PrEP Use: What to Do After Unprotected Sex? - Internal Medicine

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When it comes to the use of PrEP (pre-exposure prophylaxis) for HIV prevention, it's crucial to understand the timing and adherence to the medication regimen. PrEP is highly effective when taken consistently and correctly, but there are specific guidelines regarding its use, especially in relation to unprotected sex.

In your situation, you mentioned that you took PrEP 1.5 hours before engaging in unprotected sex. The general recommendation is to take PrEP at least 2 hours before potential exposure to ensure optimal levels of the medication in your bloodstream. However, since you were already on PrEP and had taken it shortly before the encounter, you should continue with your current regimen of 2-1-1 dosing (two pills taken 2-24 hours before sex, one pill taken 24 hours after the first dose, and another pill taken 24 hours after that).

It's important to note that while PrEP significantly reduces the risk of HIV transmission, it does not eliminate it entirely, especially if the medication was not taken as directed. The risk of HIV transmission is lower when PrEP is taken correctly, but there is still a small chance of infection if exposure occurs before the medication reaches effective levels in your system.

If you are concerned about potential exposure to HIV, it is advisable to consult with a healthcare provider. They may recommend additional testing or preventive measures, such as PEP (post-exposure prophylaxis), which is a different regimen intended for use after potential exposure to HIV. PEP is most effective when started within 72 hours of exposure and requires a 28-day course of treatment.

In summary, since you took PrEP shortly before the unprotected encounter, you should continue with your prescribed regimen of 2-1-1. However, if you have any concerns about potential HIV exposure or if you experience any symptoms, it is essential to seek medical advice promptly. Regular follow-up appointments and HIV testing are also crucial for anyone using PrEP to ensure ongoing safety and effectiveness.
In addition to PrEP, it's important to engage in regular testing for sexually transmitted infections (STIs) and to maintain open communication with sexual partners about health status and safe sex practices. Using condoms consistently can further reduce the risk of HIV and other STIs, providing an additional layer of protection.