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What Are The Uses Of PrEP?

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Posted on Mon, 7 Dec 2015
Question: Hi Doc.

I Have a question in regards to PreP or PeP

I have usually one to two new sex girls a week of unknown HIV status
I do Protected vaginal sex , oral I try to protect myself most of the time ,
we do deep french kissing , and at times I like to perform oral sex on them .

Recently I had a HIV scare my condom broke during vaginal intercourse , so far my HIV test came negative but I took the test ( RNA ) only about 7- 8 days after exposure , but this kinda shook me up a bit . I probably will not change my higher risk behavior
but I have researched online that new drug came out to prevent HIV .

PreP - so my question is can I take it ?
Do I have to do a whole regiment or PreP of 30 days or can I take one pill on the day
I have sex with one of my play friends?
Are there risks for me to take this drug ?
Are there bad side effects ?

What are your thoughts and recommendations ?

doctor
Answered by Dr. Sheetal Verma (28 minutes later)
Brief Answer:
PreP not recommended.

Detailed Answer:
Hi
Thanks for your query at HCM.
I understand your concern and situation.

The chances of HIV post condom rupture is extremely rare but if the HIV status of partner is unknown then one can take the PreP for 28 days but within 72 hours post exposure it must be started under the guidance of physician as it can have side effects. The short-term side effects, including nausea, abdominal cramping, vomiting, dizziness, headache, and fatigue are usually seen. The PCR test is recommended after 4-5 weeks post exposure. The 4 th generation ELISA test is conclusive at 12 weeks. In your case as PreP was not initiated within 72 hours so now it is not recommended. But you can take the tests as advised. As you have high risk behavior I would advise you to practice proper barrier precautions and testing for HIV when required.

Hope I answered your query.
Rating and review will be appreciated.
Dr. Sheetal Verma
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Sheetal Verma (18 hours later)
Doc , let me ask you , reason I'm little freezing out about it is that I think my left armpit feels strange , I don't feel a lump or anything but I'm concerned that it might be swollen lymph node .
Other than that I don't have any other symptoms.

Let me ask you another thing aside from intercourse where the condom broke , I had sex with another woman a day after where condom did not break but when I pulled out condom was
Bloody and I touched the blood . I don't think I had broken skin on my fingers but I like to bite my nails and skin around them . Does this put
Put me at risk ?

My HIV test rna came back negative that I took 7-8 days later . If I take another rna test 5 weeks after exposure and if it comes back negative , can I safely rule out possibility of HIV infection ?
doctor
Answered by Dr. Sheetal Verma (49 minutes later)
Brief Answer:
See details.

Detailed Answer:
Hi
1. If you think that your gland is swollen then I would advise you to visit a physician and get proper physical assessment done to rule it out.
2. You touched a bloody condom. There is practically speaking no risk of HIV infection. Do not worry.
3. The time at which you took PCR is of no use. Yes after 5 weeks if you get it repeated the test will be more reliable but not conclusive. For conclusive evidence you have to get 4 th generation ELISA test at 12 weeks post exposure. Only post 12 weeks we can say that you are absolutely safe.

Take care
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sheetal Verma (1 hour later)
ok got it :)

couple of more questions ,
I really never had swollen lymph nodes as I recall ,
What does it look like or feel ? Is it a big bump ? ( I don't see any bumps )
( I press around the armpit area and I don't really feel any abnormal pain or anything ) I am not even sure where the lymph nodes are .

Anyway , last question doc.

Since this ordeal I tried to look for answers on line ,things related to HIV and things I thought to be safe with transmission of HIV I am reading that lots of people and lots of different opinions . I am confused .

So here is some things I would like to clarify since you probably deal with this stuff on daily basis :

Transmission of HIV

1. Oral sex ( me reeving ) without condom / rare possibility for transmission yes ?
2. Vaginal sex with condom / No Transmission possible yes ?
3. Deep French Kissing / No Transmission possible yes ?
4. Me performing oral on girl / No Transmission possible yes ?

Thank you for your time :)

doctor
Answered by Dr. Sheetal Verma (1 hour later)
Brief Answer:
See details.

Detailed Answer:
Hi

1. The oral sex without condom the chances of HIV is rare. But other STD like chlamydia, herpes, etc are high.
2. Vaginal sex with condom - No risk of HIV.
3.Deep French kissing- Rare risk.
4 Performing oral- Rare risk.


Best of health
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sheetal Verma (22 minutes later)
Researching HIV transmission am I correct to assume that it mainly happen
when you have repeated sex with one person over longer period of time ?

Therefore one time unprotected sex with HIV positive woman certainly carries risk of transmission but it is still pretty low .

If you have unprotected sex with that woman on steady basis
you will likely contract the virus sooner or later .

Is my analogy of this correct ?
doctor
Answered by Dr. Sheetal Verma (3 minutes later)
Brief Answer:
Yes you are right.

Detailed Answer:
Hi

Yes what you have inferred is true. If you have one time sex with HIV positive person the risk is less than 1%. But having repetitive sex with the person increases the chances of acquiring infection.


Take care
Note: Get personalized answers to your HIV related queries You can choose to talk face to face with your doctor. Book a Video Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sheetal Verma

Infectious Diseases Specialist

Practicing since :2001

Answered : 635 Questions

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What Are The Uses Of PrEP?

Brief Answer: PreP not recommended. Detailed Answer: Hi Thanks for your query at HCM. I understand your concern and situation. The chances of HIV post condom rupture is extremely rare but if the HIV status of partner is unknown then one can take the PreP for 28 days but within 72 hours post exposure it must be started under the guidance of physician as it can have side effects. The short-term side effects, including nausea, abdominal cramping, vomiting, dizziness, headache, and fatigue are usually seen. The PCR test is recommended after 4-5 weeks post exposure. The 4 th generation ELISA test is conclusive at 12 weeks. In your case as PreP was not initiated within 72 hours so now it is not recommended. But you can take the tests as advised. As you have high risk behavior I would advise you to practice proper barrier precautions and testing for HIV when required. Hope I answered your query. Rating and review will be appreciated. Dr. Sheetal Verma