PEP Questions

[E.hms49]

Hey!

A few weeks ago I had unprotected anal sex with a guy. I was the insertive (top) during this. Realising I had been a massive idiot, I went to a GUM clinic around 9 hours after the incident. I took my first dose of PEP around 10.5 / 11 hours after the unprotected sex. Well within the 72 hour window.

Me and the doctor agreed the times I would take my pep, 8am and 8pm each day for 28 days. I take Truvada + Isentress in the morning and then the second Isentress in the evening.

My questions relate more to taking doses late.

On the fourth day of taking the prescription, I took my second (evening) Isentress tablet around 8 hours late. Unfortunately I was late getting home and thus delayed me taking the medication. I am really worried about this. How much of an issue is this?

After the first ten days I decided to change the time of day I take the pills to 12pm and 12am as they work better for my timetable. My doctor said changing the time was fine. I know that when I have been taking the pills sometimes I have taken them an hour or two late, or early? Would this effect them preventing hiv infection / how effective they are?

Does taking PEP an hour or two later effect the medication and increase my chances of HIV developing? For example I took my pill today at 13:30 instead of 12 as I was busy at work, but will be taking my 12am pill bang on time. Why is it suggsted to take the tablets the exact same time each day? I am really concerned because I know I haven't

Also I have been taking the Truvada without food most days - I know that sources differ on this requirement. Will me not having food with Truvada affect its effectiveness?

On a completely unrelated situation, several days before hand I met up with a guy and very briefly fingered him. I had no cuts at all on the fingers I used , but a very small (3mm max) nick on my thumb that looked more fresh after I literally lathered my hands in anti bac gel - do I have any reason to be concerned about this in terms of HIV? I've read a lot online and from what I gather unless I had a severe cut, say from a knife and pretty deep I have no reasonnto be concerned?

Lastly the guy I had sex with I questioned after and he sent me his negative test results from 5 weeks before we had sex. According to him he has only had sex with me and his ex boyfriend. My doctor advised to continue the medication - even though he has no likely reason to lie it is better to be cautious.

Apologies for all the questions, just need to ask!

[Jim Allen]

Lastly the guy I had sex with I questioned after and he sent me his negative test results from 5 weeks before we had sex. According to him he has only had sex with me and his ex boyfriend. My doctor advised to continue the medication - even though he has no likely reason to lie it is better to be cautious.

Indeed, so small preach for you, his negative test result means nothing to you or your risk. All it means to him is that 5 weeks ago he took a test indicating he was negative 13 weeks before that. Fat lot of good it is to you. Practice safer sex no matter what, taking risks based on someone's test results is a sure way to catch STI's including HIV.

1:

On the fourth day of taking the prescription, I took my second (evening) Isentress tablet around 8 hours late. Unfortunately I was late getting home and thus delayed me taking the medication. I am really worried about this. How much of an issue is this?

It happened, no point in "what if" and/or stressing about it now. If you miss a dose take it as soon as you realize, however do not double doze. 
Continue taking your medication and test 6 weeks and 13 weeks post finishing the course. The drugs have a long half life just take them on time from now on.

2:

Does taking PEP an hour or two later effect the medication and increase my chances of HIV developing? For example I took my pill today at 13:30 instead of 12 as I was busy at work, but will be taking my 12am pill bang on time. Why is it suggsted to take the tablets the exact same time each day? I am really concerned because I know I haven't

Look an hour either way is not going to make a difference, the drugs have a good half life but taking them consistently is important to maintain the levels of the drugs in the body blood/tissue, so it is best to build a routine of taking them at the same time everyday.

3:

Also I have been taking the Truvada without food most days - I know that sources differ on this requirement. Will me not having food with Truvada affect its effectiveness?

I can't comment on what the "sources" you have seen say.  From http://www.gilead.com "Take TRUVADA exactly as prescribed, and take TRUVADA by mouth, with or without food"

4:

On a completely unrelated situation, several days before hand I met up with a guy and very briefly fingered him.

There has simply never been a documented case of HIV transmission via fingering, you will not be the first. 

Here's what you need to know in order to avoid hiv infection:
You need to be using condoms for anal or vaginal intercourse, every time, no exceptions. As you are sexually active, it is highly recommended that you get a full sexual health check-up / screening at least annually including but not limited to hiv testing.

Remember that some sexual practices which may be described as ‘safe’ in terms of HIV transmission might still pose a risk for transmission of other STI's. So please do get fully tested regularly for all STI's including HIV and more frequently if unprotected intercourse occurs. Also note that it is possible to have an STI and show no signs or symptoms and the only way of knowing is by testing.

Finally use condoms for anal or vaginal intercourse, correctly and consistently, to avoid sexually transmitted hiv infection.

Kind regards

Jim

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