PEP effectiveness and risk after definite exposure?

[rob6]

Hi,

I had a definite exposure with an HIV+ male after a condom break. Basically I was the insertive partner (top). I estimate that we had sex for 1-2mins after the break, the length of time of my exposure. Only the head of the penis was exposed, so I am hoping the condom offered me at least some protection - there wasn't any visible blood etc. He doesn't have any other STDs and nor do I, though his viral load is 73,000.

Within 12 hours I was put on PEP, which I am on my 17th day of and have adhered 100% but I am incredibly anxious I may have become infected.  I am just wondering what the actual risks are from a one-time exposure of this kind and of the effectiveness of PEP?

I am at the end my rope with anxiety, during a period which has literally been the worst time in my life. 

[Jeff G]

Hi Rob . As you already know you had a risk and although the insertive partner ( you ) are at a lower risk than if you had been receiving , its a risk all the same . Its rare for guys to test positive after a condom break and when you add PEP into the mix I have no doubt you are going to come out of this OK . PEP , if taken within 72 hours is very effective .

PEP extends the testing window period out to 6 weeks post PEP and then you can get test again at 3 months to confirm the results , and I would expect a negative result .

I hope your doctor did an initial screening for HIV before initiating PEP , it is standard practice to do so .   

[Ann]

Rob,

In over twelve years of being on this forum, I have yet to see the insertive partner test positive following a condom break, PEP or no PEP, and I do not expect you to be the first.

PEP is very effective provided you take it every day, which you have. There is absolutely no reason to think you will test anything other than hiv negative.

You need to know that taking PEP extends your window period by 28 days. The earliest you should test is at six weeks post-PEP. The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, with the average time to seroconversion being only 22 days.

A six week negative must be confirmed at the three month point, but is highly unlikely to change.

Good luck. I fully expect you will test negative when you test at the appropriate time.

Ann

[rob6]

Jeff and Ann,

Thanks very much for your swift responses and the hard work you do on this site. Your informed words have helped to calm me somewhat and I know I just need to complete this PEP regimen.

Jeff, yes, my doctor did perform an HIV test at baseline, which was negative.

Thanks again.

[Jeff G]

Thanks Rob . You are doing everything you need to do to stay healthy , props for that .

Please do yourself a favor and try to find something productive to do during the waiting period before testing so you are not stressed and dwelling on what ifs .

We see people in this forum who spend hours combing over every thread for 3 solid months waiting to test and I think its safe to assume they are miserable for the effort . How you choose to spend this time is a choice , please choose to not add to your stress .

We really do think you are going to be OK and there is no need to reply to my thoughts here , save your last free post to come back and tell us you are HIV negative .

[rob6]

Jeff and Ann,

I am delighted to say after 28 days on PEP I tested negative on Friday following a fingerprick (antibody) test, just for peace of mind, and today I found I also had a negative result on my blood draw for the Duo test taken the same day.

I know the window is three months but my mind is pretty much at rest now. Thanks for your wise words during a very difficult period. To anyone else going through the same thing - a condom break/PEP - it is very tough, but, like me, you will come out the other side. During the 28 days I did everything I could just to get through the period - that was my only priority.

[Jeff G]

Rob,

In over twelve years of being on this forum, I have yet to see the insertive partner test positive following a condom break, PEP or no PEP, and I do not expect you to be the first.

PEP is very effective provided you take it every day, which you have. There is absolutely no reason to think you will test anything other than hiv negative.

You need to know that taking PEP extends your window period by 28 days. The earliest you should test is at six weeks post-PEP. The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, with the average time to seroconversion being only 22 days.

A six week negative must be confirmed at the three month point, but is highly unlikely to change.

Good luck. I fully expect you will test negative when you test at the appropriate time.

Ann

I think you are going to come out of this OK but testing the day you go off PEP is not the appropriate time to test . I quoted Ann's reply to you so that you know you still must test at 6 weeks and again at 3 months . I think you know this from reading your update but I just wanted to make sure . Expect a negative confirmation when the time comes .