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should I do PEP?

May 3, 2009

My partner and I have been intimate for about 3 years before we found out he was pos. I have been tested in the last 6 months three times and am negative. Last night we had a moment of unprotected sex that lasted less than 2 mins, and no ejaculate. My question is should I be taking PEP at this point? Am i at high risk? i am really worried. Please help.

Response from Dr. McGowan

Thanks for your question.

The main factors that contribute to risk of acquiring HIV sexually are: 1) How much virus there is in your partners blood/semen. A high viral load increases the risk, an undetectable viral load on treatment lessens it. 2) The type of exposure. Receptive anal intercourse (bottoming) is highest, followed by receptive vaginal intercourse, then insertive anal or vaginal (topping), and much less oral. Trauma can cause abrasions and tears in the protective lining of the rectum or vagina (mucous membranes) and increase the chance for spread. 3) The duration of the exposure. Which is another reason receptive sex is higher risk. Douching, however, should not be done since it may increase irritation and alters the normal balance of body fluids and microbes.

The risk of HIV transmission as the receptive partner in anal sex overall is about 82 in 10,000. But since your partner did not ejaculate your risk would be considerably lower. Virus is present in the pre-ejaculate (pre-cum), but the exposure would be less. Your risk is low.

Best, Joe

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