Welcome to the Forum The choice of whether to seek PEP or not is ultimately a personal choice as I am confident that you can find someone to prescribe it if you wish. As I suspect you know, PEP is recommended for persons who have a KNOWN exposure to an infected partner and this is not your situation. In Indonesia, most CSWs do not have HIV and if your partner is infected, your risk for infection from a single exposure is relatively low - 1 infection, on average per every 1000-2000 exposures.
The best possible approach would be for you to have your partner tested. If her test is negative, then clearly I would advise against PEP. If you cannot get her tested and she continues to avoid you, this is someone worrisome and I can understand if you choose to seek PEP. 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.). Further and finally, as you also know, your decision must be made quickly. The sooner after exposure PEP is started the more effective it appears to be. PEP is not recommended more than 72 hours after infection.
I realize that I have not told you yes or no. If I were you, I probably would not start PEP but this is a decision you must make. I hope the information I have provided is helpful in your decision making. EWH
Thanks so much for your follow-up. Sounds like all has ended well. Glad to hear that your partner was negative when tested (for everyone's involved). I completely agree with the actions you took and congratulate you on your level-headed approach to a worrisome situation. EWH
To conclude this thread I just wanted to round out my story.
I did in fact get a hold of my partner and she was incredibly kind enough and understanding to get tested. She was negative. I did not start PEP, and can chalk this up as a learning experience, albeit a difficult one.
Moral of the story fella's, unless you want to have doubts and paranoia it is better to wrap it up.
That being said, if you are in a similar situation right now and you are freaking out, try to relax. I was convinced that I had contracted HIV from a person who in the end didn't even carry the virus. Don't give in to the medical anxiety, it simply isn't productive.
Thanks again to Dr Hook, for his timely and professional advice during a difficult situation.
Sorry for the delay in answering- I was traveling. I agree that if she continues to dodge your efforts to determine her status and you decide to start PEP, the sooner the better. EWH
Thank you very much for the professional opinion Dr. Hook. My only followup is this...
If we assume she dodges the test again, and I presumptively conclude (right or wrong) that she is in fact HIV+, would you recommend that I start PEP at what would be the 58-62 hour mark?
I realize this is opinion not official advice, I will make my decision alone.
Thank You.