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fingering a woman with a small cut on finger
May 20, 2008

i am a little concerned with the chance of getting hiv from fingering a woman of unknown status with a small cut that was about a day old on my finger. i have been informed that my chances are low is this correct. the other problem is i naturally think the worst and asked my doctor to put me on PEP which is making me feels terrible. have i over reacted and should i stop the treatment?

concerned!

Response from Dr. Frascino

Hello,

Have you overreacted? Most likely yes. I'm also concerned that physicians are prescribing PEP simply because someone "thinks the worst," rather than actually evaluating true risk and weighing the risk-benefit ratio of taking a course of PEP. PEP is not innocuous. As you now know it can make you "feel terrible." Plus, depending on the regimen chosen, PEP can have very significant side effects and toxicities. For all these reasons I strongly recommend that anyone who has an HIV exposure significant enough to warrant a course of PEP be followed by an HIV specialist. That specialist will evaluate and document the true degree of risk associated with the exposure, adjust or optimize PEP as warranted, advise discontinuation of PEP if treatment is not warranted, evaluate and manage all PEP-related side effects and toxicities and finally arrange for and interpret all post-PEP HIV testing.

My advice is therefore that you consult with a local HIV specialist who will thoroughly evaluate your situation and make specific recommendations. I also advise you follow those recommendations, including discontinuing PEP if he so recommends.

Good luck.

Dr. Bob



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