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Q. Should I take PEP if I had protected sex with a sex worker?

Answered by
Dr. Jyotisterna Mittal
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 08, 2018

Hello doctor,

I feel so stupid. I got drunk and ended up having sex with a CSW. She gave me oral sex and then we had vaginal sex. I did not touch her vagina with my fingers. Earlier in the evening, I had trimmed myself in my pubic area and had a slight abrasion, but there was no bleeding. I used a condom with her, and she even checked to see if it was intact, it was. Immediately after sex, she wiped me down toward the tip of my penis. I then went to the bathroom and urinated. Now, I am scared that I caught something. All this happened about 90 minutes ago. What are my chances of having caught a disease or HIV? Should I go see a doctor to get a short course of antiretrovirals as prophylaxis? I am very worried. What should I do?

Dr. Jyotisterna Mittal

Dr. Jyotisterna Mittal

Cosmetology Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome to icliniq.com.

  • With protected sex, you are safe from contracting HIV (human immunodeficiency virus).

For more information consult an HIV AIDS specialist online --> https://icliniq.com./ask-a-doctor-online/HIV-AIDS-specialist

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Thank you doctor,

Please be a little more detailed. But, I read various several articles which give different percentages of protection for condoms ranging from 85 % to 100 %. So, should I still be worried? And, should I ask for an antiretroviral medication for prophylaxis, such as Truvada? How many days would you take it?

Dr. Jyotisterna Mittal

Dr. Jyotisterna Mittal

Cosmetology Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome back to icliniq.com

  • The exact percentage of effectiveness of condoms is not known and is still being researched. But, when properly used, they are considered impermeable by the virus and the risk of HIV is considered negligible to nil.
  • I do not find any need to worry or start PEP (post-exposure prophylaxis).
  • However, if you do want to take Truvada (Emtricitabine), it should be started as early as possible after exposure and continued for 28 days without skipping any dose. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent.

For further queries consult an HIV AIDS specialist online --> https://icliniq.com./ask-a-doctor-online/HIV-AIDS-specialist

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Thank you doctor,

Since I am at very low risk, do you think I can simply take four to five days of Tenofovir (Viread) instead? It is a drug for hepatitis but also used sometimes for HIV prophylaxis. My friend had some extra pills (he has hepatitis) and I just took one for prophylaxis. Or do you think this is going overboard? Should I just stop worrying?

Dr. Jyotisterna Mittal

Dr. Jyotisterna Mittal

Cosmetology Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome to icliniq.com.

  • There would be no use of four to five tablets of Tenofovir in HIV.
  • No doctor would recommend you ART (antiretroviral therapy) for this exposure according to guidelines.
  • However, if you do want to take it because of extreme anxiety, you should take a full dose of Truvada for 28 days.
  • I would advise you to stop reading about your exposure or symptoms on internet resources as it would only lead to unnecessary stress and misinformation.

Good luck.

For more information consult an HIV AIDS specialist online --> https://icliniq.com./ask-a-doctor-online/HIV-AIDS-specialist

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Thank you doctor,

Yes, the condom did not break. But, the truth is I am worried because she is a CSW, and came to my country only two years ago from a place, which is rampant with HIV. I am sure she was a CSW there too. And yes, I did read up and find out that condom use is protective in as low as 80 % of the time. If you say though that in my situation, no doctor would prescribe ART, then I will believe you (or try my best). So, bottom line, are you saying I do not need to do anything further? Can I just go on with my life?

Dr. Jyotisterna Mittal

Dr. Jyotisterna Mittal

Cosmetology Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome to icliniq.com.

  • The lower effectiveness of condoms may be for other STDs (sexually transmitted diseases) like molluscum or warts, but they are highly effective in preventing HIV. So, I find no reason to start ART after protected sex even with a high-risk individual.

For further queries consult an HIV AIDS specialist online --> https://icliniq.com./ask-a-doctor-online/HIV-AIDS-specialist

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Related Questions:
Is immuno-concentration HIV test conclusive after 15 months of sexual exposure?
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Are my symptoms indicative of HIV infection?
 

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