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How long after completing PEP should I have a blood test
Sep 5, 2017

Hi Dr. my name is Courtney I was having vaginal sex with an HIV positive male who has an undetectable viral load. We were using a condom, but about 20 seconds before he finished the condom broke and he ejaculated inside of me. I was put on PEP about 36 hours after that exposure, he has also been on ART for the last six months. I also have genital HSV and I know having other STD's can increase the risk of HIV infection. I have about 15 days left of the PEP, so far my doctors have not been helpful. They took a blood sample less than 24 hours after the exposure and did not discuss getting re-tested once the PEP was finished. Blood obviously came back negative for HIV because it had only been 12 hours. I was hoping you could talk to me about about how at risk I am for having HIV and also about when I should get re-tested. Thanks, Courtney.

Response from Dr. Young

Hello Courtney and thanks for posting.

It's standard to get HIV testing a baseline, 1 and 3 months after a potential HIV exposure. Don't forget that this is also a good time to get testing for other sexually transmitted infections and evaluation for vaccinations for hepatitis A, hepatitis B, human papilloma virus (HPV; if you're under age 26).

The real issue is whether you needed to receive post-exposure prophylaxis (PEP) at all- if we're talking about a single sexual encounter with someone living with HIV who you're sure is on ART and with an undetectable HIV viral load, there's no risk of transmission. Several massive sexual health studies have not demonstrated a single linked case of HIV infection following tens of thousands of sexual encounters when the positive partner is on treatment and has viral suppression. Though many are still being offered PEP in this situation, a critical look at the literature says that PEP isn't going to add to health risks.

If you have ongoing potential HIV exposure(s), particularly among people who are not on ART, you should also ask if you're appropriate for pre-exposure prophylaxis (PrEP). Daily oral PrEP has been shown to be highly effective in preventing HIV transmission and is recommended for people at risk of HIV infection by both US- and international (World Health Organization) guidelines.

I hope that's helpful, BY

Please advice (diagnosed with HIV and pneumonia)

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