Important note: Information in this Q&A was accurate in 2007. The state of the art may have changed since the publication date. I have been HIV+ for at least 15 years. My doctor has me on a drug holiday, since November 2005.
The virus remains attenuated: my t-cells have never been below 1000, and my viral load remains fairly low.
Given all that, what should I do if a condom ever breaks? Do the post-exposure rules apply to me, just like everyone else? I have some left-over cocktail meds that I could use.
Trevor Hawkins, M. D.
Associate Clinical Professor, Dept. Family Practice, University New Mexico
Medical Director, Southwest CARE Center, Santa Fe, NM
As someone already infected, you are really using post exposure prophylaxis (PEP) to prevent the aquisition of a drug resistant virus that would superimpose itself over your now almost certainly wild type virus. This can happen but is probably rare as resistant virus is usually not as robust as wild type.
If your partner is negative, or positive but has never been treated, then I would not use PEP. If your partner is heavily treatment experienced, but currently failing treatment, then you MIGHT consider PEP; if so, you would need a full HAART regimen as you cannot use a lesser regimen and risk developing resistance.
If your partner's staus is unknown, then to be absolutely 100% careful, use HAART for month. Nevertheless, the risk of superinfection from 1 unsafe encounter is very low, but not zero.
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