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pep condom accident and numbers !
Sep 19, 2010

bonjour (good morning) dr Robert: im 28 years old from france , so sorry for my bad english language. im a bisexual , i have a girlfriend , and i play around from times to times with males . i am a kind of guy who pay super attention when it comes to sex with males (condoms even for oral sex , verfication of the quqlity, the way that the condom is used ,and almost of the time i even satisfie with massage, mutual masturbation to reduce chances of STDS)because i dont wana bring any hurt to my sweet heart.. few days ago , i was in berlin , and a hot usa guy seduced me , i had a receptiv anal sex , protected with condom and lubrificants of corse , BUT ! i remarked during the sex , that the condom was broken !!!! what a chance . i freeked out for sure , the guy is a gogo dancer and gay porn actor , so belonging to the high risque groupe , but he told me that because of his work they test him frequently , and that he was tested one month ago negatif for all stds . he asked me to not freeking out , and that there is not a risk , but as an adult and knowing that he may be in a window period and thats more risquy , i went early in the morning to found a PEP center in berlin , and i geted my (kaletra & Truvada ) 11 hs after the exposition , im taking them very regulery , i dont care about side effect , i wana try my best . and my questions are : i read that anal reseptive sex is the risquier and it is about between 1.2 and 3% of transmission , but he didnt ejaculate inside of me , cause we stoped when i find that the condom didnt work , and when i cleaned my anus there wernt blood :am i still risking the same amout 3% of transmission ? the second question , i have read about the study of 704 case of PEP and the result of seroconversion was about 1% and it was desapointing ! so do i will benefit from my PEP wish i started 11 hs after exposure , and im taking it very regulary , or i will still have between 1.2 and 3% of chance ? the last question , i will talk to my sweety , and i decided to not having sex with her during this period of time , the doctor in the center prescribe to me a 6 W ,12 w, 24 w hiv test , if my test in 12 w its come negatif (and i hope so) can i restart the normal life with my sweety ? im realy sad , that even my very much paying attention , and reacting rapiddly , may not save me at all ... thank you for your wonderful site . have a nice day . Georges.

Response from Dr. Frascino

Bonjour Georges,

Pourquoi tu m'écris en anglais? Je peux parler la langue de Molière, Astérix et Tintin, mais peut-être tu peux pratiquer ton anglais, non? Alors, je répondrai en anglais.

1. Your level of HIV risk would be less than the statistical estimates for three reasons: 1) you don't know for certain if your go-go porno top guy was HIV positive, 2) ejaculation did not occur inside the love canal, and 3) you are taking PEP.

2. PEP is not 100% effective even when started promptly. There are PEP failures: Yours truly is an excellent example of this unfortunate fact. That said, there is no doubt PEP when appropriately prescribed and taken does reduce the risk of HIV transmission.

3. The guidelines for post-PEP HIV testing recommend testing out to six months (24 weeks) to confirm HIV status. I would recommend using latex condoms for all penetrative sex until then.

Georges, try not to worry too much. The odds are very much in your favor that you have not contracted HIV from your Berlin adventure.

Good luck. Be well.

Dr. Bob



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