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operations manual for pep?please help me
Nov 3, 2005

I have some questions to ask however but first I would like to state my problem here briefly. I had before 3 weeks a high risk contact in China I had sex with a prostitute and these have take off the condom during the sexual act. I dont noticed that because of the fact that I was drunken :o( so next morning the panic was started in my brain i went into the hospital and persist of a pep but unfortunately this medications are not easy available in China due to the strict bad hiv politic in china. Therefore i had to fly to beijing to take the drugs within the window of 72hours, after 60hours i have gotten my medicin and started the therapy I started with combivir and one day later in addition crixivan. my ask now is it commonly to extend the therapy because I didnt started within 24hours? here I dont know any hiv specialists I am totaly alone and my doctors are the internet and "the body forum" for example nobody told me that I have to take crixivan on sober stomach, nobody invited me for a midterm chek, thats why my main question is could you give me a normal operational manual for the pep and the investigations during the pep.

thanks in advance Thomas

Response from Dr. Frascino

Hello Thomas,

First off your question should have been sent to the expert forum on Safe Sex and HIV Prevention, not to the forum on Anemia and Fatigue.

The full recommended course of PEP is 28 days. There is no need to extend that course based on starting treatment at 60 hours as opposed to within 24 hours.

Regarding an "operational manual," I would suggest you download the "Recommendations from the U.S. Department of Health and Human Services for Antiretroviral Post-Exposure Prophylaxis after Sex, Injection Drug Use, or Other Nonoccupational Exposure to HIV in the United States." This article was published in the MMWR in January of this year and can be found at: http://www.cdc.gov/mmwr/preview/mmwrhtlm/rr5402al.htm. It's a 27-page document that covers evaluation, treatment and follow-up. If you cannot find a competent HIV/AIDS specialist locally, give a copy of these guidelines to your local doctor and work with him. In the unfortunate (and highly unlikely) case that you seroconvert to HIV positive, you will need to locate an HIV/AIDS specialist for further evaluation and care.

Good luck, Thomas.

Dr. Bob


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