will bring this risk down to zero.

i-Base doesn’t usually post questions about transmission online, but we often get this question. We are answering it now because it is a difficult situation that isn’t often discussed.

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