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PEP/confusion

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Elizabeth214:
Hello everyone,
Iíll get straight to the point here. I am a female and had an unknown exposure from a sexual assault by a man. I went to the ER the next day and couldnít get my prescription until the day after that. Pharmacies didnít have the medication and didnít even know what PEP is. So, I went to the health department who then referred me to an Infectious Disease doctor that specializes in HIV treatment and prevention.

That is where I was given PEP on the spot at 60 hours post exposure. They prescribed me 30 days of Biktarvy, which I know is an HIV treatment medication which is essentially what PEP is anyways.

They scheduled me for a PEP clearance appointment 5 days after my last dose of PEP
Exposure - 11/21/2021
Meds started - 11/23/2021
Clearance APT - 12/27/2021

I tested negative for all STIís other than HSV1, which Iíve had since childhood. But none the less, tested negative for HIV. I also did two unnecessary rapid tests for HIV 1 week and 2 weeks after that.

Here is where Iím confused, the doctor said since I tested negative when PEP was initiated and after PEP that I do not need to test any further. If I wasnít a panicked googler all the time, I would take the word of my doctor. Although, because I just love to ask Dr.Google constantly, I have found that it is advised to get tested immediately after PEP, 4-6 weeks after PEP and 3 months after PEP.
So, why would my doctor not mention that? I know Iíll be fine whether positive or negative but not knowing is really driving me crazy.

Any advice is appreciated. Thank you.

Jim Allen:
Hiya,

Firstly I'm sorry to hear about the assault and I hope you have access to any support you feel is needed to help you.

Regarding HIV and PEP, test at 6 weeks post finishing PEP with a blood-drawn (Lab) HIV antibodies test, a non-reactive result at that time would rarely ever change and retesting at 3 months post finishing PEP is generally not needed.


--- Quote ---So, why would my doctor not mention that?
--- End quote ---

No idea and I am not going to guess.

Kind regards

Jim

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Elizabeth214:
So that means the test I took 5 days after the last dose was pretty much pointless then, right? The office told me theyíve never had a patient end up positive after PEP and I would assume thatís from the lack of follow up testing unless the medication really is that effective. Pretty disappointing that they donít have patients come back for testing after 6 weeksÖespecially being an infectious disease doctor.

And thank you. All of these places seem to have resources for counseling but no funding otherwise itís incredibly expensive, unfortunately.

Jim Allen:

--- Quote from: Elizabeth214 on January 14, 2022, 01:46:39 pm ---And thank you. All of these places seem to have resources for counseling but no funding otherwise itís incredibly expensive, unfortunately.

--- End quote ---

I'm really sorry to hear this. As I am located in Ireland I don't have any relavent contacts to provide you, however, prehaps you can try looking for a local peer support group so that you are at least in contact with peers.


--- Quote ---So that means the test I took 5 days after the last dose was pretty much pointless then, right? The office told me theyíve never had a patient end up positive after PEP and I would assume thatís from the lack of follow up testing unless the medication really is that effective. Pretty disappointing that they donít have patients come back for testing after 6 weeksÖespecially being an infectious disease doctor.
--- End quote ---

No, the test was not irrelevant. If it had been reactive you could have started (continued) treatment and catching it that early means reducing the viral reservoir.

However, what the test did not do is exclude an HIV infection. PEP is highly effective and it rarely fails if taken correctly for the course and started within 72 hours, however,  it's not a guarantee and hence testing is needed to confirm.

P.S


--- Quote ---The office told me theyíve never had a patient end up positive after PEP
--- End quote ---

I hate these types of statements from clinics.

It's meant to be reassuring but it doesn't help, I mean I'm turning 40 next week and there are plenty of things I have not seen in life but that does not mean they don't happen or exist.

Sadly though, I have seen positive results post PEP although it very rarely happens. 

Elizabeth214:
Thank you that is a good idea to look into some groups. I live in a huge city so I know there are tons around here.

I hated that statement from the clinic as well. Especially considering that they donít continue with follow up testing.
I did take the medicine every day, at the same time everyday. And luckily, I didnít have any side effects either! Antibiotics have worse side effects than the Biktarvy did, for me. I am so thankful that these medications exist for HIV positive people and with more education and testing hopefully we can have an HIV free generation one day.

Thanks for your quick responses. I love this website and all of the information offered on here.

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