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Should I Start PEP?
Dec 6, 2012

Dear Folks:

My friend and I were fooling around the other night and we decided to go all the way. I was the top and put on a condom. Just as I was entering him I noticed it felt different. I pulled out and the condom had broken. We stopped immediately and I went and washed with soap and water. I was in him for less than a minute. He is a responsible guy who gets regular testing and as of his last was negative. We are both getting tested later today as well. We are still in the 72 hour window. Should I ask for a PEP course? Thank you very much for your help.

Response from Dr. Wohl

I would say that the risk here was really low. For one thing, you were on top, so risk is less than if you were bottom. The exposure was brief.

Still, some would offer you PEP. If your partner tests HIV negative, that would be more reassuring altho if he has had any recent exposures one would need to consider whether he is himself in the window period when antibodies to HIV are not yet detectable. This is where the new combo HIV test helps as it looks for antibody and the virus.

So, probably best to start PEP, get tested and decide whether to continue if his antibody test is negative, recognizing that you can not rule be 100% sure he is HIV negative unless he has a combo HIV test or viral load drawn.

DW



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