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HIV Expose and bizarre PEP treatment
Nov 23, 2009

I received oral sex (penis and anal) from a homeless woman whose HIV status is unknown. After 9 days of the exposure I went to see an internal medicine physician for testing. He told me that since the infection was recent he could give me a PEP of Truvada 500mg. It made me very sick.I only took a dose on day 9 and day 10. I read some articles on your sight and realized that my risk for exposure was very low since the activity was oral sex and the effectiveness of PEP after 72 hours. So, I discontinued the treatment after 2 days. On day 11 I took a HIV PCR and the results came back negative. Can taking such a small dosage of Truvada/PEP create a false negative? If so, I am now at day 23 post exposure and would like to know if it too soon for another PCR test?

I feel fine other than I do have some itching intermittently all over with no rash at all. Could that be related to HIV infection.

Thanks for your consideration. Your website is quite informative. How do I make a donation to your organization.foundation?

Response from Dr. Frascino

Hello,

Your internal medicine physician told you what???? I'd strongly recommend you fire him immediately and find a more competent physician. Your current guy isn't doing you any favors and his comments about PEP are far from "bizarre." They are flat out wrong.

You are correct: PEP must be started within 72 hours.

Regarding HIV diagnostic screening. HIV PCR tests are generally not recommended, due to their rate of false-positives, other technical considerations and cost. The best test for HIV diagnostic screening remains the HIV-antibody test taken at the three-month mark.

Your HIV-acquisition risk is minimal. PEP was never indicated and was inappropriately prescribed. If you remain concerned about HIV, I suggest you get a single HIV-antibody test at three months. I'm confident the result will be negative.

Donation information for The Robert James Frascino AIDS Foundation can be found on the foundation's Web site at www.concertedeffort.org. Thanks for your interest in making a tax-deductible contribution.

Be well.

Dr. Bob



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