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PEP medication
Jun 5, 2011

I recently had receptive anal sex with ejaculation only to find out afterwards that the person was positive. He sent me a text message when he left apologising and indicated that his viral load was 1700. I immediately called a doctor friend of mine who tested me and put me on the so called "high risk" dose of PEP. Two alluvia morning and night and one Truvada at night. My friend is an expert on HIV and he indicated that my chances are so low of becoming infected that they would probably write an article on me if I did. This is apparently due to the fact that i started the medication within 4 hours and the HIV pos guy had a low viral load. Please please please let me know your opinion on this.

Response from Dr. Frascino

Hello,

He disclosed his status via text messaging? How very "gen Y"! Not very personal, but at least he disclosed.

Unprotected receptive anal sex is risky business! Your positively charged top gun had a low bit still detectable HIV plasma viral load of 1,700. There would be a decreased risk of HIV transmission if he were on effective antiretroviral therapy that had driven his viral load to undetectable levels. Beginning PEP (post-exposure prophylaxis) within four hours should help to abort HIV transmission. However PEP, even when taken early, is not 100% effective. (Yours truly is an example!)

Your decision to have unprotected sex did indeed put you at risk for STDs, including HIV. I recommend disclosing HIV status well before the pants hit the floor. Also, we must consider all our partners could be HIV infected and take all the necessary precautions (latex condoms) to prevent spread of the virus.

At this point all you can do is take your meds as prescribed; follow up with post-PEP HIV-antibody testing at four to six weeks, three months and six months; and learn from this experience so you'll never put yourself at such risk again.

Good luck.

Dr. Bob



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