parysUK:
Hey I have very strange and worrying situation I normally take prep on deman On the 25/7 I had unprotected sex I was bottom with the guy His confirmed few times to me hi is on prep and hi is all fine Sadly I took double dose just after sex the followed with 1:1 as usual . Then I had unprotected anal (bottom ) sex with the guy on the 27/7 which was covered by last dose of prep from the previous encounter I hope but I carried on with another 2 days of pils just to be sure Then on the 4/8 I had sex with guy while I was in the other city and I was top but didn’t had my pills with me so I took double dose probably 2h after sex instead at least two hours before 😩when I got home and the followed with usual 1:1 I took oraQuick on the 12/8 negative as at that time I wasn’t concerned I decided to get back again on prep daily from that day 12/8 after oraQuick Then I had INSTI IgM/IgG on the 14/8 and another one on the 18/8 both negative I know I have to take one in the clinic as I’m well in the window period but I’m just wondering if that prep gave some protection as sadly now I came down with bad fever no other symptoms just high fever and headaches . Now I need to stop prep as apparently can delay antibody
Jim Allen:
--- Quote ---His confirmed few times to me hi is on prep and hi is all fine --- End quote ---
Irrelevant. Nothing he says means anything, also even if he tested today it means nothing due to the window period. As for him being on PrEP, who knows if that's true or if he is taking it correctly and even if he is that's nice for him, but it doesn't mean much to you.
--- Quote ---On the 25/7 I had unprotected sex I was bottom with the guy Then I had unprotected anal (bottom ) sex with the guy on the 27/7 which was covered by last dose of prep from the previous encounter I hope but I carried on with another 2 days of pils just to be sure --- End quote ---
You had anal sex on Thursday, the 25 July 2024 and again on Saturday. So the correct event-based PrEP procedure would be as follows:
Thurs - 2 PrEP pills before sex (2-24 hours before) Fri - 1 PrEP pill Sat - 1 PrEP pill Sun - 1 PrEP pill Mon - 1 PrEP pill
The reason for the additional Sunday and Monday dosage is that you had sex on Saturday and you need to continue taking PrEP for two more days after you last had sex. This is how event-based PrEP works.
--- Quote ---I’m just wondering if that prep gave some protection --- End quote ---
Yes, but it's not ideal. The double dose before sex is important.
--- Quote ---I decided to get back again on prep daily from that day 12/8 after oraQuick Now I need to stop prep as apparently can delay antibody --- End quote ---
The delayed detection (blunted HIV infection) was and is always part of the risk when using PrEP. Nothing has changed. This also happens with PEP, hence with PEP the rule of thumb, is to apply testing guidelines post-finishing PEP instead of post-exposure date.
As for daily PrEP users, we don't encourage stopping and instead urge screening with a blood-draw (lab) HIV antibody test (Not a rapid test) every three months. The reason is stopping would mean having periods with reduced protection and with HIV screening every three months even a blunted infection would be detected within the first or second screening dates. This is far less of an issue with event-based PrEP as the standard window period changes by 2+- days only after the risk event.
Ultimately it's up to you, but I see two options.
1) Stop PrEP and test in six weeks with a blood-draw (lab) HIV antibody test. 2) Continue daily PrEP and test every three months with a blood-draw (lab) HIV antibody test.
Urging on the side of caution as you have had a haphazard PrEP past, I would say stop and test in six weeks to confirm your HIV status but talk to your healthcare provider.
In addition, should you ultimately decide to continue with daily PrEP or event-based PrEP in the future as an additional layer of HIV prevention then please start using it correctly!
Here's what you need to know to reduce your HIV risks: Use condoms for anal or vaginal intercourse correctly and consistently, with no exceptions. Consider taking PrEP as an additional layer of protection against HIV and get vaccinated against HPV, Hepatitis A & B.
Keep in mind that some sexual practices described as safe in terms of acquiring HIV still pose a risk for other easier-acquired STIs. So please do get tested at least yearly for HIV & STIs, and more frequently if condomless intercourse occurs. As a PrEP user get an HIV screening every three months.
Also, note that it is possible to have an STI and show no signs or symptoms; testing is the only way to know.
Kind regards
Jim
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parysUK:
That’s the doses I did followed from 25th/August till -30t/agust which also covers my 27th encounter I do believe Thurs - 2 PrEP pills before sex (2-2 Fri - 1 PrEP pill Sat - 1 PrEP pill Sun - 1 PrEP pill Mon - 1 PrEP pill Then no prep till the 4th when I had unprotected sex when I took double dose roughly 2 late and followed same pattern 1:1 after I know people saying things means very little this days hence I spoke with my sexual clinic and stoped prep having blood test tomorrow then another one on the 45th day after event
Jim Allen:
--- Quote ---That’s the doses I did followed from 25th/August till -30t/agust which also covers my 27th encounter I do believe Thurs - 2 PrEP pills before sex (2-2 Fri - 1 PrEP pill Sat - 1 PrEP pill Sun - 1 PrEP pill Mon - 1 PrEP pill --- End quote ---
--- Quote ---On the 25/7 I had unprotected sex I was bottom with the guy His confirmed few times to me hi is on prep and hi is all fine Sadly I took double dose just after sex the followed with 1:1 as usual . Then I had unprotected anal (bottom ) sex with the guy on the 27/7 which was covered by last dose of prep from the previous encounter I hope but I carried on with another 2 days of pils just to be sure --- End quote ---
No, don't change the story as it will piss me off.
You said it was after sex, now you are saying you took it before sex. ::) You also initially said you thought the sex on Saturday 27th was covered by the last dose from the previous encounter, at that time the last dose was the Saturday dose, the sex on Saturday wasn't "covered" by this as it would require a Sunday and Monday dosing to reduce the HIV risk.
Now, thankfully you took PrEP for the 2 additional days and that does provide some risk reduction "cover it". You need to understand for the future the correct process, not that its "just to be sure" as you put it.
--- Quote ---Then no prep till the 4th when I had unprotected sex when I took double dose roughly 2 late and followed same pattern 1:1 --- End quote ---
Same mistake as you made on the 25th. You took the double dose after sex, not before.
--- Quote ---I know people saying things means very little this days --- End quote ---
It never did.
--- Quote ---I spoke with my sexual clinic and stoped prep having blood test tomorrow then another one on the 45th day after event --- End quote ---
Perfect.
Let me remind you that condoms when used correctly and consistently are nearly 100% at preventing HIV from being passed on. Their level of prevention of other STIs is much lower.
PrEP provides a good additional level of HIV prevention when used correctly and consistently, although no STI protection.
Since you no longer are using PrEP remember to use condoms and when you get your HIV screening done 6 weeks post exposure also talk to the clinic about an STI screening and getting vaccinated against HPV, Hepatitis A & B.
parysUK:
No I’m ever so sorry I just looked I got it all meddled up 😩 from what I can see in my comment 25/7 double dose before sex then carried on till 1:1 :1:1 till 29th Hence I said 27th encounter should be covered into this Then on the 4th I took the double dose late 2 hours after sex then did usual 1:1 I’m so sorry for confusion So the case of concern is for the 4th of August I understand as I was late with the dose And was no prep from 29/7 till 4th