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Author Topic: PEP after risk of exposure  (Read 1211 times)

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Offline Alopez6772

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PEP after risk of exposure
« on: December 10, 2021, 05:54:43 pm »
Hi all. Thanks in advance for your taking your time helping.

I had an exposure back in october 5. Basically it was oral sex (receptive), not even, was just the ending of it (fluids coming to my mouth, which spats out inmediatelly).

Without hesitation I went to the ER and ask for PEP (had to lie about the exposure, if not they woulnd grant me PEP). I know is very low risk, but is still a risk, was it my lucky day? I don't know, but I didn't want to try either. Long story short, they took a sample of my blood (from a vane it my arm) and I took my first dose 5 hours after exposure. 2 days later had an appointment with a specialist, who told me I was tested negative initially so we continue with the traetment.

The Problem: I took my first dose at 4 am, put my alarm every day but on day 5 I couldnt hear the alarm and took it 5 hours later than what was planned (9AM), so what I did from there on was to start taking my pills every day around 9AM. ending my traetment on november 2 without any toher incident.

Question:
1.-  Might this be categorized as not having acted as indicated resulting in treatment failure? reading about it now, found that it might be not enough drug in the body and inducing a failure in the traetment

Doctor call me for a test just finishing with PEP but I couldnt assist (work issues with my schedules), and frankly I was not very worry due the very low risk and PEP. Called them back and they gave me a new appointment for the end of January.

Facts: By the end of november (4 weeks after finishing PEP), a painful swollen lymph gland  appeared on my armpit (NEVER HAD THIS BEFORE IN MY LIFE) and started to felling really  tired  I immediately associated it with symptoms. I understand you dont evaluate symptoms here, and that my symptoms are not directly related with an HIV  diagnose but this freak me out.

Question:
2.- Do PEP delays infection if it has failed? Can it delay the symptoms if there are any?

I went this morning to my regular doctor, I told him about the situation and I was surprised to see that he did not know what PEP is , he did not give much importance to the case and gave me an appointment to do some blood tests next Monday (Syphilis, Mono, HIV, and others). I dont know what type of HIV test they gonna do it because the paper just say HIV screening. (the test will be performed 70 days after exposure and 42 days after having finished PEP)

Sorry for the long story, but want to include all the details and my concerns. I would really appreciate an opinion based on my case and my questions if that would be possible. Again I was not even worry because it was a very low risk exposure and I took PEP after it, but the symptons mentioned 4 weeks after having finished PEP are driving me crazy, too much coincident and at the same time make no sense to me due the low low risk.

Kind of having a hard time due the waiting time.

Thanks!!

Offline Jim Allen

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Re: PEP after risk of exposure
« Reply #1 on: December 10, 2021, 06:17:43 pm »
Okay...

Look taking a doze of PEP a few hours late isn't an issue and will not change the outcome even if you had had a risk.

Quote
I went this morning to my regular doctor, I told him about the situation and I was surprised to see that he did not know what PEP is

I'm not surprised.

Quote
Do PEP delays infection if it has failed?

It could delay the detection of HIV, meaning the window period to test would be extended but that window period would even on the cautious side only by the amount of time you took the PEP.

Quote
Might this be categorized as not having acted as indicated resulting in treatment failure?

No.

Quote
2 days later had an appointment with a specialist, who told me I was tested negative initially so we continue with the traetment.

So if this was your only sexual contact within the last 3 months there is no reason for HIV concern.

Quote
too much coincident and at the same time make no sense to me due the low low risk.

No, it's not and makes perfect sense.

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. Consider talking to your health care provider about 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 and at least yearly for all STI's including but not limited to HIV and test 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.

Kind regards

Jim

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HIV 101 - Everything you need to know
HIV 101
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline Jim Allen

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Re: PEP after risk of exposure
« Reply #2 on: December 10, 2021, 06:19:40 pm »
P.S Here is your assement.

You should not have lied to the ER, you did not need PEP and over this specific incident, you did not even need testing outside of standard yearly routine STI & HIV screening. 

