Question
PrEP question about dosing
9 April 2024. Related: All topics, PrEP.
Hello, I am a gay male. I use prep on demand. I took 2 pills on day 1 and continued with 1 pill on day 2 and another 1 pill on day 3. In total I took 4 pills. However, I did not have sex. I stopped taking the prep, now for 5 days. I want to have sex tonight. Can I restart with 1 pill, because it was so recent, or do I need to restart with 2 pills, and then continue with 1 pill every day after sex?
Thank you.
Answer
Hi there
Please see detailed info on event-based 2:1:1 dosing in this updated guide:
https://i-base.info/guides/prep
Either way, there is unlikely to be much difference whether you started with a double dose again or not. Dosing can be very flexible and levels of PrEP would have been good either way.
Hi Joey, oral sex carries little to no risk of transmission. Saliva contains antiviral properties that prevent HIV transmission via this route – there has never been a documented case.
PrEP will be effective at preventing transmission of HIV.
More information about testing and transmission can be found here: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Hi Josh,
Thank you for the reply. Yes, I performed oral sex nearly 1.5 to 2 hrs after taking prep. I have a lingering question: does the 2:1:1 dosing prevent transmission through oral sex?
Thank you
Joey
Hi Joey, to clarify you had taken a double dose and then 1.5 hours later you had sex? Meaning you were only half an hour early?
In this case you do not need to extend PrEP/seek PEP. Within 30 minutes of taking PrEP you will already be afforded most of the protection from PrEP. Having sex these 30 minutes early are not going to have a significant impact on your risk and you do not need to worry. You can complete your course of on-demand PrEP when originally planned.
Hi,
I have a question about on-demand dosing too.
I took the double dose the day I engaged in sexual activities. However, I realized there were not enough time interval between first double dose and sex (approximately 1 hour and a half). I continue dosing on the following days, now it’s nearly third day. Is there a risk? Should I extend Prep or shoud I seek PEP
Thank you!