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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does genital manipulation cause AIDS?

Iam an Oral and Maxillofacial Surgeon working in Asmara, Eritrea , East Africa. I am writing this mail for a friend of mine who is a non medico, working as a teacher here .
Last Saturday night he had called in a prostitute to his house but he did not have sex with the girl. He fingered the girl for five to six minutes and when he was washing his hand after 10-12 mts he noticed that on the finger he had inserted he had a peel off of the skin where the nail meets the skin. The peeled area was very small He washed the area thoroughly with soap and put an antiseptic solution on the area.
It was not a cut . The area did not have any bleed since it was on its healing phase although a breach in continuity of the skin was visible but not at all deep. Now my friend is thoroughly apprehensive . He would like to know whether he is at a risk of contracting AIDS.
The queries I would like to ask for him as a doc are
1.     Is he at a risk of getting AIDS
2.     Does he have to go for an ELISA test
3.     Should he go for the basic regimen of PEP, If so for how long
4.     If PEP basic regimen is advised what are the side effects of the antiviral drugs used in the regimen


Kindly address these queries and send me your expert opinion
Mon, 25 Aug 2014
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General & Family Physician 's  Response
hi
thanks for question.
if the girl is HIV positive then your friend is at a slight risk of contracting HIV but exactly the percentage of chance of getting HIV cant be predicted but as per my opinion the chance is less than 2%.

immediately he can go for RT-PCR( reverse transcriptase polymerase chain reaction ) which detects HIV at a very early stage.
post exposure prophylaxis(PEP) in your friends case can be adviced if the duration has not exceeded 72 hours of exposure. if it has crossed 72 hours then there is no use of taking PEP.
The most commonly reported side effects are nausea and fatigue. Side effects can be reduced by prescribing a 2 drug regimen rather than three-drug regimen, by prescribing medicine to reduce side effects (such as antiemetic for nausea) and by advising people on how to reduce side effects (for instance, by taking medicines with food).
A complete course of PEP comprises 28 days of medicine
hope i have answered yor all doubts
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