PEP and chance of infdction

[vvirtuoso]

I did unprotected insertive vaginal intercourse with Indonesia indirect CSW who clakmed she just did it for 1 month and has only been unprotected with 5 guys.


23 hours later, i consumed my PEP of Tenofovir , lamivudine, and aluvia (lopinavir ritonavir) as there is nk truvada here.

My baseline test are all good, and 2 days after exposure i tested the woman with self help test and she is also negative.

Question

1. How high is my chance?
My calculation is

Insertive penile exp. 1:2500
HIV prevalence among Indo CSW 5.3 :100
PEP efficacy : 89%

2 : 1,000,000 ?

2. Is my pep regimen good? I followed WHO recommendation as there is no Truvada and isentress

3. When should i be tested ? 1 and 3 month after exposure ?

4. Is there long term side effects of PEP?

Thank you

[vvirtuoso]

Thank you Mike_no, one last quesrion based on your advices, when can i have unprotected intercourse again with my partner? Thank you

[mike_no]

”If you choose to finish your 28 days of dosage, wait for another 28 days and test with a IV Gen HIV test and get over this incident. "

[vvirtuoso]

Sorry Mike just askjng, i read CDC guideline regarding follow up after pep and they recommend 4 to 6 week after exposure  is this guide outdated? Thank you

[AnxiousNoMore]

You won't find consensus and CDC is overly conservative.

[vvirtuoso]

Mike_no i finished my dosage. If i only have access to anybody rapid self help test, when can i do it? Thank you

[mike_no]

Test with a standard Duo test (laboratory) at 28 days from the date of exposure or if you choose to use an oral swab, you would have to wait for 12 weeks.

[mike_no]

*correction : 28 days from the date of your last pep dosage / 12 weeks for oral swab home testing kit.

[mike_no]

Risk was low. It's observed that it is relatively difficult for a male partner to contract the virus from a one time FTM scenario.

PEP was not necessary, not sure how did your doctor determine your qualification to give you PEP.

The fact that your partner also tested negative only indicates that you are okay.

If you choose to finish your 28 days of dosage, wait for another 28 days and test with a IV Gen HIV test and get over this incident. If you ask me, I personally feel that you are doing fine, you didn't need a PEP, you are only due for a negative.

[vvirtuoso]

Thanks mike_no for the reply.

1. If , and if, there is micro lesion , will it enhnce my risk? I did not find any blood trace anywhere.

2.Somebody told me that although her HIV test is negative, i should continue my PEP , due to the chance she is in acute phase and even more risky. How high is the chance to meet with somebody in acute phase of HIV?

3. Regarding my regimen which is based on WHO recommendation (although it is updated in 2014) as i couldnt find truvada anywhere in my coubtry, is it an effective PEP?

4. When can i have unprotected intercourse again? After 3 month of negative test or 1 month?

6. If you can quantify the risk, how much is my odd?

Thank you

[vvirtuoso]

Well in my city in Indonesia, literally nobody knows about PEP. In fact, im the first person who asks for nPEP since 2018.

[vvirtuoso]

I also read that some doctors said test upon completion of PEP with 4th gen test is dependable? Thank you

[vvirtuoso]

After finding out that she is negative (with self help antibody test), the doctor still insists on continuing PEP as the test is considered not conclusive, fearing she could be in acute phase. How much is the odd of it?

[AnxiousNoMore]

Mike says PEP is unnecessary, so that advice can't change.
You can find the side effect risks on the package insert from the drug, but if you lost it then you can go to the manufacturer's site and read them. All known side effects are published by the manufacturer. This is the law.

[vvirtuoso]

Thanks anxiousnomore for dropping by. As yoh are one of the experts here, what is your personal opinion reg. This matter? Thank you

[AnxiousNoMore]

You can't go wrong with mike's advice. hiv prevention is straightforward so it isn't like surgery where medical professionals have different opinions.

[vvirtuoso]

Anxiousnomore, what factor that makes all of you deem PEP unnecessary?

1. Her negative HIV test
2. FTM low transmission rate
3. Low risk of insertive vaginal exposure

Thank you

[mike_no]

All of the above.

We have discussed about your scenario in detail and there is nothing left to be desired.

At this point your questions are being repetitive, I would urge you to read each response carefully instead of rephrasing the original queries.

PEP is a subject matter that needs to be discussed with your doctor and not on an online forum, from a risk evaluation point of view, we have already offered our opinion on this and it can't change.

We understand that you are anxious. However, we can't help you with it since this is an HIV prevention forum.

I repeat, your chances of testing positive from your event is extremely low, the likelihood of you finding a pearl in an oyster seems way higher than contracting HIV from this incident.

[AnxiousNoMore]

Did you use a condom?
Normally doctors won't give you pep unless you know the other person has hiv, because there are potential side effects.

[vvirtuoso]

Unprotected, so no condom.