Aug 23, 2005
Dear Dr. Frascino, This weekend my partner and I were having sex (he's + and I'm -). The condom broke and he came inside. After searching the website, making many phone calls to doctors and hotlines, we were advised to go to the ER and get PEP treatment started. I saw a doctor in the ER who started me on the treatment but only gave me medication (Crixivan, Epivir, and AZT) for 3 days because they wanted to assure that I would seek follow-up treatment. Bloodwork was also taken so they could have a baseline to go by. They said I would be getting bloodwork done periodically and I would be on this treatment for a month. I made an appointment with an Infectious Disease MD for tomorrow. I would like to know what to expect while being on this treatment. I am not experiencing any major side effects expect mornining nausea as of yet. I've only been on the medicine for 3 days. Also, what are the chances of my contracting HIV. I started the treatment the same day the condom broke within 6 hours. If I do test positive, do I have to continue taking all these medications, being that I started them from the beginning? I've been visiting this site since my 1 1/2 year relationship and find it to be very informative and HIV- friendly. Thanks for being here.
Response from Dr. Frascino
I agree PEP is warranted for this significant exposure, although I would not pick Crixivan, Epivir and AZT as my first choice for a PEP regimen, as it can be difficult to tolerate. Chances are the HIV specialist may change the regimen. He should also explain in detail "what to expect while being on treatment." This explanation should include a detailed discussion of potential drug side effects and a schedule for follow-up testing and care. In general all folks with a significant HIV exposure requiring PEP should be tested for the presence of HIV antibodies at baseline (as you were) and then at six weeks, three months and six months after exposure. The choice of PEP regimen should take into account the medications your partner is taking, as well as those he may have demonstrated resistance to in the past.
The estimated risk of acquiring HIV per episode of unprotected (or condom failure) receptive anal sex with a partner confirmed to be HIV positive is 50 per 10,000 exposures. Your estimated risk would be less due to beginning PEP within 72 hours (six hours, to be exact) of your exposure.
If you have additional questions or concerns after your visit with the HIV specialist, let me know. I'll send you my very best luck that your HIV tests remain negative and that you tolerate your PEP regimen without difficultly.
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