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Demanded PEP
Dec 27, 2005

Dr. Frascino

About a year ago I went to a house party with some friends an ended up getting a bj from one of the strippers after drinking to much. The next day when I sobered up I realized what I did and went to my doc to get PEP. He has been my family doctor since i was a kid I am now 24. HE REFUSED. He told me that I wont get hiv that way but to be careful because i might get other stds this way. I immediately went home and started looking up hiv transmission and then called him and told him that I found on the internet that there is an extremly small chance even though there arent any documented cases and that I should come back for PEP to make it an extremely extremely small chance. He REFUSED again said that extremely low means it doesnt happen but it is not 100% immposible given a stretch of the imagination. He then went onto say I should not worry and assured me I didnt get hiv from this encounter. He said again it just doesnt happen that way. I finally believed him and then the shit hit the fan two weeks later. I came down with a high fever(103), slight sore throat, and a small heat rash on my stomach that went away as shrtly after taking the blankets off. Went back to my doctor and he said I probably had the flu or some other bug and told me to take tylenol for the fever. After taking tylenol that night the fever broke and went to 99 but when it broke I had a drenching night sweat(only one). I have been to the doctor one more time since then and he continues to assure me that I did not catch hiv from this type of exposure and that it was flu season. I am just mad that he didnt give me PEP. Do you think my doctor is right in what he did and what he said?

Response from Dr. Frascino

Hello,

Yes, I agree with your doctor. In a nonoccupational setting, I would only recommend PEP for folks who had an exposure that represented a substantial risk for HIV transmission to blood, genital secretions or other potentially infected body fluids from a person known to be HIV infected. Your situation would not qualify on several accounts.

When indicated, PEP should be started as soon as possible, and no later than 72 hours from the time of exposure, to have the best chance of success.

I applaud your physician's very rational and reasonable decision and agree you most likely have the flu! If you remained worried, and HIV ELISA test at the three-month mark would be definitive and provide you with peace of mind.

Good luck.

Dr. Bob



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