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pep question
Oct 13, 2008

Hello I am a 22 year old healthy male. The past weekend i was sexually assualted. The assaliant was hiv positive. I went the the er And was subscribed atripla as a pep medication. I have been taking atripla once a day at bedtime for 5 days now and have been handling the side effects well. I started the pep around 67 hours. I was doing some research online and saw that cocaine speeds up the hiv process. Unfortunately i was using cocaine the whole time before starting my pep. My question is How effective is the pep even though i was using cocaine. I was tested at the er and my results came back negative. I was told i need to be tested at 30 days 90 days and 6 months to know if i constracted the virus or not. In your professional opinion do you think i have a high risk factor for contracting the virus even though starting the pep due to the cocaine use. And if you could what are the statistics on people taking the pep after exposure and what are the chances i will contract the virus. Thanks for all your help, i know you doctors on here recieve alot of questions but after looking through the forums i couldnt find anything related to the cocaine use. Thanks for everything!

Response from Dr. Frascino

Hi,

Cocaine can cause all sorts of medical complications. However, if you stay off it, the cocaine you took prior to starting your course of PEP should not interfere with your PEP's efficacy. I agree with your testing schedule.

Unfortunately, we don't have accurate statistical estimates for PEP efficacy, as there are far too many potentially confounding variables to consider, such as viral strain, host immune integrity, trauma during the assault, interval before first dose of PEP, etc. We do know that PEP is not 100% effective. There are PEP failures, even when it is begun immediately. (Yours truly is an excellent example of that.) However, at this point, you are doing absolutely everything you can to prevent the infection. Consequently my advice is straightforward:

1. Continue your PEP as prescribed. Don't miss any doses. Adherence is important.

2. Get post-PEP HIV testing as scheduled.

3. Stop cocaine permanently. If you don't, it will ruin your health and future happiness.

Good luck.

Dr. Bob



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