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Author Topic: Sex while on PEP  (Read 938 times)

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Offline ReallyStressed

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Sex while on PEP
« on: February 13, 2020, 10:41:55 pm »
Hello everyone. I am a male that was sexually assaulted 11 days ago by a female. From what I gathered (from the female)  unprotected intercourse occurred while I was passed out. It was all unprotected. 1&1/2 days later I went to the ER to report the incident and get assistance. I was put on PEP before the 48hr mark. Iíve been taking it consistently everyday (truvada once and Isentres twice a day). However today (11 days after incident) I had protected intercourse with my wife. We used a condom which maintained intact the whole time. The sex lasted less than 5 minutes as I soon broke down and told her what had occurred. I am concerned for both of us. Should she get tested and started on PEP as well? How effective is the PEP that I am on? And how likely is it to reduce the possibility of infection? My doctor said that I donít have to abstain from sex, but I think that I should since I couldnít control my emotions after what transpired.

Offline Jim Allen

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Re: Sex while on PEP
« Reply #1 on: February 14, 2020, 02:00:10 am »
Hiya,

Firstly I'm sorry to hear about the assault and, I truly hope you are getting any support you need.

Quote
However today (11 days after incident) I had protected intercourse with my wife. We used a condom which maintained intact the whole time.

Regarding the intercourse with your partner, HIV can't transmit through an intact latex or polyurethane condom. If a condom fails during the act of intercourse it's obvious to the insertive partner. There is no reason to be stressing about intercourse as long as this obvious issue did not happen.

Quote
Should she get tested and started on PEP as well?
I can't really do risk assessments for 3rd party ... Look what you posted here was not a concern for your partner and if this was the only sexual contact then even testing outside of standard routine is not warranted for her let alone PEP.

Quote
How effective is the PEP that I am on?

It's highly effective, so much so, that if what you posted was your only exposure I would fully expect your results to be HIV negative when you do test.

Quote
My doctor said that I donít have to abstain from sex, but I think that I should since I couldnít control my emotions after what transpired.

What you have been through can be highly traumatic, do what is right for you at the moment, but do consider getting support to help you through this. Talk to your doctor and I am sure they will have information on local support groups and assistance.

Kind regards

Jim

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HIV 101 - Everything you need to know
HIV 101
Read more about Testing here:
HIV Testing
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HIV TasP
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HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline ReallyStressed

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Re: Sex while on PEP
« Reply #2 on: February 25, 2020, 02:20:22 am »
Hi Jim,

Thanks so much for your clarifying and understanding reply. Itís now been three weeks since the incident occurred to me. Itís been difficult to cope with everything that occurred and Iím fearful for my health. Praying and talking with relatives has helped immensely.

Today I decided to take an Oraquick swab test, which came back negative. After taking it I read that it shouldnít be utilized if you are on preventative treatment for HIV, Iím assuming this is referring to PEP and PreP. Does this mean that itíll affect my treatment? Somehow weaken the effectiveness of PEP? Or only that the test result will be inaccurate?

I have read that the test result wonít be accurate until 3 months post exposure, however I have noticed two small bumps on my belly button that itch a lot and tend to get irritated during showering. I am unsure if two bumps would necessarily constitute a rash. If these bumps were somehow part of seroconversion then the oraquick test would have came back positive, correct?

I really appreciate you taking the time to read and address my concerns.

Offline Jim Allen

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Re: Sex while on PEP
« Reply #3 on: February 25, 2020, 03:15:40 am »
Hiya,

Quote
Does this mean that itíll affect my treatment?

No, testing will not affect the effectiveness of PEP.

Test with a blood-drawn HIV antibodies test 6 weeks post-finishing PEP for a result, this result will rarely ever change and if you wish for peace of mind you can test at 3 months post-finishing PEP for a conclusive result.

Quote
I have noticed two small bumps on my belly button that itch a lot and tend to get irritated during showering.

Nothing to do with HIV, see your doctor and treat whatever it is. Also, stop looking for symptoms, simply test when due.

