Do I need to take PEP?

[Cornerstone19]

Hi all; have a question, need some help.  I had unprotected sex with a man I recently met from a dating site.  We've had protected sex in the past, but this last time we did not (I will blame my own stupidity and alcohol).  This was Friday night (12/6/19).  

He has stated (several times) he is clean, wasn't with anyone since his ex and was also tested before moving here in April.  Is PEP even recommended in my situation?

Yes, I will also be tested at 28 days.

Thanks!

[CurfewX]

PEP can interfere with test results.  That's why you need to have ceased PEP for 28 days prior to taking the test.

[mike_no]

You can obtain a conclusive result only after 28 days from the last dose of your PEP medication with a IV / V generation HIV test.

[Cornerstone19]

Thanks

[Cornerstone19]

Sorry, why wait another 28 days after the last dose?  I'm new to this, obviously.

[mike_no]

Basic external structure of the virus is:

1. RNA, this contains all of it's genetic information.
2. Reverse transcriptase, a key enzyme it uses to replicate.
3. P24, a protein that binds to human cell to cause infection.

When a person is infected, the viral protein binds with the infected cell and releases its RNA and the enzyme- reverse transcriptase.

ARV drugs work to prevent the release of this enzyme because without this enzyme the viral genome can't be incorporated in to the host cell and therefore, can't be replicated further. This is exactly why, PEP is recommended with in 72 hours from the suspected time of exposure.

Although PEP is shown to have a high success ratio however, sometimes, in certain circumstances, it can fail, in such cases the window period is extended since "sero-conversion", a process during which a specific antibody develops and becomes detectable in the blood can take place after ARV drugs no longer influence the body's normal course of action to deal with the original infection.

For a IV/V Generation of HIV test, a window period of 28 days from the date of exposure or last date of PEP dosage is sufficient to detect antibodies to HIV infection and / or P24 antigen, if the individual is originally infected.

[Cornerstone19]

Spoke with my PCP, she recommended I take it, starting ASAP.  She went ahead and did an HIV test which I am freaking out about because I was with someone prior (also told me he was "fine"), so we'll see what happens.

[GuitarRox]

Oh boy.  Your PCP did you zero favors with that.  Prepare for side effects. The HIV test you just took will have no bearing on a result from this event on Friday.  Weird she wasted your time/money for that.  PEP needs to be started with 72 hours.  And most doctors do not give it unless the other person is known to be HIV+  Because the transmission rate from a single exposure is less than 2 % even if someone has HIV.  It's zero if they don't. So, follow the guidelines now and test after you conclude PEP.

[Cornerstone19]

Thanks Guitar - you and Mike are truly great to volunteer on here and guide us anxious members.

And she tested me to be sure I wasn't positive already, also did Hep B amd Hep C testing; stated I could've got something from a previous encounter, although I've only been with one other person since my divorce last year and I tested after him and was fine. She said as long as I started PeP by 10 p.m. tonight, I was still in the 72 hour window.

Thanks again for the help.

[GuitarRox]

Well, good luck.  I'm not sure I'd do PEP for what you describe but that is between you and your doctor.  I am fairly certain it will all be fine and you will be negative down the road.  

[GuitarRox]

I believe you are outside the window to start PEP at this point.  And it's a pretty toxic drug so it isn't given for any exposure.  You've normally engaged in protected sex with the guy showing that he normally uses condoms as you do.  Quite doubtful that he has HIV.  But go ahead and get tested as Mike suggests at 28 days and beyond. I would not bother with worrying about PEP.  All the odds are that you will not have HIV.

[mike_no]

PEP is generally recommended for instances where the partner is known to be a confirmed positive.

You did put your self at some risk. However, the reassurance your partner has provided can't be ignored since most people won't lie so blatantly.

You could just take a test at 28 days with a IV Generation of HIV test and move on. I am assuming this is an hetrosexual encounter, therefore, the risk is minimal.

[Cornerstone19]

Yes, it was a hetero encounter