[Question #10431] worry about gloden shower and oral ulcers

23 months ago

Hi Doctor

I am a single male from Japan，Sorry for my bad English。

I enjoy use escort service， but casue I am paranoid about hiv ，so i try my best to prevent HIV infection ，a month ago，i saw my doctor and he prescribe me PrEP（Taficita ：Generic Descovy）take 1 tablet every day。

Yesterday（Day 20 of taking the PrEP）,I went to see dominatrix and cause i always wanted to try the Golden Shower，so she urinated in my mouth and i drank a lot urine，and some of urine get on my face ，body and penis，and also she spit in my mouth，I can't see the blood in the saliva，but about urine ，I'm not sure if there's blood in the urine ，but at least its color looks somewhere between yellow to dark yellow（I checked online that if there is blood in the urine, it seems more likely that it will appear pink or red.）， what really worries me is the next morning I found a tiny ulcer in my mouth。

My question

1.Am i at risk on hiv , does the PrEP I take reduce oral exposure risk to no risk? should i switch PrEP to PEP for above exposure

2.I plan every 3 months for repeat HIV tests cause i am taking PrEP,Do I need test for this exposure? or just wait until my PrEP regular test

Thanks in advance

Edward W. Hook M.D.

23 months ago

Welcome to our Forum and thanks for your questions. congratulations on your commitment to safe sex. I'll be glad to comment. Before I answer your specific questions, let me comment about the nature of your encounter. First, most dominatrixes do not have HIV. Even more importantly however, there is no scientific evidence that HIV is transmitted by either urine or saliva. In addition, there is no evidence that swallowing HIV leads to infection. For these reasons, this was a safe sexual exposure. Now, in reaaspnse to yoru specific questions:

1.Am i at risk on hiv , does the PrEP I take reduce oral exposure risk to no risk? should i switch PrEP to PEP for above exposure.

The PrEP that you are taking virtually eliminates any risk of HIV as long as you take the medicine regularly as prescribed. No need to change medicnes.

2.I plan every 3 months for repeat HIV tests cause i am taking PrEP,Do I need test for this exposure? or just wait until my PrEP regular test

Thanks in advance

Similarly, and related to the comments I've made above, there is no need for additional testing related to the exposure that you describe.

I hope this information is helpful. Please don't worry. EWH

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23 months ago

Dr. Hook

Thank you for your help

Can I understand that there is no real risk to me from the above exposures even there is no PrEP

There are two reasons why I ask this. One is About 2.5 hours after taking prep, dominatrix digs her fingers into my throat and I felt dry heaving（not ask her to do this，but she did） ,I don't remember vomiting anything ,but I'm a little worried about it.

After 2.5hours , is PrEP basically absorbed, not affect the effect？

second question ua about continue PrEP in future ,i always use escort service but i am focus on safe sex , just like receiving handjob/footjob , facesitting(across underwear),foot fetish(lick/smell foot) ,rarely have vaginal sex (always use comdom)

i knew saliva and urine are generally regarded as safe but these body fluid may contain with blood,so if in the future I plan receiving saliva play or golden shower (drink urine ) from CSW , Should i continue my PrEP for these "body fluid exposure"(Worry about long-term side effects)

i asked my doctor he just say PrEP is a personal decision ,so I want to ask for your advice.

Again, I thank you for your kind responses.

Edward W. Hook M.D.

23 months ago

I explained why there is no risk for HIV from your exposures above. Please re-read my original reply. That she dug her fingers into your throat is also no risk.

PrEP medications are certainly absorbed into the body two hours after the pills have been taken, there effect then is present and continues throughout the day and is still present when the next dose of medications taken.

In my opinion, with the sorts of sexual activity you describe, you do not need PrEP. There is no risk of HIV or other STIs from receipt of masturbation ("hand jobs" or foot jobs), from face sitting pr foot fetish activities. Condom protected sex is safe sex. Finally, most escorts do not have HIV. The risk of the activities you describe is very, very low- close to zero.

Even if saliva or urine contained blood, there would be no risk for infection. As I already told you, there are no HIV infections reported from exposure to urine or saliva, even when blood is present.

I agree with your doctor that PrEP is a personal decision however, given the sorts of sexual activities you describe, I would not feel the need to take PrEP

EWH

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23 months ago

Dr. Hook

Thank you for your help

Thanks also for advice on PrEP,i will keep to have safe sex and try to overcome paranoid fear of hiv,rethinking the necessity of prep,not just forr educe anxiety.

Edward W. Hook M.D.

23 months ago

I think that is a good decision. Stay safe. EWH---