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.
Note: This answer was last updated in July 2021 from an original post from December 2011.
Good evening . On January 14th, a girl’s condom slipped off. (She has sex with the homeless and African immigrants, unfortunately I learned that too late). After 8 hours I went to the emergency room and they gave me tld to use it for 28 days and I committed to it. Then I ran a quick test and it was negative. Then 23 days after the completion of pep i.e. 51 days. I took the girl to a laboratory for medical analysis, and we did an HIV test together, and the result was negative, with a result of 0.3. As for my result, it was 0.06. The test is 4th generation chemiluminescence abbot. This was done 51 days after the first and last exposure, or 23 days after completion of the PEP. But 35 days after completing PEP, I have swollen lymph nodes below the ear and jaw, and swelling in the neck. I do not have any sore throat or tonsillitis that continues until now with stiffness in the neck. The temperature does not exceed 37.3 when measured from the mouth the day before yesterday, Thursday, that is, 40 days after the completion of pep. I underwent a rapid analysis, which was negative. Also, on the 38th, I did a quantitive PCR RNA test, but I’m still waiting for the result. I bought azithromycin and used it from Thursday until now, but no improvement. I also did a comprehensive blood picture, which showed that my neutrophils were 72 percent, 5,832 out of a total of 8,100 white cells, while lymphocytes were 20 percent, 1,620, while monosites were 486, which is equivalent to 6 percent. So am I in danger?
Hi Steve, please follow this link for more information: https://i-base.info/qa/factsheets/hiv-transmission-and-testing and for questions about PEP see here: https://i-base.info/qa/factsheets/pep-faq
Hi,I slept with a woman and I suspected she is positive,but it was after 72hrs.What should I do? please help
Hi Zebu, from what you write here, my first concern if for your partner. No-one has the right to make another person take an HIV test. How did she react and how is she managing now. Does she have support and access to treatment?
Hello there.
I paid a woman to have sex with me on 2nd October 2022 and two days later I had to take an HIV test with her and she was positive and I was not.
We went to the health unit and I got pep
But ever since then I have been testing negative and I tested again after 4 months and still negative
However, there’s something over bothering me, ever since I finished my pep there has been a persistent thrust (white tongue)
Does this mean I have HIV
I need your help
Hi A, please read info here about PEP:
https://i-base.info/pep-and-prep/
Or see the links here for much more info about HIV:
https://i-base.info/qa/11844
Hi Mr.Josh, I had tested with 4th gen test kit last week which is exactly 2 weeks after end of my PEP and result is negative. My doctor keep telling me that my result will be negative even I test again in future and my result can be conclusive. He tested syphilis with rapid test kit and came out with negative. What shall I do?
Thank you so much for your time mr.josh
Hi Purity – please read the info linked here about HIV risk, especially the FAQ or the linked booklet:
https://i-base.info/qa/11844
Okay i have a question but i slept with my partner without protection while on pep ..but the person whom i got exposured said he is negative and the test kit showed negative only tht i didnt trust him ..can i infect my husband
Hi Purity, it is good you finished PEP. Please talk to your doctor about any symptoms but this is unlikely to be related.