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UNPROTECTED SEX/PEP WITHIN 72 HOURS

Question: 

Good afternoon,

I had unprotected sex 3 times on a Saturday and again 3 times on a Sunday with a lady i had just met. I started taking pep within 72 hours of the first exposure. but before PEP we did an antibody test with the lady which tested for HIV 1 and 2 but it was non reactive. the lady also told me that she last had sex four months ago and it was protected sex. she also told me she had done a test a week ago. she did not even resist to go for another HIV test with me which gave a reason to believe her. i have been taking PEP even though she was negative in case of the window period.

At home i have been using condoms with my partner and one day the condom broke. what is the risk of infecting her and me being infected. the condom broke and within seconds i came out. it broke when i was trying to enter her and i had taken pep for 16 days.

Answer: 

Hello and thank you for your inquiry.

We gather that you are wondering about the risk of passing the HIV virus to your partner when your condom failed during vaginal sex. You were 16 days into a PEP regimen after having unprotected sex with a person of unknown HIV status when this condom failure with your partner occurred.

Protected vaginal sex is classified as a Low Risk activity for transmission of HIV, meaning that evidence of transmission occurs through these activities when certain conditions are met. Condom failure is an example of these certain conditions.

Unprotected sex is considered to be a high risk activity for transmission of HIV. PEP (post exposure prophylaxis) is effective when taken within 72 hours of suspected high risk exposure to HIV. It involves antiretroviral medications taken once daily for four weeks (28 days). (1) Strict adherence to taking PEP daily for 28 days along with eliminating high risk exposures during this time is of great importance. (2) Regardless, PEP is not 100% effective, even in the most ideal situations.

It was precautious of you to initiate PEP after sex with a person of unknown HIV status. It was also smart to use a condom when you had sex with your partner. What you might have done differently was to have abstained from sex with your partner while you were taking PEP and until you had your own HIV testing done outside the window period.

While you may have potentially exposed yourself and your partner to the HIV virus, it seems unlikely given the details your provided. It sounds like you do not believe the woman you had unprotected sex with to be in a high risk group, and she tested non-reactive.

Recommendation: For this scenario, HIV testing is recommended once you have finished PEP, and are outside the testing window period.

Regards, AIDS Vancouve Helpline/Online Volunteer, Dyson