URGENT: Decision on whether to take PEP or not

Hello Doctor,   On Feb 6 night I had an encounter with a CSW (escort from a website).  About 10 minutes into having vaginal sex, I noticed that the condom was completely broken, condom might have been broken for about 5 minutes or so without my noticing. I am not circumcised and I have Herpes. I was able to convince the CSW to take a HIV test on Feb 7. We both took the oral swab rapid test, and both tested negative. However,  i was still concerned about the roughly 3 month or so lag that perhaps these tests have to catch something. Feb 8th morning met my primary physician and since was a bit insistent, the physician consulted a specialist and then decided to give a regiment of Atripla for atleast 30 days (he told me to keep taking it until the results are negative 6 weeks from now). I have insurance and picked up the supply today.

1. After coming home with Atripla and reading on the internet about its side effects, I am developing cold feet on whether to take the medicine or not.  In particular the effects on kidney, liver etc.  One European study mentioned central nervous system effects. Can a 30-day regimen possibly affect the body permanently besides the many other serious daily side effects?

2.  I was a bit surprised that my doctor gave me Atripla, and told me nothing about side effects.  When i asked him, he brought a book back to the room and started mentioning the simple effects - nausea, stomach cramps, rashes etc (did not mention others).  Also,  i had to request him to add blood tests every few days to monitor my situation with Atripla. was almost hoping though that the doctor would prescribe me a PEP.  Was wondering if the doctor had the appropriate knowledge to prescribe this

3.   So,  i guess i have another 20 or so hours to decide whether i should take Atripla, and I am leaning towards not taking it?  At the same time, thinking about Not taking it is affecting my peace of mind. What would you recommend

thanks

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Unfortunately I cannot help.  An online forum is not a suitable source for specific treatment advice.  You have seen a physician about your potential exposure, and I am not going to tell you whether or not to take the advice you received.

I will say that, statistically, it is very unlikely your partner had HIV, and her negative test result shows she isn't infected.  Considering those facts and the low risk for any single unprotected vaginal sex exposure, for sure I would not have prescribed PEP.  But now that you have actually received a prescription, any decision to continue or not is entirely between you and your doctor.  To your specific questions:

1,2) Talk with your doctor about the medicine's side effects.  From my knowledge and experience, however, I do not believe that any long term side effects are very likely. I cannot fill in the information you should have had from your doctor.  I have no personal experience prescribing Atripla for PEP.

3) As I said, talk again to your doctor.  Online forums do not give specific treatment advice.  We do not provide medical care.

Regards--  HHH, MD