Jim
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 ReallyStressed

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Re: Sex while on PEP
« Reply #4 on: March 02, 2020, 02:24:03 am »
Hello Jim,

Thank you for clarifying the testing question. I have some concerns regarding PEP, when I went to the ER (Feb 4) I was given truvada and Isentres that evening (sometime after 8pm). The next morning around 8-830am I took both pills again, when I shouldíve only taken the Isentres. From there on Iíve been taking both pills at 620am and Isentres at 620pm, plus or minus 10minutes.

Can those time changes effect the effectiveness of PEP? A couple weeks ago I thought it was fine, since I took it before the 12 hour mark of the previous dose. So if anything I would just be overlapping the dose, itíd be more of an overdose than a missed dose. Am I correct in thinking this and did I make the right decision? I had to change the time due to work.

Also since I used a truvada pill the morning of Feb 5 should I request another pill for the final day of treatment? I complete my PEP treatment this week and will only be taking one Isentres on the 31st day of treatment which is March 5. This is just the way that the pills lined up since my first dose was in the evening.

On March 19, I go in to see my doctor and to take a blood drawn test. My doctor mentioned that if the result is negative (praying that it will be) I wonít require further testing. This will be 6weeks and 4days post exposure but only 2 weeks post finishing PEP. This confused me because I thought the tests were definitive 6 weeks and 3 months post finishing PEP. Are there new tests that can actually detect antibodies/antigens 6 weeks post exposure after taking PEP?

I apologize if some of these questions are far fetched, I truly hope it does not annoy/irritate you. I believe that Iím overthinking some of this, however I just wanted clarification to stop overthinking it. Thank you so much for what you do and the support you provide.

Offline Jim Allen

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Re: Sex while on PEP
« Reply #5 on: March 02, 2020, 02:50:59 am »
Quote
Thank you for clarifying the testing question. I have some concerns regarding PEP, when I went to the ER (Feb 4) I was given truvada and Isentres that evening (sometime after 8pm). The next morning around 8-830am I took both pills again, when I shouldíve only taken the Isentres. From there on Iíve been taking both pills at 620am and Isentres at 620pm, plus or minus 10minutes.

Can those time changes effect the effectiveness of PEP? A couple weeks ago I thought it was fine, since I took it before the 12 hour mark of the previous dose. So if anything I would just be overlapping the dose, itíd be more of an overdose than a missed dose. Am I correct in thinking this and did I make the right decision? I had to change the time due to work.

relax it's fine.

Quote
Also since I used a truvada pill the morning of Feb 5 should I request another pill for the final day of treatment? I complete my PEP treatment this week and will only be taking one Isentres on the 31st day of treatment which is March 5. This is just the way that the pills lined up since my first dose was in the evening.

no, should be just fine.

Quote
On March 19, I go in to see my doctor and to take a blood drawn test. My doctor mentioned that if the result is negative (praying that it will be) I wonít require further testing. This will be 6weeks and 4days post exposure but only 2 weeks post finishing PEP. This confused me because I thought the tests were definitive 6 weeks and 3 months post finishing PEP. Are there new tests that can actually detect antibodies/antigens 6 weeks post exposure after taking PEP?

The tests may pick up on HIV infection as early as 2 weeks, but most people take longer to develop antibodies at detectable levels, hence testing at 6 weeks will rule out the vast majority of cases. 3 months for a definite result is more peace of mind than anything else.

There have always been two trains of thought on nPEP /oPEP and testing, given the evidence so far I lean towards the conservative train of thought when given testing guidelines on the forum in combination with ART usage (HIV Meds).

ART if taken correctly rarely fails, although there are cases when it fails with result in acute infection-causing delayed detection.  Hence the rule of thumb, PEP is a 28-day delay so simply apply testing guideline post finishing PEP instead of post-exposure.

Test with a blood-drawn HIV antibodies test 6 weeks post-finishing PEP for a result, this result will rarely ever change and if you wish for peace of mind you can test at 3 months post-finishing PEP for a conclusive result.

Best, Jim

PEP.

2015:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4641668/
2017:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578893/
2016:
R.Harrington
https://depts.washington.edu/nwaetc/presentations/uploads/219/nonoccupational_hiv_post_exposure_prophylaxis_npep.pdf

PrEP:
https://www.aidsmap.com/news/may-2018/prep-may-make-it-hard-tell-if-someone-has-hiv-infection
« Last Edit: March 02, 2020, 02:53:28 am 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

 


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