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what is the best PEP to always have ready if needed?
May 17, 2009

Hi Dr. Many thanks to all of you helping us with a lot of love. I am HIV+ for about 7 months, I am on Atripla for the same time my VL<40 & CD4 800 & CD4%47. My question is that in case I am having protected sex with my wife and the condom break for example what does she need to do immediately and thereafter? What is the best, simplest and most potent PEP to have always ready in that case and for how long to take it and how to take it? I am patiently waiting your valuable answer. Thanks in advance.

Response from Dr. McGowan

Since your HIV is undetectable on Atripla your risk of transmitting HIV is very low. There are no definitive studies of which treatment is best to treatment is best to prevent transmission of HIV after sexual exposure. Based on current guidelines, perhaps the best option in your wife's case is Truvada (tenofovir/emtricitabine) as soon as possible after exposure and for four weeks. Efavirenz which is also part of Atripla can cause birth defects and is not recommended in women who are pregnant or are capable of becoming pregnant. Therefore, I would not advise her to take Atripla or Sustiva since they both contain Efavirenz. Your ongoing condom use is the best way for her to avoid exposure to HIV. Thanks Joe



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