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PEP, Kaletra, Insetress

Jul 22, 2014

Dr. Young,

I was out of town when I had insertive anal sex with a man, condom broke -- he ejaculated twice -- and afteward he told me he was negative, as it said in his online profie. But something about way he said it ("don't worrry, all tests clean last month") seemed odd. Next day check his profile -- word "negative" was gone. I calledh im, 24 hours out, and asked straight out, are you positive? he said, well, not technically -- yes, he actually said that. Said he was poz undetectable and that I had "nothing to worry about" and that all his friends in neg/poz couples did it and was no problem. Anyway -- you can imagine my concern. Was not in my home city and this city , well, it's not a place you'd want to go to emergency room. Nonetheless, at 48 hours out, i went. They said if he was undetectable they're now advising against PEP but it was up to me. I said i want it and was leavng for home next day. They gave me truvada and kaletra, 3 day supply. When i got home went to a clinic and the switched me to Truvada/insentress. Want to know if if this all sounds okay -- 48 hours out, switching meds, and also, if he was undetectable and telling the truth, should I be less worried?

Response from Dr. Young

Hello and thanks for posting your question about PEP.

Yes, this all sounds fine. Kaletra and Isentress can be used interchangeably in this setting, indeed, Isentress is recommended by more recent PEP guidelines and is much better tolerated.

And yes, if your partner was indeed undetectable, your risk is much lower yet.

Between the PEP and undetectability, I wouldn't be worried. Do make sure to get the recommended HIV antibody tests at 1 and 3 months after exposure.

Be well, BY

HIV and Genital Warts
Finding a competent doctor educated in HIV and addiction (a bonus but not critical)

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