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is PEP needed- urgent /anxious!

I had an episode of unprotected oral and protected vaginal sex with a Sex worker , originally from ukraine. During the short period of vaginal sex, the had come off once i removed my penis- the length of unprotected exposure was only short( < 3 mins). I am unaware of HIV status of Worker. I rinsed my penis and swabbed with alcohol after. I also commenced Truvada that evening ( approx 4 hrs post exposure) . Is this adequate . I have now been on it for a week . I was considering commencing kaletra as well . Is my risk high ? would you recommend anything else?
thanks for advice
worried !!
3 Responses
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300980 tn?1194929400
MEDICAL PROFESSIONAL
I doubt thathere is much to be gained by adding kaletra to the Truvada you are already taking.

EWH
Helpful - 1
Avatar universal
Thank you for your response. Yes I did panic and I agree low risk possible exposure. I am a health care professional( MD) and thus have some knowledge and the access to the medication . I decicded that my anxiety was too large not to at least take some PEP.   I just dont know whether taking Kaletra I week after event after a week of truvada will have any further benefit or just increase SE profile ? I have made an appointment with another health care provider to manage my case . so far no SE besides mild nausea with Truvada.
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
This situation is a bit of a mess.  You  panicked.  Your risk from the exposure you describe is low. you do not know that your partner had HIV and the probability that she was is quite low.  Furthermore, there is virtually no risk of HIV from receipt of oral sex and, IF your partner had HIV, your risk of HIV form a single brief episode of unprotected intercourse is less than 1 in 1000.  You then began to take post-exposure prophylaxis, apparently without a health care provider's supervision.  

I would not have recommended PEP for you but of course, if you want it, I am sure you can get it.  Decisions about PEP are a personal decision in which one should consider the likelihood that infection will occur, the likelihood of drug side effects, one's personal anxiety and the cost of the drugs (expensive, typically in the neighborhood of $1000).   If you choose to try to find someone to provide you with PEP, please hold them accountable for all that goes with it (i.e. follow-up, answering your questions, etc).  Sadly, there are all too many health care providers willing to provide it, thinking that their jobs are done when the prescriptions are written.  This is not the case.  In my opinion, it is essential that anyone who provides PEP also provide follow-up and a commitment to answer their patient's questions about risk, side effects, etc.  Often this is not done.

Truvada with or without Kaletra would likely reduce your risk for HIV.  Most people would suggest it should be taken for 4 weeks.  At this point you need to discuss what to do with a health care provider who will see you over time.  EWH
Helpful - 0

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