I was at a massage parlour where i was offered a happy ending massage . I closed my eyes and as she was giving me a hand job - i suddenly felt differently.  I opened my eyes and realised she was giving me a BLOWJOB . I stopped her but there was a cold sore on her lips. She had bright red lipstick and therefore its hard to tell if there was blood on her cold sore but i feel like i saw a little bit of blood . . As i had shaved the night before there were a couple of shaving cuts on my penis. Blood could be from my cut or from her sore. 

She then put on a condom and there was some genital to genital rubbing and some kissing. There was absolutely no insertion. 

I felt very uncomfortable and left without any ejaculation . 

30 hours later i was put onto pep because of the possibility of blood , cold sore/blisters and cuts.  The clinic said protected genital to genital comtact without any insertion is zero risk.

My tests for syphilis, gon etc are negative. 

At 8 weeks post exposure iv tested negative on a duo hiv test. 

My question is as follows 

1. Uk ( BASHH) guidelines say follow up testing after pep must happen 8-12 weeks post exposure . The doctor showed me these guidelines and iv double checked on the internet. Why are US guidelines seperate?

2. Do you think that i need another test ? Would you recommed to your patients in Usa to do another test if they had the same risk as i do ? 

3. Have you ever seen anyone test negative at 4 weeks post pep but later gone onto become positive ? 

4. Statistically speaking - what do you think are my chances given a 4 week post pep negative test ?

If you were in my place - would you have unprotected sex with your wife. 

My clinic in london says move on - im just not sure what to do . 

Welcome to our Forum. I'll be happy to comment.  If you had asked us whether or not you needed PEP, I would have said no.  Official estimates are that the risk of getting HIV from receipt of oral sex is about 1 infection per 20,000 sex acts and I have never heard of, or seen a person who has become infected in this way.  Even if the presence of a cold sore, gum disease, or blood in her mouth doubled the risk (which is unproven), that would still make your risk about 1 in 10,000 and that is only if she had HIV and most commercial sex workers do not have HIV.  You do not know if your masseuse had HIV  I would not have prescribed PEP for you and would not have worried.  That said, let me address your questions:

 

Thank you for your re-assurance. Its been an extremely hard 8 weeks for me.

Just a quick clarification and then you could close this topic -

1. I hope you didnt miss the fact that i had a cut on my penis because of shaving my pubic hair. Would your recommendation of not testing further, sex with my wife and believing my test result still hold true.

2. I took my last pep on a saturday . Then i tested 4 saturdays later. I hope that counts as 4 weeks later  or does it count as 27 days ? I mean i took it on the 28th day after the last day of pep. Is that ok ?

I really want to move on. My local doctor has said i can move on . Your assurance would be the final thing i need to move on. 

1.  I did not miss the fact that you had sustained a cut while shaving your public hair.  This does not change my advice. 

2.  you can count your testing as having occurred 4 weeks after completion of PEP.

I agree with your doctor.  I would feel quite comfortable moving forward without further concern at this time.  EWH