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Is Post-exposure Prophylaxis Effective In Prevention Of HIV?
Question: I am actually writing this question for a family member to allay my fears so please be patient.
Last week a family member hooked up with a gril who he met online and had spoken to her for a while. Well the morning after there date they had intercourse. The family member always uses a condom as he did in this case. Anyway after they had finished he saw that there was a lot of blood on his groind, base of orga, thighs, and sheet. He freaked out and started to get worried, the girl said she had just finished her period or something. She also said she didn't have anything and was last tested a year ago (whatever difference that makes). Anyway after taking a shower and cleaning up the family member went to a local std clinic and told the physisican what had happened. Dr. there said his chance of catching HIV wass about 1%, I don't think he is to up to date with information. Anyway he prescribed the family member PEP which consisted of Truvada and another drug, sorry can't remember the name. My questions are:
1. was this a high risk exposure, a condom was used through and stayed intact, I am more worried about the amount of blood on the skin.
2. Was PEP right for this situation? Is PEP effective?
3. How long does he need to wait and test or is testing even necessary in this situation? If so what type of testing should be done?
4. I am worried about the familys members well being as you can see and hope to find some objective answers which will help me calm down, it's been a horrendous week and appreciate any input.
Last week a family member hooked up with a gril who he met online and had spoken to her for a while. Well the morning after there date they had intercourse. The family member always uses a condom as he did in this case. Anyway after they had finished he saw that there was a lot of blood on his groind, base of orga, thighs, and sheet. He freaked out and started to get worried, the girl said she had just finished her period or something. She also said she didn't have anything and was last tested a year ago (whatever difference that makes). Anyway after taking a shower and cleaning up the family member went to a local std clinic and told the physisican what had happened. Dr. there said his chance of catching HIV wass about 1%, I don't think he is to up to date with information. Anyway he prescribed the family member PEP which consisted of Truvada and another drug, sorry can't remember the name. My questions are:
1. was this a high risk exposure, a condom was used through and stayed intact, I am more worried about the amount of blood on the skin.
2. Was PEP right for this situation? Is PEP effective?
3. How long does he need to wait and test or is testing even necessary in this situation? If so what type of testing should be done?
4. I am worried about the familys members well being as you can see and hope to find some objective answers which will help me calm down, it's been a horrendous week and appreciate any input.
Brief Answer:
No worries
Detailed Answer:
Thanks for your questions. I am Dr Matin and will be answering your queries one by one
1. First of all , it is not confirmed whether the girl was HIV + indeed . Then the HIV risk remains extremely low at best for your relative , assuming the latex condom was used properly and did not break. HIV in infected blood cannot penetrate intact skin. Assuming the skin in his pubic are was intact, his HIV risk from the menstrual blood remains minimal.
2. I guess the PEP is not warranted here as it is still not confirmed whether the girl is positive or not and with her being available , could have been counseled to undergo the HIV test . If found her being positive , PEP should have been started
3. My advice would be to stop worrying! And tell him to do a single HIV-antibody test at the three-month mark post exposure , if he /you are so much concerned. The odds he did not contract HIV are astronomically in his favor.
4. I don't see this becoming a family problem and family members getting infected , it really amuses me. Stop worrying .
Hope this helps
Regards
No worries
Detailed Answer:
Thanks for your questions. I am Dr Matin and will be answering your queries one by one
1. First of all , it is not confirmed whether the girl was HIV + indeed . Then the HIV risk remains extremely low at best for your relative , assuming the latex condom was used properly and did not break. HIV in infected blood cannot penetrate intact skin. Assuming the skin in his pubic are was intact, his HIV risk from the menstrual blood remains minimal.
2. I guess the PEP is not warranted here as it is still not confirmed whether the girl is positive or not and with her being available , could have been counseled to undergo the HIV test . If found her being positive , PEP should have been started
3. My advice would be to stop worrying! And tell him to do a single HIV-antibody test at the three-month mark post exposure , if he /you are so much concerned. The odds he did not contract HIV are astronomically in his favor.
4. I don't see this becoming a family problem and family members getting infected , it really amuses me. Stop worrying .
Hope this helps
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Thank you Doctor for the quick follow up. The condom was indeed intact. IsPEP effective in the early transmission of hiv? I know you said it wasnt necessary but the family member still decided to go with it. So based on the information i shouldnt worry about this event? Thanks again.
Brief Answer:
PEP indeed is effective
Detailed Answer:
Thanks for your kind response.
With condom remaining intact or not breaking up, the chances for HIV transmission are negligible.
PEP indeed is effective in transmission of HIV if taken within 72 hours of exposure and with 100% adherence to medicines.
I am still amused why PEP in this case , but once the person concerned takes a decision to initiate PEP in consultation with his doctor , then he has to complete protocol (to take medicines for a month) .
Hope this helps.
Regards
http://bit.ly/askdrmatinahmedkhan
PEP indeed is effective
Detailed Answer:
Thanks for your kind response.
With condom remaining intact or not breaking up, the chances for HIV transmission are negligible.
PEP indeed is effective in transmission of HIV if taken within 72 hours of exposure and with 100% adherence to medicines.
I am still amused why PEP in this case , but once the person concerned takes a decision to initiate PEP in consultation with his doctor , then he has to complete protocol (to take medicines for a month) .
Hope this helps.
Regards
http://bit.ly/askdrmatinahmedkhan
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank you Dr. For your quick redponse. One ladt question and i will be done, promise. Lets say if there was a small wound, would the chances increase significantly? In concludion do you think i am over reacting and should not worry about this rvent and move on? Thank you!
Brief Answer:
No problem
Detailed Answer:
Thanks for your response.
Since we are still to prove whether the girl concerned was HIV positive and the person had protected sex without the condom being slipped or torn so he is for all purposes HIV negative for me , and in a HIV negative person the wounds would have no effect upon the HIV tests.
Yes, you are overreacting . C' mon take yourself out of it .
Bring in positive thoughts of life and stop worrying about HIV positive issue .
Hope this helps.
Regards
No problem
Detailed Answer:
Thanks for your response.
Since we are still to prove whether the girl concerned was HIV positive and the person had protected sex without the condom being slipped or torn so he is for all purposes HIV negative for me , and in a HIV negative person the wounds would have no effect upon the HIV tests.
Yes, you are overreacting . C' mon take yourself out of it .
Bring in positive thoughts of life and stop worrying about HIV positive issue .
Hope this helps.
Regards
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Above answer was peer-reviewed by :
Dr. Prasad
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