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Effectivess of taking PEP on the fifth day after exposure

Nov 13, 2009

Dear Dr. R Frascino,

Am I HIV positive? This, to me, is what is on everyones lips and thought when writing to you. Been tested for HIV is the only TRUE and unchallenged answer to that question. But the issue of one going for HIV is not as easy as it sounds. We all are writing to seek assurance from you that we are actually HIV negative, and that our jiga jiga, a South African slang for messing around without prevention from sexual diseases, would, somehow, make us feel better, which does, on many occasions.

Having said that, I am one of them many persons on the same boat. In July 2009, I had an unprotected sexual intercourse with my ex-girlfriend (we broke-up in 2005). She recently (on 02 Nov 09) died of HIV related diseases. God rest her soul. Four days after we had the sexual encounter, I phone my GP and she to prescribe PEP, after much deliberations, she reluctantly gave me a script for the medication. How effective is this? Will it help me at all, or could it have helped me at all?

I am now overdue for my HIV test and I am feeling like KAK. I avoided having a sexual intercourse with my wife until few days ago, when she just pounced on me. I did not know how to tell her that I have been avoiding having sexual encounter with her for many reasons, of which all married men reading this will understand. Me, been a coward, for sleeping with her without protection, am worried to the bone and I hardly can sleep.

I have now committed to going for my HIV testing on 13 November 2009, and I will share with your audience my results, why? Because I want those people who have done the same thing as I did to not expose those they love to HIV due to their own hidden coward-ness etc. but save the lives of their beloved ones

I currently have spasms on my neck and tonsils and I pray that I am just getting a flu, not anything else. But problem is this has been going on for a week.


Response from Dr. Frascino

Hello Top Deck,

"Jiga-jiga" does put you at risk for STDs, including HIV. That you jiga-jiga'ed with an ex who was HIV positive significantly increases your HIV acquisition risk.

PEP (post-exposure prophylaxis) is most effective when taken immediately after an HIV exposure. The longer the time lapse is between exposure and the first dose of PEP, the less effective the treatment is in aborting HIV transmission. Consequently, PEP after one hour is more effective than PEP after one day. After 72 hours have lapsed since the time of exposure, PEP is no longer felt to be effective and should not be taken. Consequently, your PEP begun four days following your encounter would not be expected to be helpful.

Why are you "overdue" for your HIV tests? Your initial jiga-jiga was a severe lapse in judgment. Not following up for your scheduled HIV tests is purely irresponsible. Having unprotected sex with your wife (pounce or no pounce!) is beyond irresponsible. I agree you are acting like a "coward." It's time to man-up and start doing what you know is right.

My advice is straightforward:

1. Stop being a coward.

2. Stop procrastinating.

3. Man-up, admit your mistakes and take responsibility for your actions.

4. Level with your wife regarding your indiscretion.

5. Get tested and start behaving more responsibly.

Dr. Bob

dr bob, please answer. second time posting
While on PEP, can i still transmit a virus to another negative homosexual

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