I’ve been on prep for a few months now and have been finding it has really helped me feel safer. I am a male and mostly engage in unprotected oral with other men. 

I know the risk is very low even without prep. But I have a specific concern. I had my lower impacted wisdom tooth removed 3 weeks ago. I had planned on avoiding all sexual contact for a month afterwards until the socket healed. 

However, this week (3 weeks out) my extraction socket felt much better so I decided to engage in oral sex with a guy and gave him brief unprotected oral (maybe 1-1.5 mins at most). He did not ejaculate in my mouth, but there may have been pre-seminal fluid. 

On top of that I have had bad allergies this season and my throat has been dry and scratchy (almost a bit sore). 

I keep reading that the only time oral is really a risk is if you have a gaping wound like a tooth extraction, so I have been freaked out a bit by reading that online. 

My socket is no longer bleeding or hurting, but there is still swelling and a hole there, which makes me concerned. 

Does the Truvada prep negate any concern still? Should I feel confident I am safe? 

Your healing wisdom tooth extraction has not significantly increased your risk of HIV. Exposure of open sores in the mouth or elsewhere in theory might elevate the risk of HIV if exposed, but there are few if any reported cases in which this actually occurred with open lesions in the mouth or anywhere else. And you are correct that your risk of HIV "is very low even without prep." In fact, many HIV expert physicians and clinics would not have agreed to even prescribe PrEP for someone whose only potential exposures were oral sex. Finally, it sounds like your extraction site had healed before the event:  that there still is a "hole" with a bit of swelling is not likely to be significant. Finally, even with the highest risk exposures (unprotected anal sex, injection drug use with contaminated needles) PrEP with Truvada is close to 100% protective.

You aren't at risk for HIV on account of this event. I don't advise HIV testing or any other precautions in this situation. You really needn't be worried.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

It doesn't matter whether your extraction site is completely healed. Look at it this way:  oral exposure to HIV almost never result in infection, despite the fact that over the years there must have been millions or even billions of oral exposure in the presence of gum inflammation or bleeding, recent tooth extraction, or other sores in the mouth -- and yet still the total number of HIV infections acquired by oral exposure is near zero.

And on top of all that you're on PrEP for goodness' sake! This really isn't anything to be worried about.

I assume since it was such a small amount (2mg 3x a day for only 2 days) and the exposure was 21 days after that it really isn’t an issue with it affecting my immune system. I know this is probably a stupid question, but I’ve been confused by it, and would love your opinion if possible. 

I know this is my last response for the question, thank you so much for reassuring me. 

Trust me on this:  there is nothing you will think of that would change my evaluation and advice. No matter what other concerns might come to mind about these events, you can ignore them! Perhaps you also would like to know that in the 21 years of this and our preceding forum -- starting in 2004 -- with thousands of questions from persons concerned about HIV after a possible exposure, not one has yet reported they eventually tested positive. You will not be the first. If and when it finally happens, surely it will be from a genuinely risky exposure -- think unprotected anal with a known infected partner, for example -- and not a near zero risk situation like yours.

As you understand, that indeed concludes this thread. I hope the discussion has been helpful.