Hi there, great forum
My partner is on ARV for 6 weeks now. She's taking tribuss. 1 pill a day.
We discovered her status after unprotected sex and I was placed on PEP 56 hours after. 8 weeks after PEP I went for a test and result was negative.
So we've been having protected sex since I finished my PEP and I started PREP about 4 days after my test. So recently we had sex and the condom broke, although I have a cut on my penile shaft due to underwear spray irritation.
I want to know if am still safe. But the clinic told me I shouldn't stop my PrEP Medication I should continue for the next 28 days and get tested after that.
Hi there -- Thank you for the kind words, I am always pleased when people find this forum helpful.
So based on the circumstances you described you are as protected from HIV as one could possibly be if they are sexually active. Here's why:
(1) PrEP protects the HIV negative partner whether a condom is used or not. It is more than 99% effective at reducing one's chances of acquiring HIV if they were exposed to detectable viral loads. You do not need to use a condom to protect you from HIV if you are using it as prescribed (https://www.robertmgrant.org/project/does-prep-work-if-condoms-are-not-used/).
(2) Your partner is on treatment medicines. And although our proven data shows that a person living with HIV is unable to transmit HIV after six months of viral suppression, our medical information shows she is likely undetectable and untransmittable much sooner than 6 months (https://www.preventionaccess.org/). She cannot transmit HIV through sexual contact once undetectable, with or without you using PrEP.
(3) You are the insertive partner in this relationship. That means even if there was no PrEP and no treatment involved, your chances of acquiring HIV from her through vaginal sex are still less than 1%. Anal sex is a little higher, but not by much. If you are circumcised that low risk is even lower. You can check out the data about these low likelihoods here: (https://www.poz.com/article/HIV-risk-25382-5829).
Given that you were fully protected during this encounter, a responsible informed provider would not switch you from PrEP to PEP. PrEP was developed and studied on occasions where HIV negative individuals were exposed to detectable HIV viral loads, often through receptive anal sex. Even in those instances, daily use of PrEP protected by more than 99% (http://www.thebody.com/content/80972/has-anyone-gotten-hiv-when-they-were-on-prep.html).
I'd be more concerned about the irritation from your underwear spray than from HIV right now. What kind of product are you using? It is probably not a good idea to use a spray that you may be allergic to and/or cause irritation or tears in the genital area.
But no matter what spray you are sprayed in your underwear, or whether you use a condom or not, you are very well protected from HIV in this instance. I hope this information allows you to and your partner to create the kind of fun, intimacy, and connection you both so richly deserve.
To learn more about PrEP use and rethinking sexual health, please join my Facebook "PrEP Facts" group where we discuss these issues 24/7. Enjoy! https://www.facebook.com/groups/PrEPFacts