HIV - Prevention Expert Forum
Less than 3 Seconds Receptive Anal PEP Truvada
About This Forum:

This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank

Less than 3 Seconds Receptive Anal PEP Truvada

Hi Doctor, Sorry for my English in advance, I am very nervous and worry.
I am gay (bottom), I met a stranger yesterday and we had sex.
I am very sure he used a condom in the beginning, as I double checked.
However, in the middle, he suddenly stopped and insert again, I thought he was putting more gel, but when he put in again, I found very strange and I push him away and  I found he pull off the condom, the unprotected contact was only about 2 seconds and halfway in.
I was very nervous, and I asked if he has done test, and he claimed he is negative. But I am still very worry, as his behavior make me doubt.
I went to health care center today, and explained the situation to doctor
I did a rapid test there as control, and which is negative. and then doctor prescribed me Truvada as PEP for a month, and asked me to do a RNA after finish the Truvada.
I keep searching "Effectiveness of Truvada alone as PEP" in internet, I am not sure if this is a normal practice for issuing  Truvada alone. As the doctor said, there is another pill that can be taken with Truvada as PEP, but it cost almost a double, and only for people with partner with HIV+ confirmed.
I am still within the 72 hours, should I ask the doctor to issue an extra pills ?Isentress ?Kaletra ?



239123_tn?1267651214
Welcome to tthe forum.

There are no data on which to base a risk estimate for receptive anal sex of different durations.  Logically, a very brief exposure like this would carry less risk than more prolonged exposure with ejaculation in the rectum.  If you were in my clinic, I probably would not recommend PEP.  However, this is a judgment call, and decisions about PEP always should be made by local doctors or clinics who understand the local epidemiology of HIV, and I don't necessarily disagree with the recommendation of your doctor.

You could speak with your partner and ask him to have an HIV test.  If negative, you will know for sure you were not exposed and could ask your doctor whether it would be OK to discontinue PEP.

There is an important downside of PEP you may wish to consider.  If PEP is not effective in preventing HIV, it may prolong the time to a definitive test result, and some experts recommend extending testing to 6 months.  (Without PEP, 4-8 weeks generally is sufficient, depending on the specific test or combination of tests.)  So one result of PEP often is to greatly prolong the period of uncertainty and anxiety.  Follow your doctor's advice about follow-up HIV testing.

Truvada alone is the most frequent PEP treatment and is believed to be highly effective. I see no reason to start Keletra or anything else.  But if you remain concerned, you could discuss it with your doctor.

Finally, after this sort of exposure, you should also have been tested for gonorrhea and chlamydia (with a rectal swab) and have a blood test for syphilis.  Probably these were done by your doctor.  If not, discuss it with him.

I hope this has helped. Best wishes--  HHH, MD
5 Comments
Blank
Avatar_m_tn
Thank you very much.
I have few more question about the medicine I am currently taking, as  I have gout problem, and gov doctor issued me the following medicine which i need to take daily

Colchicine Tablet 0.5 MG   / 3 Tablet a day / To lower urine acid
Allopurinol Tablet  100 MG / 2 Tablet a day / To lower urine acid
Diclofenac Sodium Slow Release Tab 100 MG/  1 Tablet a day  / Pain Kill

I have been searching internet about the drug interaction with Truvada, I found few studies talking about Kidney Failure risk of taking truvada with diclofenac, I am not sure if the studies are confident or not.

Can you kindly advise if I can still take the above medicines ?

Blank
Avatar_m_tn
Thank you very much.
I have few more question about the medicine I am currently taking, as  I have gout problem, and gov doctor issued me the following medicine which i need to take daily

Colchicine Tablet 0.5 MG   / 3 Tablet a day / To lower urine acid
Allopurinol Tablet  100 MG / 2 Tablet a day / To lower urine acid
Diclofenac Sodium Slow Release Tab 100 MG/  1 Tablet a day  / Pain Kill

I have been searching internet about the drug interaction with Truvada, I found few studies talking about Kidney Failure risk of taking truvada with diclofenac, I am not sure if the studies are confident or not.

Can you kindly advise if I can still take the above medicines ?
Blank
239123_tn?1267651214
I believe any risks are low for serious interactions of these drugs and interactions with Truvada.  However, I have no personal experience with them.  You'll need to ask the doctor who prescribed PEP.

That will end this thread; I won't have any further comments or advice.  Good luck.
Blank
Avatar_f_tn
A related discussion, PEP was started.
Blank
Continue discussion Blank
This Forum's Experts
239123_tn?1267651214
H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
233488_tn?1310696703
Blank
Marathon Running Done Over Many Yea...
May 21 by John C Hagan III, MD, FACS, FAAOBlank
233488_tn?1310696703
Blank
New Article on Multifocal IOL vs &q...
May 21 by John C Hagan III, MD, FACS, FAAOBlank
748543_tn?1371753642
Blank
TMJ/TMJ The Connection Between Teet...
Jan 27 by Hamidreza Nassery , DMD, FICOI, FAGDBlank