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PEP (Magnetic Couple)
Sep 9, 2011

Dear Dr. Bob,

First I'd just like to say that your website is fantastic! So much great information. So here's my story. I have been in a magnetic relationship for a little while now. I am the negative partner. We are both gay men. Things have been great but we were having sex the other night and the condom broke, I was the top. We immediately stopped after so my exposure was 5 seconds or so. I went to the doctor the next day and started a combo of Truvda and Isentress 12 hours after the incident. My partner has had an undetectable viral load for a more over a year now. Given this combination of factors do you think that it's likely that I will seroconvert? How effective is nPEP in a situation like this?

Thank you, Brian

Response from Dr. Frascino

Hello, Brian.

Broken-condom anal sex with a positive partner does place you at some degree of risk for acquiring HIV. Your HIV acquisition risk, however, is lessened by three factors:

1. Your exposure was very brief.

2. Your positively charged partner is on effective antiretroviral therapy, which has driven his HIV plasma viral load to undetectable levels.

3. Your began a course of post-exposure prophylaxis (PEP) 12 hours after the incident. We know nPEP (non-occupational PEP) helps abort HIV transmission/acquisition; however, I can't give you an exact percentage of efficacy, because there are many variables (viral strain, viral load, time until first dose, choice of PEP meds, etc.). You've done everything you can at this point. You should adhere to your PEP regimen and then follow the post-PEP testing guidelines that recommend HIV-antibody testing at four-to-six weeks, three months and six months from the date of exposure.

You and your Mr. Happily Ever After should read through the information in the chapter in the archives of this forum dedicated to magnetic couples. You may want to consider implementing some of the harm-reduction strategies discussed (starter pack of PEP, PrEP, etc.).

Good luck! Stay well.

Dr. Bob



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