Do I need PEP if I'm already on PrEP?

Question

Hello,

I am currently HIV- and have been on PrEP since October 2015, but missed two doses in a row last week and was back on my regimen for five days before having (what may have been) unprotected insertive anal sex on Monday AM. Are the levels of PrEP in my body enough to help protect against potential exposure or should I supplement with a PEP regimen? It has been just about 48 hours since the incident.

Thank you

Answer

Hello and thanks for posting.

As long as you've been on your PrEP regimen for more than the 7 or so days it takes (we think) to be fully active, and you've been adherent to the dosing, there's no reason why you should need to alter treatment for post-exposure prophylaxis (PEP).

Missing a couple of doses is relevant, but since you were back on treatment for 5 prior to the possible exposure, your drug levels should have returned to the therapeutic levels.

Hope that's helpful, BY