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Indo Worries
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Indo Worries

Doc,

I was very intoxiated in Jakarta and met a CSW in an upscale hotel bar.  Both of us had been drinking a lot, and we performed oral, and had likely had unprotected intercourse for 2 mintues before we feel asleep.   In the morning we had protected intercourse.  I ask here if she was HIV positive, and after a few minutes of explaining as her english was not very good, she said she was clean and had been tested about 3 months ago. She is about 22 years old and recently had a western boyfriend, but definitely works at the bar a few times a week. I was parnoid, so the next day in Singapore (36 hours later) i went to a clinic and they put me on PEP and i have been on it for 6 days.  My questions for you are as follows:

1.  Given my incounter was so brief, even if it happened at all, should i stay on the medication?
2.  Are there any side effects i should think about when being on the medication and maybe that is a reason not to take it.  So far, i just have loose stool.
3.  Assuming i take the 30 day course, with a PCR test/lab corp, when will be the earliest after completion of the meds i can be tested so i can get this behind me.

I have tried to figure out what my own answers and there are a lot of varying opinions, can you please give me yours.  Thank you so much for your time.

Best,
1024580_tn?1331577721
Hello,
Thank you very much for your post and welcome to our forum.
I will give your answers here below:
1.) That is entirely up to you.  However bearing in mind the circumstances, I would not have recommended PEP because of the very low risk to you with a lady of unknown status.  Even assuming that she was positive, the risk to you would be less than 0.1%.  That is why the guidelines would have not advised PEP.
2.) PEP can cause nausea, vomiting, diarrhoea, abnormal liver function tests, etc.  However these side effects are only temporary and will disappear as soon as PEP is discontinued.
3.) A PCR RNA could give you a highly relaible test result 10 days after finishing PEP.  However this will not be fully conclusive and you would still need a HIV Duo test at least 6-8 weeks after finishing PEP for a conclusive test result.
Best wishes,
Dr José
5 Comments
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Avatar_m_tn
She was agressive in kissing and bit an inside-the-mouth oral sore, it healed very fast over the next 2 days, but wondered if the oral sex increased my odds given the fact pattern i provided. tx
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Avatar_m_tn
bite and oral sex change your opinion.  I feel silly taking all these meds with a low chance experience. tx
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Avatar_m_tn
tx,
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1024580_tn?1331577721
No, that does not change my opinion.
Kind regards,
Dr José
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