HIV testing before starting PrEP

Question

Hello. I have a question concerning HIV testing before beginning PrEP. I would like to start PrEP. I engaged in short dipping (as top) with someone (don't know his status) 3 weeks ago . I haven't had unprotected sex since then. Is it sufficient to get tested (4th gen test) 4 weeks after the dipping and if the test is negative start PrEP or is it better to wait longer to get tested? Thanks a lot!

Answer

Hello! Congratulations on your decision to start using PrEP to protect yourself and your partners. This is a major shift in HIV prevention which reduces one's chances of acquiring HIV to nearly zero (http://www.thebody.com/content/80972/has-anyone-gotten-hiv-when-they-were-on-prep.html).

Fourth generation HIV tests would be able to find HIV in most people by the third week (http://sfaf.org/hiv-info/testing/). A possible HIV exposure would not be a valid medical reason to stop someone from starting PrEP, it just may be a reason for the patient to receive an additional HIV test 30 days after starting the drug.

Additionally, the activities you are describing put you are nearly zero risk of acquiring HIV. Even if your partner was HIV positive and not on treatment (and detectable), the likelihood of you getting HIV as a top are less than 1% (https://www.poz.com/article/HIV-risk-25382-5829). I've never heard of a case of someone becoming HIV by simply dipping.

In other words, it seems to me you're good to go. You haven't had an HIV exposure in over 4 weeks, and your most recent 4th generation test showed you are HIV negative. This would be the time for you to start PrEP and seek out the kind of pleasurable connections that you bring you and your partner satisfaction and joy. Have fun!

To learn more about PrEP, please feel free to visit my Facebook "PrEP Facts" group where we discuss these and many other issues 24/7: https://www.facebook.com/groups/PrEPFacts/