Taking PEP more than one time
I am thinking of getting PEP for a second time. It's been 7 weeks since I finished my first course of PEP, and I tested negative at 6 weeks post PEP. Now I had this exposure where I was having protected anal sex with another man, but at one moment, while he was rimming me, I didn't realize he placed his penis on the entrance of my anus and forced it for about 5 seconds before i realized and pushed him away, I don't think there was a penetration, maybe just shaft, but I'm afraid there could be precum involved, especially because my anus still is quite sore and hurt. My questions are:
- is there a risk if I take another course of PEP now very close to the finish of the other one? It will probably be an old regimen.
- do you think PEP is warranted in this case?
Hello and thanks for posting.
- If you had a second HIV exposure, even within the time you were taking a first PEP regimen, conventional wisdom would dictate that you should continue for an additional 4 weeks time- even if it's the same regimen.
A somewhat unorthodox view would say however, that since you were taking PEP for about 3 weeks prior to the latest exposure, this actually comprised a pre-exposure prophlaxis (or PrEP). PrEP can be very effective in reducing risk of contracting HIV, and should generally be taken for at least several days before and a week or more after the last exposure.
If you had condomless penetrative anal sex, even briefly, I'd consider that a potential exposure, unless you know that your sex partner was HIV negative or positive with an undetectable viral load. Even then, without a high degree of certainty, PEP would be a consideration.
I know you didn't ask three questions, but I generally advise HIV-negative sexually active men (and transgender women) who have sex with men to consider if PrEP is appropriate for them. Two episodes of possible exposure that make one consider post-exposure prophylaxis suggests that you are possibly at sufficient risk to take a daily PrEP pill for prevention.
Hope that's helpful. Be well, BY