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Bit my partner
Feb 11, 2007

Doc Bob:

I have a well controled (usually undetectable) male partner. During noctural activites I bit him in the nipple and got maybe a drop or two of his blood on my tounge then swallowed without thinking.

I started nPEP the following day (3 drug expanded). My questions are what is the chance of transmission? Does PEP lessen or mask the symptoms of primary infection and when should I test? I did follow up with my family doc and have a test scheduled in two weeks (7 weeks post bite and 3 weeks post nPEP). We have no other risk factors. Please answer my question and I promise I'll never bite again! Thanks a ton. I love reading your responses. You're so sassy!

Response from Dr. Frascino

Hello Count Dracula (or is it Countess Draculina?),

A nip of the nipple is one thing, but drawing blood? OUCHAMAGOUCHA!

As for your chances of acquiring HIV, we don't have an estimated statistical risk for your specific situation, but I agree nPEP is warranted.

Does nPEP lessen or mask ARS symptoms? That's another question we can't really answer with great certainty, as it would be difficult to study scientifically (as you can probably imagine). Theoretically it is possible.

When to test if you've had a non-occupational HIV exposure and are going to take nPEP? That one I can answer. The guidelines suggest HIV-antibody testing immediately and at 4-6 weeks, three months and six months after exposure.

Generally speaking, for exposures significant enough to warrant nPEP, I recommend being followed by an HIV specialist if possible. The specialist would document and assess your actual degree of risk, evaluate and manage any nPEP side effects or toxicities and arrange for and interpret all follow-up HIV tests.

Good luck.

Dr. Bob



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