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Sex during PEP
Jul 8, 2005

I am currently on HIV PEP (triomune which I begun within 10 hours of exposure) after I discovered a considerable amount of menstrual blood on the base of penis shaft where condom ends. skin intergrity looked ok but Source partner tested hiv postive. Here is the question. Two weeks after I commenced PEP I had one episode of unprotected sex with my wife. Was this risky enough to transmit hiv to her so that in the end she tests postive whilst I test negative?

Worried Isaac

Response from Dr. Frascino

Hello Worried Isaac,

Two points need clarification here.

First, whenever someone is on PEP, it means they've had a significant enough exposure to HIV that there is a risk of acquiring HIV. PEP is given to try to abort a potential HIV infection. Consequently, while someone is on PEP, they should always use latex condoms with their sexual partners to prevent the potential further transmission of HIV infection. Therefore, you definitely should have used protection when having sex with your wife.

Next, could you transmit HIV to her, but remain HIV negative yourself? No, this is not possible. The only options are:

1. You are not HIV positive, (either you did not contract HIV at the time of your exposure or the PEP worked) and therefore since you don't have it you cannot transmit what you do not have on to someone else.

2. PEP failed and you are HIV positive. In this case, there is actually the possibility you could have infected your wife. Then you both would ultimately test positive. There is also the possibility that PEP failed, you are positive, but despite your unprotected sex with your wife, you did not transmit the virus. Then end result in this case would be that you are HIV positive, but she remains negative.

The only option that is not possible is the one you ask about where you transmit HIV to her, but you remain HIV negative.

Isaac, I suggest it's time you level with your wife, confront your mistakes and adopt behaviors that are more responsible. It will not only prevent future worries, but it's also the right thing to do.

Good luck to you both.

Dr. Bob



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