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Mixed Feelings (PEP and HIV SPECIALISTS)
Jun 9, 2008

Hello, I been worried sick since the end of last month. My boyfriend and I had a threesome with an HIV+ guy. Now, he did not mention this until we have done some stuff. We all shared blow jobs, he gave us rim jobs, there was kissing involved and he fingered my bf. Now, he did try to top my bf but with a condom, thats when we all stopped. There was no swallowing involved. Now, I am not sure if he was on meds but he seemed very healthy. We went to see our doctor the next day and we started the PEP that day (Convivir). We got examined, no cuts in mouth and we haven't had any symptoms. Our initial HIV test was negative and our CBC test were normal. We just did the RNA test and we are waiting for the results.

On to the questions, are we over reacting? From weeks of reading HIV website as and blogs, this seems to be low risk encounter. The RNA test is due this coming week, what if its negative? What if its positive? Also, we been really careful and havent had sex since. We have tried to not to think about it so much but its hard since its such a life altering issue.

Response from Dr. Frascino

Hello Ménage-A-Trois Guys,

Are you overreacting? Yep! In my opinion you are overreacting and your doctor is over-prescribing. I would not have encouraged a course of PEP for such a low-risk encounter. As for your pending PCR RNA test, well, I don't recommend PCR RNA tests for routine HIV screening, due to the rate of false-positives, other technical concerns and cost. What if its' negative? That would be encouraging news. What if it's positive? That gets more complicated, as you would then need additional testing to see if it could be a false-positive. As I have stated here many times before, anyone who has an HIV exposure significant enough to warrant a course of PEP should be evaluated and followed by an HIV specialist if at all possible. The specialist would assess and document the actual degree of HIV risk, evaluate and optimize the PEP regimen (or discontinue it if it were unwarranted), evaluate and manage all PEP-related side effects and toxicities and arrange for and interpret all HIV-related tests, including post-PEP HIV testing.

Dr. Bob



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