|Oral Sex, PEP and testing
Oct 10, 2003
Dear Dr Frascino
I live in South Africa, where doctors have about 4 years of university training instead of 8. So my question to you:
I performed oral sex on a man of unknown HIV status, and swallwed some of his semen. I had to take an out-of-town business trip early the next morning, but when I got home my worries over what I had done prompted me to go to a clinic. The doctor there said he considered my behavior fairly low-risk, but offered PEP if I wanted it. I chose to take it and started Combivir immediately. This was about 65 hours after my possible exposure.
An initial baseline ELISA test was negative, and I had had no potential exposures for close to a year prior to that.
I completed the 28-day treatment (no nasty side effects at all) and went in for a 6-week follow-up test, also negative. They have told me to come in again in 6 months for another test.
I know that a majority of people who have contracted HIV will test positive at 6 weeks and that virtually all will do so by 3 months.
My questions are these:
1) Even the CDC still recommends 6 months for a "significant event" such as rape or intercourse with a known HIV+ partner. This clinic deals mainly with rape victims, so they are probably giving me the standard recommendation. In my case, is there any need to test after 3 months?
2)Is there any evidence that taking PEP might delay seroconversion, so that my 6-week negative test might be considered meaningless and even a 3-month test not definitive?
For what it may be worth, the lab used a 3rd-generation ELISA test.
I'd really be grateful for your answer.
Thanks for a great forum and for being one of the most understanding and humane people I've run across.
Joe in Joburg
| Response from Dr. Frascino
Hello Joburg Joe,
In my opinion, your minimal risk did not warrant the risk of PEP. To answer your questions:
1. The 3-month test is conclusive for your situation. 2. No, the test would still be accurate.
Good luck on your 3-month test.
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