[Question #13405] Frotting + Oral HIV Risk

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1 months ago
Hello,

About a week ago, I hooked up with a crossdresser. No penetration this time, however they performed oral sex on me (sucked me) and grinded on my penis with their anus (frotting). I still take PrEP everyday, not always at the same time, but everyday. I am a bit concerned, because I think due to the hard oral, I received a small cut on the side of my penis, and then they frotted on me after that. I did not see any blood or cuts on them, but I'm concerned that bodily/rectal fluids from them may have touched the cut, I'm not entirely sure if it did, it was dark. I was masturbating at times when they frotted me, so their anus wouldn't have touched, but not the entire time I think. I asked the individual if they were negative and on PrEP twice, before and after and they said yes, but didn't give me an answer on when they were last tested. I am concerned. I developed a small cold, sinuses mostly, after the encounter, has seemed to mostly go away. Hopefully just allergies. Am I in the clear or is this something to be concerned about? I am quite anxious about it. Thank you.
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H. Hunter Handsfield, MD
1 months ago
Welcome back. However, in scanning your several previous forum questions and replies, I see both Dr. Hook and I commented on your over-estimation of the risks of HIV. You again describe exposures with little if any risk of HIV transmission. Frottage is no risk at all, and there has never been a proved case of HIV transmitted oral to penis (and CDC once calculated a risk of one 20,000 if the oral partner had untreated HIV -- which is equivalent to receiving BJs by infected men once daily for 55 years before catching the virus might be likely. That the recent oral sex was "hard" doesn't necessarily make it more risky. If these events are typical for your sexual lifestyle, I see no need for PrEP. 

As for your cold, HIV doesn't do that -- no nasal congestion or "sinus" symptoms. Your suspicion of allergy is more realistic. I don't suggest HIV testing.

HHH, MD
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1 months ago
I'm concerned that rectal fluid might have come in contact with the small cut/tear on the side of my penis when they were grinding on my penis with their anus (frottage). This fluid can hold the HIV virus right? Can't this happen during frottage?
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H. Hunter Handsfield, MD
1 months ago
You're assuming that any contact with any fluids that contains HIV could be risky. Usually it is not. It takes LOTS of exposure to LOTS of virus for HIV infection to take hold. For example, when an infected male whose semen is loaded with HIV ejaclates into a woman't vagina, her risk of catching HIV is one chance in a thousand. The amount of exposure to the virus you had from potential contact with rectal fluid or blood is teeny compared to that. And there has NEVER been a proved case of HIV in someone whose only possible exposure was frontage. You certainly aren't going to be the first.---
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1 months ago
Thanks doc, I didn't know that. Plus I'm on the daily PrEP. Sounds like I did overestimate the risk. Well, this is reassuring, thank you. You asked if these are my usual behaviours. Sometimes, I may have an occasional unprotected anal sex hookup event with a crossdresser or transgender woman, as a top. That's basically why I stay on daily PrEP and and take a dose of DoxyPEP after the event. Because, I want the least risk possible. But each time, it causes me anxiety like this. I think I have just had enough and want to pursue heterosexual monogamous relationships. Maybe, I'm just not made for the hookup culture. It's not very fulfilling anyways. If I decided to get married, have children, I would probably stop the PrEP and DoxyPEP altogether. Do you know if there are any long term risks while on PrEP and/or DoxyPEP medication?
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H. Hunter Handsfield, MD
1 months ago
Whatever lifestyle give you the greatest sexual and romantic satisfaction of course are usually the best path. If your future plays out as you describe, you certainly could stop both PEP and PrEP; and I believe you can safely stop them now. However, we do not give specific treatment advice; you should speak with the health care provider or clinic where they were prescribed, or at least a highly expert source (in person) and follow their advice.

In general, there is a similarity in all your several questions over the years, reassuring you that your presumed safe events indeed carried little or no risk of HIV. Let's have no more questions about such exposures; you now know enough to accurately predict our replies. Repeated and similar questions are discouraged and have limited educational value for other readers. Let's make this your last until and unless you have genuinely high risk exposures. Thanks for your understanding.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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