Should my partner consider PEP? Urgent answer please
Aug 29, 2011
I've been on treatment with atripla in about 5 months. My test one and half month ago showed viral load of 200, a big drop from 4000 before. I have taken my meds regularly til now and assume my load would be even lower. The problem is that on yesterday (saturday at 11.00, 27 aug.) I had sex with my partner without condoms ( we want even to go for having baby in a couple of months). After that we noticed that she was bleeding inside her vaginae. Since then we are completely out of ourselves. I called the hospital nearby and talk to a doctor, who meant there is no need to be worry, since my viral load is low and her bleeding actually runs the virus out of her body. Therefor she meant no need for PEP. How can we trust her assignment, she even did not see her? What do you mean Doctor, where I live there is a boundary of 24 hours for PEP. But I hear that other places is the first 72 hours. PEP is taking ARV medication in one month, isn't it? I have my atripla, couldn't she just take it in one month so we prevent a huge unwanted accident? I will appreciate your answer very much.
Response from Dr. Frascino
Unprotected sex places your partner at risk for acquiring the virus, even if your HIV plasma viral load is low or undetectable. I would recommend a course of PEP for this exposure. It should be started as soon as possible and no later than 72 hours after exposure. Assuming your partner is not pregnant now, yes, she could begin PEP by taking one Atripla per day. (Efavirenz, a component of Atripla, should not be used in women who are pregnant or trying to become pregnant.) Your partner should then quickly establish care with an HIV specialist to follow her through her 28-day course of treatment and post-PEP testing out to six months. Perhaps your HIV specialist would be willing to do this for you and her. The HIV specialist may switch her to a different PEP regimen when he evaluates her, but the important thing now is to get started on treatment immediately. I disagree with the phone advice you were given by the Emergency Room.
Regarding your desire to start a family, see link below. You and your partner should also read through the information in the chapter in the archives of this forum dedicated to magnetic couples. You may wish to consider some of the harm-reduction strategies discussed there.
Good luck to you both.
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