If this was your only sexual contact within the last 3 months of the non-reactive HIV test then relax and move on with your life!

Use condoms for any intercourse, consider talking to your healthcare provider about PrEP (not PEP) as an additional layer of HIV prevention for the future and test out of standard routine at least yearly. 
HIV 101 - Everything you need to know
HIV 101
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline Alopez6772

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Re: PEP after risk of exposure
« Reply #3 on: December 10, 2021, 07:00:45 pm »
Hi Jim, Thanks for your promt response.

Understood, except for:

1.-
Quote
"Look taking a doze of PEP a few hours late isn't an issue and will not change the outcome even if you had had a risk"[/shadow]

Was not just on Doze. After that Doze I Started taking all of them at that specific time for rest of the treatmen. For example I used to take it at 4AM. One day Took it at 9AM and for the rest of the treatment I continued doing so at 9 am.

2.-

"too much coincident and at the same time make no sense to me due the low low risk."
Quote
""No, it's not and makes perfect sense.""

Sorry but I did not understand what you mean here.  Too much coincident for me Swollen lymph glands/nodes just after 4 week of PEP, making non sense at the same time because of the very low risk and PEP. ???

For the rest of it and your assesment, Thank you again! :)




Offline Jim Allen

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Re: PEP after risk of exposure
« Reply #4 on: December 10, 2021, 10:24:02 pm »
Quote
Was not just on Doze. After that Doze I Started taking all of them at that specific time for rest of the treatmen. For example I used to take it at 4AM. One day Took it at 9AM and for the rest of the treatment I continued doing so at 9 am.

There was a 29 hours gap between dosages when you first took the meds at 9 am instead of 4 am. For all other dosages, you took them on time at 24 hours apart.

So, this means you were only late once from a medication perspective.

Quote
too much coincident

No, it's not.

Quote
at the same time make no sense to me

Makes perfect sense.



Anyhow, as said, if this was your only sexual contact within the last 3 months of the non-reactive HIV test then relax and move on with your life!

Use condoms for any intercourse, consider talking to your healthcare provider about PrEP (not PEP) as an additional layer of HIV prevention for the future and test out of standard routine at least yearly.
« Last Edit: December 10, 2021, 10:27:04 pm by Jim Allen »
HIV 101 - Everything you need to know
HIV 101
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline Alopez6772

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Re: PEP after risk of exposure
« Reply #5 on: December 15, 2021, 01:43:40 pm »
Hi Jim

How important is to eat meals when taking the pills? I was not having food while taking the pills, just took the pills with water. (TDF + TDC + DTG).

I was reading and it says you must eat while taking TDF+TDC. this would increase absortion by 30% more was stated in one post. Other says It will reduce absortion if not taken with foods.

Kind of worry and still waiting for my results, I will have it this friday.

Offline Jim Allen

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Re: PEP after risk of exposure
« Reply #6 on: December 15, 2021, 03:01:07 pm »
You have no reason to be taking PEP,  you lied to get PEP so why are you worried about the result? Unless you have left out a real exposure in your story ??

Quote
You should not have lied to the ER, you did not need PEP and over this specific incident, you did not even need testing outside of standard yearly routine STI & HIV screening.

If this was your only sexual contact within the last 3 months of the non-reactive HIV test then relax and move on with your life!

Use condoms for any intercourse, consider talking to your healthcare provider about PrEP (not PEP) as an additional layer of HIV prevention for the future and test out of standard routine at least yearly.

TDF & TDC & DTG ... Are you sure??

.
HIV 101 - Everything you need to know
HIV 101
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline Jim Allen

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Re: PEP after risk of exposure
« Reply #7 on: December 15, 2021, 03:10:04 pm »
I presume that's a typo and you are taking TDF + FTC & DTG.

TDF + FTC = tenofovir disoproxil fumarate + emtricitabine and DTG = dolutegravir.
This combination can be taken with or without food.

https://www.poz.com/drug_charts/hiv-medications
HIV 101 - Everything you need to know
HIV 101
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

 


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