Hello,

I' m HIV positive since several years (no treatment, low viral load) and my partner isn't. We have been having sex today and I have been anal fingering my partner. After, we noticed my finger was bleeding. Would you recommend a Pepse treatment? Thank you for your answer. K.

Hello K.,

"Pepse treatment"? What's that? If your finger was actively bleeding while you were digitally stimulating your negative partner's backdoor, post-exposure prophylaxis (PEP, not Pepse, by the way) may well be warranted. To be most effective, PEP needs to be started as soon as possible after exposure. If greater than 72 hours have elapsed, PEP would no longer be recommended. Consequently, your partner should start PEP ASAP if he is still within the 72-hour window. He should then be followed by an HIV specialist during the 28-day course of PEP. The HIV specialist physician will further document the actual risk, based on many factors, including viral load, amount of bleeding, local trauma, etc. He will also optimize the PEP regimen if needed or advise your partner to discontinue it if it is not warranted. He will evaluate and manage all PEP-related side effects and toxicities as well as any "symptoms" that may evolve during the course of therapy. He will also arrange for and interpret the post-PEP follow-up HIV tests.

Good luck.

Dr. Bob