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Do I need to go on PEP if I have been on PREP for months

Oct 11, 2017

Dear doctors,

I have been on prep non stop for several months. I have never missed my daily dosage. Recently, less than 24 hours I have been exposed to HIV by being the receptive (bottom) to a HIV positive, undetectable man. During the intercourse there was no condom used and he ejaculated inside of my rectum. I went to the bathroom and their was semen discharged along with something that looked to be some blood. Should I go the emergency room and asked to be put on PEP? Please, help me, I do not know what to do! Thank you!

Response from Dr. Young

Hello and thanks for posting your very relevant question.

The whole point of taking pre-exposure prophylaxis (PrEP) is to prevent HIV infection with medications taken before exposure.

You don't need to go to the emergency room. PrEP is very effective, and if you've been adherent to PrEP, there's no need whatsoever to take post-exposure prophylaxis (PEP) after sex.

Rather than PEP for HIV, if you had condomless sex, should should consider getting screened for other sexually transmitted infections, since PrEP is only effective in preventing HIV, but does nothing to reduce the risk of other bacterial (syphilis, gonorrhea or chlamydia) or viral (hep C, HPV) infections. If you've not been vaccinated for hepatitis A, hepatitis B or meningitis (and if your under age 26, HPV), I'd strongly recommend that you ask about getting vaccines to prevent these infections.

I hope that's helpful. BY



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