Question
Is PEP effective if taken 48 hours after exposure?
2 July 2021. Related: All topics, PEP/PEPSE.
I paid for sex with a woman but the condom tore and I only realised after I was done. There is a high chance that she was HIV positive. I started PEP after 48 hours.
I got a PCR test done 17 days after exposure. It had a less than 20/ml (undetectable) result.
Now between 14 and 35 days after exposure I have had signs of thrush, mild red rash on my face and a couple elsewhere. But no fever or swollen lymph glands.
Can the rash and thrush be because of utter stress and obsession?
My doctor says that the PCR can be relied upon and that I am negative.
Can the PEP have reduced the viral load to less than 20/ml as I took it for 15 days before the PCR test?
Please give your expert advice. I am very anxious. Thank you.
Answer
Thank you for your question.
The risk of HIV from one broken condom is very low. If your partner had an undetectable viral load on treatment, then the risk would be zero. If they were not on treatment the risk might still be only 1 in 300 or lower.
You cannot guess someones HIV status so your assumptions might also be wrong.
You started PEP within 48 hours, so it is likely it will work.
PEP – stands for Post-Exposure Prophylaxis. It is a term used for taking HIV drugs to reduce the risk of infection. PEP usually involves taking a combination of three HIV drugs for one month. The earlier PEP is started, the more likely it will work. Ideally, this should be within a couple of hours. If this is not possible, then still the earlier the better.
Some guidelines include a two-day window to do this (i.e. within 48 hours). After this, effectiveness is much less likely. Other guidelines allow up to 3 days (i.e. within 72 hours). Sometimes this may be more for psychological benefit. For example, if someone is very stressed or traumatised.
No guidelines recommend starting PEP after 72 hours.
After finishing PEP you need to wait a 4-6 weeks before testing.
If the PEP has worked, or the person was not initially infected, this will show as a negative HIV test. The test you did 17 days after the exposure will not be accurate yet.
If the PEP has not worked, this will be shown in a positive test result. Testing 4 weeks after PEP will detect 95% of infections. Testing after six weeks will detect more than 99% of infections. This result doesn’t need to be tested again.
If PEP has not worked, serosonversion usually occurs 1-3 weeks after PEP is finished. However, only 80% of people show symptoms.
Please test 6 weeks after you finished PEP is finished. If you test any earlier, you need to take a second test 3 months later.
Viral load (PRC) tests are not approved to test for HIV. In some cases they can have a role.
Please see a doctor to talk about your symptoms he best way to confirm what is causing them is to see your doctor. He/she will be able to diagnose and treat the symptoms accordingly.
Please see this link for more information about PEP:
https://i-base.info/qa/factsheets/pep-faq
Note: This answer was last updated in July 2021 from an original post from December 2011.
Hi Roy Trevelion
am 50 days tested after pep finished and I tested negative can I relax now that my answer will never change to become positive without any exposure?
Hi Gigison,
The only way to know for sure if you’re ok or not is to test. I know this can be nerving, but it needs to be done.
Hello. Thank you so much for the work you are doing.
I am a male. I had sex with a female sex worker, and the condom broke, but I had already ejaculated in her. I have no idea about her HIV status. So after 24 hours, I started taking PEP (Efavirenz 600mg, Lamivudine 300mg, Tenofovir Disoproxil Fumarate 300mg, all rolled into one capsule though).
I took it everyday, at around the same time, for 22 days, then I stopped. The 22nd day was Monday 17th December, and since then I have been having off and on fever, or feeling a bit feverish. I don’t have any other symptoms , no rash or loss of appetite or sore throat, or swollen part of the body. Nothing else. I am scared to take a test. I will like to know how much of a risk, I am at? I am really scared. Am I at a high risk of being infected?
Hi Thato,
It’s good that you started PEP quickly. But missing just 1 or 2 doses is probably fine. It’s a good idea to work out a way of remembering to take them. Perhaps chose a time of day when you’re regulary doing something else.
Can the clinic give you any support to help finish the course?
hi.
please I nid help.i had sex nd realised after 10min Dat a Condom has busted while the guy tried fitting his penis in.
I talked to mi sister abt the incident nd xe told me Dat that guy is positive.i immediately run to a clinic nd they gave PEP.
I missed 2 tablets Dat I had to drink in the evening.nd I sometimes miss Times.
am I more likely to be affected by the HIV virus??
Hi,
PEP needs to be taken within max 72hrs after a possible risk. You’re going to need to test.
Hi I’m having sex with someone who don’t know their status then I’m taking morning after.I’m checking every month and I’m sure I’m negative so now realise that he is positive and he don’t take treatment ,can I take truvada even it 15 days after exposure pls help I’m scared.thank you
Hi Higan,
Your questions are anwsered here.
Thank you for good help you give us.
I had protected sex with infected person
and I had three open wounds on my
hands.in time of removing condom Her
vaginal secretions go on my hands open
wounds.
1.how I am risk to HIV positive?
I took pep in 24hours after exposure
(efavirenz, lamivudine and tenofovir). I take
it full monthly.i after 1 day of month of pep I
tested negative and at five weeks after
exposure I had some symptoms like
headache, sore throat, swollen lymph
glands, night sweat, dry cough, sore and
ulcers on my tongue and muscles pain on
my neck and sometimes joints pain and
also my white tongue.i went to my doctor to
look what cause those symptoms, he find
that no illness I had. after 6 weeks of
exposure( Two weeks ago after pep course)
I test again negative.
2.is that symptoms means that I will be HIV
positive???
3. is pep increasing the window period??
4.test after month of exposure doesn’t have
high meaning from pep who took pep??
thanks for your
Hi Jean,
Unfortunately you have to wait for 28 days after finishing your PEP to have the HIV test to confirm you’re HIV negative. But were your wounds open? A cut has to be open to be a risk.
Please see this chart showing risks for transmission. But it’s a good idea to see your doctor about your symptoms to find out what’s causing them.