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magnetic couple needs advice after possible exposure!!
Jun 27, 2010

Dr:

My partner and I are in need of some advice. I am + and he is -. We always use caution when having sex and we always use condoms. I am on Atripla and have been undetectable for about 5 months now.

Last night we were having sex and I orgasmed first on my self. We continued to fool around. At least 3 to 5 minutes after my orgasm I inserted a finger into his rectum. I continued that for a few minutes and pulled out when I realized I had not washed my hands after my orgasm. I know there had been some cum on my other hand, but I am not sure if there was some on the finger I insterted into him. If there was, it was a small amount i had dragged from my stomach. We used a combo of spit and lube for the insertion. I told him about it, and he does not seem to concerned. However, I am worried about the possibility that what we did may infect him.

I have two questions: 1) is the possible exposure that occurred sufficient that you would recommend a 28 day pep. 2) he is not keen on taking the 28 days, if he took a week of my Atripla would that be sufficient to prevent infection. Please respond. I love my partner and the last thing I want to do is infect him. Thank you for your attention.

-john

Response from Dr. Frascino

Hello John,

1. PEP would not be recommended for the scenario you describe. The amount of spunk was "small," if present at all. Plus, it would have been diluted by the "spit and lube combo." In addition, you are on Atripla, which has driven your HIV plasma viral load to undetectable levels for five months. This would significantly decrease any chance for viral transmission. Adding all these factors together, your HIV transmission risk would be extremely remote at best and therefore not warrant a course of PEP.

2. I would strongly advise against considering a shortened course of PEP. It's doubtful a one-week course would be at all helpful. If PEP were warranted, a full 28-day course should be taken.

John, I would suggest you and your partner peruse the information in the archives of this forum. We have a chapter devoted to magnetic couples.

Good luck.

Dr. Bob



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