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thanks for the answer

Sep 7, 2003

Hi doctor and thanks for the answer. I ended up going into an hiv specialist who did me put on pep which has gone on for two weeks. He drew blood about 32 hours after the exposure and ran an ultr-sensitive pcr rna (50copies) and send that if I had contracted the virus the day before that it would show up because of the phenomenal rate of viral replication prior to antibody development. My test came back undetectable and his advice was get off the meds and that I didn't contract hiv.

1. My lips were badly blistered that was the reason for my initial concern. Would agree to get off of them or just finish the full 30 days since I have already done 14?

2. I am taking emtriva, viread, and videx. I can definitely feel their effects but have been able to keep working etc. Can any of these drugs cause hair loss? Maybe I am just getting old.

3. Is my doctor correct in saying that I did not catch the virus and that the viral load with be in the many many thousands of copies even after a day and a half?

4. Would that ultra sensitive test pick up a possible exposure from 11 months ago? I ran a 6 month antibody test which came back neg but that was a much riskier situation. Thanks for all of your help and keep up the great work.

I performed oral sex on a hooker very briefly at a bachelor party. Should I see my doctor for pep treatment?


No. PEP (post-exposure prophylaxis) is warranted only for significant exposures, such as unprotected receptive anal or vaginal sex with an HIV-positive partner. Oral sex on a hooker doesn't qualify. The risk of HIV transmission from oral sex is extremely low and not worth the risk of side effects from the HIV medications.

Dr. Bob

Response from Dr. Frascino


My advice remains the same, even with the extra information you provide:

1. Yes, stop PEP. I, and the vast majority of HIV specialists would not have started it in the first place badly blistered lips or not! 2. Emtriva is new, but it's similar to another drug, 3TC, which has been linked to hair loss. But it usually takes longer than 2 weeks to occur, so I'd say you're probably just getting old. Welcome to the club! Ever consider Rogaine? 3. Possibly, although this has not been exhaustively studied for obvious reasons. The clinical trial would be impossible to conduct! 4. Yes, the PCR would pick up previous exposures. It just reconfirmed what you already knew from your negative 6-month antibody test!

Stay well. I am absolutely convinced you are indeed well!

Dr. Bob

oral sex, & the CDC

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