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5 days on HIV Post-exposure meds
Mar 13, 2012

I recently had unprotected anal sex with a man where I was the insertive partner only. We both get tested regularly, and have both always been hiv-neg, so we didn't use condoms based on logic of serosorting. It had been about 4 months since his last test, so I really encouraged him to get retested and unfortunately, he tested positive yesterday. I am very sad for him, and for us, but am right now just trying to deal with aftermath. I know that being the top is much lower risk, but because I assume his viral load is quite high, I went to the ER and they gave me a 5-day supply of PEP meds (800mg Crixvan 3x/day + 300mg Lamivudine-Zidov 2x/day). I started the meds 24hours after exposure. My question is whether I really need to take the full 28-day dose, or would the 5-day supply I received be sufficient? I still think that my risk is quite low, especially considering the fact the we had unprotected sex several times two months ago when he was probably serocoverting, and I am still negative as of last test (1 week ago). FU*K HIV! I'm so sick of dealing with this. I love this VERY informatiev site though, and really appreciate your input.

Response from Dr. Wohl

Unfortunately we do not know how long is just right when it comes to PEP. The original data looked at 4 weeks so that is what we are stuck with.

Some important considerations:

- The chance that PEP would be effective days after an exposure seems very low based on exposure experiments in non-human primates.

- Crixivan is a weird choice for PEP. More typical would be a combo of Truvada plus Kaletra.

I would seek out an HIV specialist to discuss if you even need to be on PEP and to conduct proper testing post exposure.

Thanks

DW



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