Doc, what you think?

Question

Hi Doc,

Sorry if I make grammar mistakes English is not my primary language! I would like to submit my case to your opinion. Im a gay male, and Ive been drunk and due to my stupidity I went to a gay sauna and engaged in non protected oral sex, receptive and insertive with three different male partners, without ejaculation. Plus, I rimmed a fourth one, and penetrated him, briefly, last then a minute, with no condom. Im really upset with my behavior, especially because I know the risks and Ive been there before! So about 50 hours after, even if the Pep hotline said to the ER doctor the risk was very low, he prescribed me Truvada once daily, and asked me to be followed by a Doctor. So I went to this HIV Specialist today. He was very nice and did a full examination/anamnesis and draw blood for STD screening, including HIV, that wasnt done at the ER He also added Kaletra (4pills daily) to my pep regimen. I have a few questions:

  1. Do you think is ok Truvada+Kaletra for this kind of situation?
  2. Do you too consider my risk very low?
  3. When Doc when I will be able to have peace of mind? I mean, how soon can I have a test that will guarantee at least a good percentage of negativity?

Thank you so much for your work!

Answer

Hi,

Yes, Truvada plus Kaletra is a recommended post-exposure prophylaxis (PEP) regimen.

Because you were in a gay sauna and had sex with four different guys, including brief unprotected insertive anal sex, I would agree you have a significant enough HIV-acquisition risk to warrant a course of PEP.

You will need to complete a full 28-day course of nPEP and then have post-PEP HIV-antibody testing out to six months from the date of your sauna night out with the boys. Specifically the guidelines recommend post-PEP HIV-antibody testing at four to six weeks, three months and six months.

Good luck!

Dr. Bob