Considering PEP, seeking advice.

[Concerned01]

Hi.  My story is this- I had brief unprotected vaginal intercourse 2x with a Thai girl I only met on the same day, did not ejaculate in her either time.  This was ~50 hours ago as I write this message.

I've never had unprotected sex with a stranger like that before, so I'm freaking out about it.  She has told me since that one-night stands are not her thing either and she was embarrassed about it as well.  But she didn't say anything about whether she's been tested or what her partner frequency is, etc.  She said she was not concerned but didn't expand upon that, and told me if I were concerned I should go get tested (the fact that she was not concerned herself after having unprotected sex with a guy she just met adds to concern). Since unprotected sex is not my thing, I did not know much about the testing details.  I went to the doctor yesterday to get tested, of course to learn about the 3+ month window for testing.  So I had them test me for other things while I was there.  The doctor did not mention anything about PEP, and I only learned about it reading here tonight as I couldn't sleep.

I have a sore throat and headache that have developed since, so that has given me some extra concern.  It sounds like I shouldn't be concerned unless this happens closer to 2 weeks out, but I do have an autoimmune disease (ulcerative colitis), so I'm a little fearful maybe that has accelerated the symptoms for me, because my immune system sometimes seems overactive.

So I'm considering PEP since I'm in that 72 hour window.  I'm guessing you will say the risk is small, but since there is a chance I may have contracted HIV wouldn't it be better to get on it?  At the least, I could start it while I'm still in the 72-hour window, and then if she gets tested and confirms she's negative, I could stop the meds?  I'm going to try calling another doctor about this as well but any advice would be appreciated, thanks.
   

[Jeff G]

The risk for the insertive partner is significantly lower than it is for the receptive partner but it is a risk all the same . Here are the guidelines for prescribing PEP

Insertive anal sex: PEP is recommended if you have had insertive anal sex (when you are the 'top') with someone who is known to be HIV positive, unless they have an undetectable viral load.
Vaginal sex: PEP is recommended if you have had vaginal sex with someone who is known to be HIV positive, unless they have an undetectable viral load.

Strictly going by the guidelines PEP isn't indicated in your situation because of the fact you were the insertive partner and you do not know your partners status . Its recommended when the guidelines I posted above are met . 

You have to decide whether you are going to pursue PEP  . If you do PEP, it means that you can test initially at 6 weeks after completing the 28 days of PEP. If you get a negative result, which I think there's a good chance for, then you test at 3 months after PEP for a conclusive negative result.