[Question #4513] HIV Question

27 months ago

Hello,

Last Friday evening, I received unprotected oral sex from a female csw (hiv status unknown).

1. What is the likelihood that I contracted hiv from this incident?

2. Should I get tested over this incident?

3. Should I get on pep for this incident?

4. Is it safe to have unprotected sex with my partner?

H. Hunter Handsfield, MD

27 months ago

Welcome back to the forum and thanks for your continued confidence in our services. However, these questions are pretty much the same as your previous ones a year ago, even if the particular exposure is a recent one. As discussed then, the large majority of female CSWs in the US do not have HIV (1 in 1,000 to 1 in 100, depending on the setting, city, etc).

1) There has never been a scientifically proved transmission of HIV mouth to penis. CDC estimates it carries a risk of 1 in 20,000 if the oral partner has HIV. That's equivalent to receiving BJs by infected persons once daily for 55 years before transmission might be likely.

2) Therefore, testing is not necessary in this situation. But of course you are free to be tested if having a negative result would help reassure you. Anxious persons often are more reassured by a negative test than by probability and statistics, even from an expert. If so, have a duo (antigen-antibody) test 4-6 weeks after the event.

3) PEP definitely is unnecessary and not recommended.

4) It is safe to continue sex with your regular partner. That's what I would do if somehow I were in your situation.

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

HHH, MD

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