Creator: Dr. Basti Bharatesh Devendra
Published: 2022-01-03T06:30:02-04:00

Patient's Query

Hello doctor,

My partner turned HIV positive when he was tested five months ago. I tested previously, and it was negative. My partner and I decided not to have intercourse till my reports came in. However, last night we had quick intercourse wearing a condom. It was the correct way and for less than three minutes. The intercourse had no ejaculation inside, even with a condom. Before starting medications, my partner had a viral load of 10,000 copies/ml. And now he is on drugs for two months and three days. Is there a need for me to start post-exposure prophylaxis now? Please note that I was receptive. Can you give me your opinion on this?

Thank you.

Answered by Dr. Basti Bharatesh Devendra

Hello,

Welcome to icliniq.com.

Thanks for writing in, and I understand your concern. The chances of transmission of the human immunodeficiency virus (HIV) by single protected intercourse with an HIV-positive person are almost nil. If there is no contact of blood or semen or infected secretions, the chances are again nil. So, in my opinion, with the given description, it appears there is no contact of semen or infected secretions. So the risk seems nil right at the moment.

Moreover, he appears to be on antiretroviral therapy (ART), which might have reduced the viral load too. I do not see the need for post-exposure prophylactic medications (PEP). You can discuss with your doctor in detail the risk of exposure and decide on the need for PEP because it has to be initiated as early as possible, not later than 72 hours of exposure.

Thank you.

Patient's Query

Hello doctor,

Thank you for your response.

I am still worried because he was placing his hand on his penis, and then I put the condom on him myself. He touched the condom, which we used further during intercourse. Is this any risk? I am sure that no other contact of semen happened, and there was no leakage, and no semen came out as the condom was not broken. We had unprotected sex five months ago and thankfully I did not contract the virus as he was not aware of it back then. I have explained the situation to you, and I am still within 72 hours of exposure. Please give me your medical advice noting that the PEP here in my country is expensive. But I will get it if you say it is necessary. I do not have another doctor to consult. You are my only source for now. Please give me you are advice on this.

Thank you.

Answered by Dr. Basti Bharatesh Devendra

Hello,

Welcome back to icliniq.com.

In my opinion, if it was just contact of his hand and skin of the penis and no contact with secretions, the chances of transmission of HIV are still nil. And If you are sure of not coming in contact with semen, secretions, or blood, then I do not see the need for post-exposure prophylactic medications (PEP).

Regards.

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