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Will Truvada Help Me?
Nov 7, 2012

I had unprotected anal sex with a man that has HIV. His load is undetectable though. He topped me and there was not a lot of semen. This was a 1-time only thing and I will NEVER risk it again. I'm worried he might have infected me. Anyways, after talking to him, he told me I should take Truvada. He said even if I did get the virus, Truvada will destroy it before I get HIV. I know you are supposed to get them from a doctor but I'm 18 with no way of getting to one without my parents. I'm not on any meds at all with no health conditions. Is it OK for me to take Truvada for the 28 days like he told me? Is it safe? And will it prevent me from getting HIV? I need to know ASAP. Please help, and thank you for reading.

Response from Dr. Wohl

Truvada has been used to prevent HIV infection in two major ways:

First, is Pre-Exposure Prophylaxis (PrEP) - that is taking the medication daily to prevent infection during exposures that occur while on the drug.

Second, is Post Exposure Prophylaxis (PEP) - this is what you are talking about and involves starting the medication after an exposure.

For PEP to be effective, it has to be started very early after the exposure. We are talking hours not days. In animal models of infection, effectiveness of PEP really suffers as the delay in initiation increases. Most experts feel that after 3 days there is no use to starting PEP. Additionally, many also now accept that Truvada alone may not be sufficient for PEP and that adding a third drug is better. If it has been within 3 days of your exposure you should be able to discuss PEP with someone at a public STD clinic (if you are in the US or Europe) and probably get a supply of PEP.

In your case, the odds are in your favor anyway. If your partner really has an undetectable HIV level, his ability to transmit the virus to you is low. Regardless, this is what you need to do: get an HIV test now and again in 4 to 6 weeks, get tested for syphilis, gonorrhea and chlamydia (swab of butt and throat and testing of your urine), buy condoms.

DW



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