[Question #10380] Urgent! PEP and Oral Question

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23 months ago

Hello, I am a male and met up with another male around my age (mid 20). We kissed, I never go further than a handjob. But I don’t know what overcame me and gave him a deep unprotected blow job, He did not finish in my mouth, but I know there was some pre-seminal fluid. I am a hypochondriac so I am terrified of HIV. I know the risk is small, but it exists and that worries me. The issue is that my mouth has been very dry/stinging the past week or so, and I had a few nights of drinking which had made it worse, so my mouth would be in a more vulnerable state. 

He told me twice he had no STI but I didn’t specifically ask about HIV. Was in a different city so I don’t know if I can contact him again. 

It’s not been more than 12 hours yet. I can go on PEP? Do you think there is absolutely any need? I also know that PEP delays testing which I know will consume my mental health for almost 12+ weeks, instead of just 6 weeks at most (and earlier if I take an RNA test). I’m very confused as to what to do. I know that my risk is low, but I don’t want to actually get infected because my mouth was not in the best condition (and I’m not sure why, I think I might have some sort of allergic reaction to new foods I’ve been trying). So just trying to get an opinion. 

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Edward W. Hook M.D.
23 months ago
Into our forum. Thanks for your question and for your confidence in our service. I’ll be glad to comment. The short answer is that if you approached me as a patient asking for PEP, I would decline to give it to you. The risk that you acquired HIV from the close to no risk exposure that you describe is close to zero. 

Having provided my answer. Now let me provide you with my reasoning behind my recommendation. First the chance that your partner had untreated HIV is very, very low. Most persons do not have HIV, and the fact that your partner said that he had no STI’s is strong evidence that he does not have HIV either. Most testing for STI’s routinely includes testing for HIV. Secondly, even if he did have untreated HIV, the risk of transmission is vanishingly low, estimated by the CDC to be less than one infection per more than 10,000 exposures. In other words, the chances you were infected in the unlikely event that he has untreated HIV are more than 99.99% that you would not be infected. The risk of PEP side effects and the cost of PEP far out way , any realistic risk that you were infected by the encounter you describe. 

I heard you not to seek PEP and not to worry. Whether or not you choose to test for HIV in the future is obviously a personal choice, but the odds of your infection are very low and I would consider even testing to be optional. I hope this information is helpful to you. EWH. 
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23 months ago
Thank you so much Doctor! I got the prescription but I’m going to not fill it based on what you said. Just confirming that the state of my mouth makes no difference on your assessment of HIV risk? I’m not sure what’s going on, it’s been feeling just raw and stingy/red all in my mouth, including my lips. plus I think I have a canker sore. No active bleeding though. 
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Edward W. Hook M.D.
23 months ago
Correct.  The state of your mouth, including gum or dental disease makes no difference.  EWH ---