Hi Dr. Bob, You helped me a lot go through this with your answers in the past, I need to bother you with an urgent question. I'm a 31 year old guy in new york, HIV positive, on atripla for about half a year with undetectable viral load. Last night I was having sex with a guy of unknown status, he was the insertive partner, when he pulled out we noticed that the condom was broken, he did not come inside me but he was inside me for quite a while. When I told him that he should seek PEP immediately he did not seem to panic at all, he said he was negative but I'm not sure he was telling the truth. Now I cannot stop thinking that he could have transmitted a drug resistant virus to me, should I go to an emergency room immediately? Would they add a few more drugs to my regimen in case he was positive and had a virus resistant to atripla? I really don't know I'd there is such a thing as PEP for already infected to prevent superinfection. I'm very worried, my doctor is on vacation and can't tell if I should run to an emergency room.

Hello,

PEP to abort HIV superinfection is not warranted. You are already on effective combination antiretroviral therapy. Adding additional antiretrovirals is not warranted and would most likely lead to side effects or toxicity problems. Relax Max. No need to panic, OK? When your doctor gets back from vacation, you might want to have the basic STD screening due to the broken-condom incident. However, augmenting your HIV regimen is not warranted.

Good luck.

Dr. Bob