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Do I Need Post Exposure Propylaxis? I Had A Sexual
Question: Do I need post exposure propylaxis? I had a sexual encounter last night with a random guy that I met online. He seemed concerned about STDs and asked me several times if I was clean. We had oral sex(no condom) and anal sex(with condom). The sex was very rough and I had to stop due to pain. When he removed the condom afterwards, it ripped. I think the condom stayed intact during sex, but I have to wonder about the integrity of the condom since it ripped when he was removing it. It was one of the thin, ultra sensitive condoms. He was angry that I couldn't continue sex, so he left. So I'm not sure if I should take PEP or not.
Brief Answer:
I would suggest taking PEP
Detailed Answer:
Hello,
I'm Dr. Branch, thanks for using the 'Ask A Doctor' service.
In general, condomless anal intercourse would be considered a high-risk exposure, and given the situation, your partner would be considered high risk, though unknown, for HIV infection.
The only gray area here is whether or not the condom was intact during sexual activity.
However, given that receptive anal intercourse has a relatively high risk of transmitting the HIV infection (about 1 in 72 without a condom), I would suggest seeing a doctor about getting post-exposure prophylaxis.
I hope that helps.
Please let me know if you have any other questions about that and I would be glad to discuss it with you further.
I would suggest taking PEP
Detailed Answer:
Hello,
I'm Dr. Branch, thanks for using the 'Ask A Doctor' service.
In general, condomless anal intercourse would be considered a high-risk exposure, and given the situation, your partner would be considered high risk, though unknown, for HIV infection.
The only gray area here is whether or not the condom was intact during sexual activity.
However, given that receptive anal intercourse has a relatively high risk of transmitting the HIV infection (about 1 in 72 without a condom), I would suggest seeing a doctor about getting post-exposure prophylaxis.
I hope that helps.
Please let me know if you have any other questions about that and I would be glad to discuss it with you further.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
So,I saw a doctor on 3/15. She didn't think that my risk for HIV was high enough to warrant going on PEP. Shes sending me for labs in 2-3 weeks. I noticed that the lab order says HIV 1/2 4th gen. What is the accuracy of this test at 2-3 weeks post exposure?
Brief Answer:
About 95% accurate.
Detailed Answer:
Hello again. I don't necessarily disagree with the doctor you saw, it all depends on the likelihood the condom broke, and she may not have thought it was likely based on your situation.
At 4 weeks I have seen reports that the 4th gen antibody/antigen test is about 95% sensitive for picking up HIV (which means if you are positive, it will be positive 95% of the time). If there is still concern after that, it is suggested to test again at 12 weeks, at which time the test would be very accurate, more than 99.9%, and would be considered conclusive.
I hope that helps, please let me know if you have any other questions.
About 95% accurate.
Detailed Answer:
Hello again. I don't necessarily disagree with the doctor you saw, it all depends on the likelihood the condom broke, and she may not have thought it was likely based on your situation.
At 4 weeks I have seen reports that the 4th gen antibody/antigen test is about 95% sensitive for picking up HIV (which means if you are positive, it will be positive 95% of the time). If there is still concern after that, it is suggested to test again at 12 weeks, at which time the test would be very accurate, more than 99.9%, and would be considered conclusive.
I hope that helps, please let me know if you have any other questions.
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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