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PEP running out on condom breach
Apr 22, 2011

Hi Dr. Frascino. I visit massage parlors once in a while in the SF Bay Area. For the first time I experienced a 'condom breach'. I did ejaculate, but pulled out immediately. In your forum this puts the risk to be same as unprotected sex with a sex worker. I called CDC immediately and they suggested that I should go to a hospital. I visited the local hospital and the doctor asked me if the prostitute was HIV+. She had told me that she got tested every 3 months. Dr. Admitted me to emergency room and after 4 hrs of wait, a nurse practitioner told me that my risk was low and PEP has seroius side effects and suggetsed that I get an HIV test. I told her that an immediate test was not going to be of value and returned home.

I woke up at 4:00Am sweating profusely this morning. It has been 16 hrs. I am wondering if I got the right recommendation. Should I go back to the hospital?

Thank you for considering my question. I am sure you get

Response from Dr. Frascino

Hi,

Generally speaking PEP would not be recommended for your degree of HIV risk. "Sweating profusely" 16 hours after a potential HIV exposure would not be related to HIV infection. The symptoms associated with HIV acute retroviral syndrome generally manifest two to three weeks after HIV primary infection. Your sweating is most likely due to anxiety.

If you are still in SF, you could consider asking the rub-a-dub-dub gal if she will get a rapid HIV test. Results are available within a few minutes. If she tests HIV negative, your HIV risk becomes much more remote, as it would be limited to the very unlikely possibility that she got HIV infected very recently and is still in her window period (HIV infected, but not yet having developed detectable levels of anti-HIV antibodies in her blood).

I would advise you get an HIV-antibody test performed now as a baseline and again at the three-month mark.

Good luck.

Dr. Bob



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