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Should I get a nPEP?

Nov 19, 2010

Hi! I hope you can help me. I'm scared. Sunday night I had insertive anal sex with a person which I was later informed he was HIV positive even though his viral load is undetectable. Before I penetrated him I introduced my head once to his rectus for about 10 seconds max. Right after, I put a condom and I started penetration. During penetration I notice he started to bleed. I stop in than instant. The condom was intact and I didn't have any blood in my penis after I remove the condom after cleaning it. I did not have either any bruises in my penis. Should I get a nPEP or should I just wait until the 3 month mark to check my HIV status? I called the HIV hotline and they said I shouldn't get the PEP. However I have been worried that I should. I'm still in the 72 hours window. It's been 36 hours now.


Response from Dr. Frascino


Your HIV-acquisition risk involves brief insertive anal sex with a partner confirmed to be HIV positive. PEP generally would be offered in such situations. Certainly that your exposure was brief (10 seconds max) and that your bottom guy has an undetectable viral load would decrease HIV-transmission risk; however, it would not completely eliminate it.

I would suggest you begin nPEP immediately and contact an HIV specialist physician for follow-up care during your 28-day course of treatment. PEP can be obtained at any urgent care center or emergency room. The HIV specialist physician will take a very detailed history to document your exposure and assess your degree of risk. Following that assessment, he may advise discontinuing nPEP if it's felt your HIV-acquisition risk is low.

Good luck.

Dr. Bob

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