Question: Hi,
I had sex with a sex provider 2 days ago and unfortunately the condom broke. When I noticed it I remove my penis from her. I asked her her status and she said that she is ok and that she was in her 3rd day doing this.... but she did not appeared to be worried at all. I went to the ER and they put me on PEP.
I am taking 4 tablets of Kaletra 200/50mg and 1 of TRUVADA 200/300mg once a day. I am trying to take these medicine before going to bed, but I am having headache and burning sensation in the stomach.
My questions are, what are my chance to get HIV from this?
When I can have a blood test? PEP will mask my results?
When I can get tested for other STDs?
How effective is PEP?
What can I do to reduce the side effects of the medicine, without lowering the effect of the antiviral medication?
Brief Answer:
PEP offers a high degree of protection.
Detailed Answer:
Hi,
Welcome to HCM.
You had protected sex but the condom broken. Then your risk for HIV is lesser than with the penetrative vagina sex without protection which itself is about 5 per 10000 exposures as per CDC, Atlanta.
You are on PEP. When exactly it was started for you? If it had been initiated well before 24 hours your risk for HIV is almost nil as it could be aborted if there was an infection. Even if you started PEP within 72 hours the risk is negligible only.
PEP may be likely to delay the HIV antibody production and the sensitivity of antibody test if there could be a possibility of infection. So it is better to have a follow up up to six months whereas Antigen tests (DNA PCR and P24 Antigen test) would not have been affected by PEP.
Tests for STD can be performed after 6 weeks.
You have to be tested as per PEP guidelines with a basic HIV test on 0 day, after 3 months then after 6 months.
PEP is highly effective when it is started as early as possible (preferably within 6 hours after the exposure).
Tablets Kaletra can be taken as two in morning and two in the evening instead of taking together.Adding tablet Ranitidine 150 mg twice a day will reduce the burning sensation following the drugs.
Dr S.Murugan
Follow up: Dr. Sankaranantham Murugan (32 minutes later)
Thank you for your answer Doctor.
Just to clarify...
when the condom broke the head of my penis was exposed inside her vagina...this why I am very concerned.
This happened around 8.00pm on Thursday March 27 and I took the first tablets of PEP on March 28th around 4.00 am (I left ER at that time). So I actually started taking the medicine between 8-9 hours of the incident.
I was tested for HIV that day, but I won't have results until 2 weeks (Canada's law)
the Early detection HIV RNA Test won't be affected by the PEP? When is an appropriate time to take this test? I've read that this new approved test can give you conclusive results in 2 weeks after exposure... is this correct? this will apply if I am on PEP?
Brief Answer:
PEP within 9hours ensures total eradication of HIV
Detailed Answer:
Hi,
Welcome back.
You started the PEP within nine hours. That itself ensures that it could abort any infection if it had occurred.
HIV DNA or RNA tests do not get affected by PEP as they are antigen based tests.
But there is a possibility of delay in disease getting established inside body or blood, if any (Remote possibilty), in presence of PEP and there may be a likely chances for the DNA or RNA appearing in the body gets delayed than the infection without a PEP. So go for the test after completion of 4 weeks after the incident to get a more conclusive result.
Dr S.Murugan
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.
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When Should Be STD Test Done After Exposure?
Brief Answer:
PEP offers a high degree of protection.
Detailed Answer:
Hi,
Welcome to HCM.
You had protected sex but the condom broken. Then your risk for HIV is lesser than with the penetrative vagina sex without protection which itself is about 5 per 10000 exposures as per CDC, Atlanta.
You are on PEP. When exactly it was started for you? If it had been initiated well before 24 hours your risk for HIV is almost nil as it could be aborted if there was an infection. Even if you started PEP within 72 hours the risk is negligible only.
PEP may be likely to delay the HIV antibody production and the sensitivity of antibody test if there could be a possibility of infection. So it is better to have a follow up up to six months whereas Antigen tests (DNA PCR and P24 Antigen test) would not have been affected by PEP.
Tests for STD can be performed after 6 weeks.
You have to be tested as per PEP guidelines with a basic HIV test on 0 day, after 3 months then after 6 months.
PEP is highly effective when it is started as early as possible (preferably within 6 hours after the exposure).
Tablets Kaletra can be taken as two in morning and two in the evening instead of taking together.Adding tablet Ranitidine 150 mg twice a day will reduce the burning sensation following the drugs.
Dr S.Murugan