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PEPSE in 36 hours
Oct 12, 2007

Hi from Madrid. Last friday september 28th I had insertive anal sex with a man (me as top), and the condom broke and a little wound in my penies was made (close to the glans) with, aparently, no bleeding. We had a little oral sex (me as receptive) too and I think I got contact with a little pre-seminal fluid from him, with no visible wounds in my mouth. He made me oral sex, too. ER Doctors made a quick hiv-test and my fried was positive and me negative, so they decided to give me a profilaxis with Truvada and Kaletra, starting it 36 hours after the sexual contact. My couple told us then that he received the same profilaxis treatment on january 15th, and that 1 month later, the result was negative. He couldn' made more test because he had to travel for work (that's what he said), so doctors said that probably he wasn't in a primary infection phase (more infectious). My question is: ¿Is it eficient a profilaxis treatment started 36 hours after the contact? ¿Do I have a high , moderate or low risk of having hiv after this? Thank you very much for your help!!

Response from Dr. Wohl

PEP probably works best if administered as soon as possible after the exposure. After days we know HIV has travelled widely throughout the body and has infected cells where it can hide. We do not really know if there is a benefit of PEP after 36 or 48 or more hours after exposure. Animal data would suggest probably not.

It is difficult to answer your question regarding risk. I am unclear if your partner is HIV+ or not. Having sex with an HIV+ person carries a significant risk of transmission. If your partner is HIV uninfected, obviously there would be no risk of this sexually transmitted disease but there could be for others.

DW



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