Hi, Doctor Im in a PEP treatment and I would like your opinion about his efectiviness.

The fact is this: one week ago I had a sexual relation with a man of unknown status. First he perfomed me a fellatio with out condom and then a rimming during 30 seconds aprox (I suffer hemorrhoids). After that I put a condom on, and he cover the condom with an anesthetic cream used for quirurgical procedures (a mistake I know), and finally I penetrated him about 20 seconds with the condom. That was all the sexual intercourse. I didnt noticed condom failures. When I came to my home 30 minutes later, I noticed a wound with a bit of blood in my gland, probably the man bit me while he perfoms me the fellatio, so I experienced a panic attack and I decided to call him and asked about his status and his oral hygienic. He answer me that he had recently washed and flossed his teeth (which usually involves the risk of bleed gums), so I decided go to the hospital in order to have a medical opinion. 9 hours after the incident I started a PEP treatment under medical supervision. One pill of Zivoduvina of 300 grs each 12 hours (two pills per day)

My questions are the following: 1. How is supposed the PEP treatment works to stop a probably hiv infection? 2. There are some studies about the effectiveness of PEP treatment in biological or sexual incidents? 3. If I have a possible exposure to other STDs how long I have to wait to go tested. I know for Hiv is three months, how long for other STDs? 4. Which is your opinion about my risk from that sexual experience? 5. If I stop the PEP treatment during the second week by the secondary effects or other reasons, could it has an effect on the possible results against an hiv infection?

Thanks a lot and I apologize for my English but Im not a native speaker and in my country is difficult to find a specialists like you.

Regards from Colombia

My replies to your questions are below. I will say that based on your exposure description, I do not think PEP was indicated. Your sexual activity was protected and it seems that any biting would have occurred before the anesthetic cream was applied and you would have know it.

1. How is supposed the PEP treatment works to stop a probably hiv infection?

By taking HIV medication soon after an exposure, PEP attempts to limit the ability of HIV to replicate and spread. When started early in animal models, infection was halted.

2. There are some studies about the effectiveness of PEP treatment in biological or sexual incidents?

Best data come from monkey exposure studies and PEP did work when given to animals exposed to HIV via the genital tract or rectally.

3. If I have a possible exposure to other STDs how long I have to wait to go tested. I know for Hiv is three months, how long for other STDs?

Testing for most STDs can be done soon after exposure and testing for gonorrhea and chlamydia can be done a week or more after exposure. Testing for syphilis can be done but positive result may take a couple of weeks longer to emerge if infection occurred.

4. Which is your opinion about my risk from that sexual experience?

Very low for HIV. Oral sex can lead to any of the others I mentioned above.

5. If I stop the PEP treatment during the second week by the secondary effects or other reasons, could it has an effect on the possible results against an hiv infection?

No

DW