I received oral sex this morning from an SW and when I went to was my penis there was some blood on it.  Looking at her lips she did have a couple cuts (from dry skin) that were bleeding slightly.  I'm now very concerned I may have caught something including HIV.  What are my realistic risks here?  Should I go on PEP?

You are at little or no risk of HIV from this event. There has never been a case of HIV by oral sex (mouth to penis; there have been rare cases penis to mouth). And if you think about it, among the billions of oral sex events that have happened over the years, many (millions?) must have included blood exposure of the sort you ask about -- and still no known cases of HIV infection.

I would definitely not advise PEP in this situation. However, decisions about PEP are highly personal; and the decision should be based on evaluation by a health expert familiar with the risks and probabilities. For example, some experts might consider PEP a consideration if HIV is known to be common in the sex workers wherever you are. (The chance any particular CSW has HIV is very different in various cities and countries around the world. If you remain concerned, feel free to see an expert doctor or clinic. However, if somehow I were in your situation I would not feel a need and definitely would not seek PEP.

Changing the subject, I'm curious how things went after your last forum question. Did you see a doctor about your testicular pain? Was epididymis diagnosed?

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

HHH, MD