I was involved in fisting a sex worker. I reported to a Doctor who prescribed PEP six days later. Please advise if I stand a serious risk of infection and if the PEP would be helpful at all.

Hi,

A doctor recommended PEP six days after a potential exposure??? What??? Another incompetent nincompoop of a physician??? I think that's the third post this evening in which PEP has been inappropriately prescribed by a physician! If more than 72 hours have lapsed since a potential exposure, PEP is not warranted.

As for your fisting episode, was it protected with a latex glove? Were you the fister or fistee? There are health risks involved with fisting that go beyond possible HIV transmission. Damage can be done when trying to ram oversized objects (fist) into small tight spaces (your backdoor). But that's a whole other issue.

Regarding PEP, as I have said multiple times in this forum, I recommend anyone who has had an HIV exposure significant enough to warrant a course of PEP be followed by an HIV specialist physician. Any HIV specialist physician worth his salt would advise you to discontinue PEP, as it certainly isn't helping you to abort an HIV infection if your exposure was six days ago! I would recommend follow-up HIV-antibody testing at the three-month mark. (A six-month test would also be recommended if you had a significant exposure to someone known to be HIV infected.)

Play safe to stay safe. Good luck.

Dr. Bob