Im a 35 year old male from South Africa. A girl of unknown status from a bar tried to perform oral on me two or three times. My penis couldn’t have been in her mouth for more than 5 seconds at a time. I pusher her away each time because I didn’t want to do oral without a condom but she kept trying. She also tried analingus but stopped her again. I later found out she’s a transgender woman (born male) and an escort. 

1. Given my penis was in her mouth for a few seconds, what is the chance of HIV or other STI’s? HIV is main concern and causing so much stress and anxiety I struggle to get through the day. 

2. Should I go on PEP given it’s only been a few hours since exposure?

3. Do I need testing? Main concern is HIV. 

4. Can I continue sex with my girlfriend?

I’ve heard you say receiving oral is basically zero risk but am just looking for reassurance whether I can move on with my life without worry? The threat of HIV gives me immense anxiety. 

1.  The exposures you describe are very close to no risk of events. Receipt of oral sex is amongst the lowest risk sorts of penetrative sexual encounters, and the brief duration of the possible exposures you describe make your risk lower still. There is no meaningful risk of HIV whatsoever. There are no proven cases in which HIV has been acquired from receiving oral sex, either oral to penis or oral to anus.  The chief STI, which you might be at risk for would be gonorrhea and given the brevity of your exposure the risk of that is exceedingly low.

2.  Please see my comments above. I strongly recommend against PEP in your situation. There are no proven cases of acquired of HIV acquired due to the exposures you report.  I would have no concerns at all.

3.  I see no need for testing related to the exposure you describe. For that matter, I see no reason for testing in any way. As I mentioned, there is a minuscule risk for acquisition of gonorrhea however, if you had acquired gonorrhea, which is very unlikely, there is a greater than 90% chance that you would become obviously asymptomatic within 3 to 5 days following the exposure.

4.  I see no reason for you to abstain from unprotected sexual activity with your regular partner.

I hope that this information is helpful to you. I see no reason for concern and no reason to change your usual activities. If any part of this response is unclear, please don’t hesitate to use your up to to follow ups for clarification. Take care. EWH.