PrEP and PEP confusion

[globalact76]

Hello,

Thanks for providing such a wonderful community space.

I have a quick question regarding PrEP and PEP and general risk. To be clear, I will be getting tested anyway as part of my PrEP and now PEP regiment, but here it goes:

I have been a pretty consistent PrEP user for about 9 months, with a couple stops and starts due to the pandemic and lack of activities, but generally no more than 3-5 days missed here and then.

For the purpose of making my question a little clearer, here is the timeline of my questions:

a) Days 1-30 I was on PrEP consistently
b) Days 31-39 off PrEP (I was away on vacation)
c) Days 40-47 on PrEP consistently
d) Day 48 - potential exposure. Granted it was low risk, but I didn't know the bottom's status and my doctor was slightly concerned about the break in PrEP so he asked me to start PEP. This sounds silly, but I don't even think I penetrated the guy I was with successfully - we were both quite drunk and eventually got off on other non-intercourse activities, but I am leaving room to default to me penetrating without a condom).
e) Day 49- PrEP
f) Day 50 - Doctor suggests PEP which I've been taking.

I've since had a couple more sexual experiences - one with a condom and the other just oral sex/fingering.  I will finish my course of PEP in about 12 days and then be retested.

So my long questions are - were there any particular risk points in this timeline? And does being on PEP (Truvada and tivicay) for over a week basically mean I'm on PrEP and protected? Finally, I understand fingering is a low risk activity but what about potential rectal fluids that would be on your finger followed by masturbating?

Thanks again and continue the good work.

[Jim Allen]

were there any particular risk points in this timeline? And does being on PEP (Truvada and tivicay) for over a week basically mean I'm on PrEP and protected? Finally, I understand fingering is a low risk activity but what about potential rectal fluids that would be on your finger followed by masturbating?

Well, the potential condomless intercourse was a risk, but that you already seem to know from your post. I will presume that's what happened.

As for the fingering and touching/masturbating yourself afterwards is no HIV risk whatsoever regardless of what drugs you are taking. About the oral sex, look receiving a blowjob is no HIV risk and giving a blowjob is such a minute risk we would not even recommend testing for it outside of routine.

And does being on PEP (Truvada and tivicay) for over a week basically mean I'm on PrEP and protected?

Well, the events posted whilst on PEP was no real HIV risk, however, if you had had a real risk then the PEP combined with the week before that being on PrEP would act and continue as PrEP to reduce your risk.

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Keep taking PrEP going forward as an additional layer of HIV protection.

Keep in mind 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.

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.

Kind regards

Jim

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[globalact76]

 Thanks a bunch!

Best to you.

[Jim Allen]

np