Hello,

About 10 days ago i started a PEP regimen of Combivir and Cirxivan after accidently having brief intercourse (30 sec) without a condom. When i recieved the medications the crixivan didn't explicitly tell me to take two tablets three times a day every eight hours, all it said was three times a day every 8 hours. For the past 10 days i have been taking only one crixivan every eight hours along with two combivir. My question is, although now i am taking the the right dose, could i have increased my chances of contracting HIV or possibly helped develop a strain in my body that is resistant to drug treatment?

Thanks for your time.

Hello,

I'm curious. How does one accidentally have intercourse??? Did you perhaps just happen to fall on an erect penis? Or perhaps you were playing leapfrog and happened to land just right??? Oh never mind.

First, my usual spiel about PEP. If at all possible, anyone who has had an HIV exposure significant enough to warrant PEP should, in my opinion, be followed by an HIV specialist. The HIV specialist is best equipped to evaluate (1) the actual HIV risk and need for PEP, (2) the best PEP regimen to take, (3) any PEP-related side effects or toxicities and (4) post-PEP follow-up HIV tests.

Whether PEP is even indicated for this type of "accident" is debatable. The choice of Crixivan plus Combivir would not be my first choice for a PEP regimen. That you were not given explicit instructions regarding the regimen is also concerning. Hopefully you were told that Crixivan should be taken on an empty stomach (one hour before or two hours after meals) and that you need to drink plenty of water while on this medication.

By the way your post reads: "For the past 10 days I have been taking only one Crixivan every eight hours along with two Combivir." Have you been taking two Combivir every eight hours? If so, that's too much! You should take only one tablet twice daily.

Finally, not taking any medication exactly as prescribed can decrease the chance of it being effective. I do not believe you should worry about resistance drug strains. My advice is that from here on out you take your medications exactly as the HIV specialist prescribed them and that you follow the published guidelines for the use of PEP for nonoccupational HIV exposures.

Good luck.

Dr. Bob