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MSM Intercourse, condom broke, I was top/insertive (MORE INCORRECT PEP ADVICE, 2011)
Sep 7, 2011

I had MSM Intercourse, condom broke, I was top/insertive. The incident was on a public toilet. After that happened I peed and then cleaned my member with some water (soap was not there). After coming home at about 40 Minutes later I put iodine lotion, then alcohol based desinfectant spray, which I found 2nd in the first aid kit, and then iodine lotion on my member also inside the opening. It hurted a little, but beeing cut since childhood (age 5 because of fimosis) I dont feel too much there. Then I had a horrible fearful night, drove in the next morning to a hospital that send me to another one and finally, 14h after the incident, I got a starterpack of PEP (kaletra 200mg dose: 2/0/2 and Truvada 200mg dose:1/0/0) which I should take for 3 Days only. Then I should stop the PEP and wait 14 Days for PCR to be made to decide if, God forbid, I got infected. The doc extimated my risk w/o pep to be very little, but said that I could try PEP for 3 days because the most important phase are the initial 3 days. Is it enough to take PEP only 3 days, could there be build up some resistances? Should I take it for longer time? What about my risks?

Thanks a lot for your advice.

Response from Dr. Frascino

Hello.

The doctor told you only to take PEP for three days, because the most important phase is the initial three days??? WOWZA! That doctor must be suffering from cranio-rectal inversion. That means he has his head up his butt.

A course of PEP is 28 days. There is no indication that a three-day course provides protection. In fact there are animal studies showing a three-day course is not effective! If you are still within the three-day-starter-pack-dosing period, you should contact an HIV specialist. He will perform a more complete evaluation and provide the additional 25 days of therapy if PEP is warranted. You should also ask the HIV specialist to contact the hospital that gave you the misinformation. The physician responsible should be reprimanded and instructed to take a remedial course in basic HIV medicine so that he doesn't repeat the same mistake.

Good luck.

Dr. Bob



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