[Question #570] Protected Oral with thai massage, petrified of HIV

43 months ago
Hi on Tuesday I had an encounter with thai massage girl. Had protected oral for 15 seconds ejaculated, she offered sex I declined then she attempted oral again for 20 seconds but I stopped. Petrified of catching sti I saw dr at tourist clinic who prescribed pep, shot in backside and anti bio tics. Going out of my head with fear I have caught hiv
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
Welcome to the forum. Thanks for your question.

It seems to me the tourist clinic doctor overreacted. Oral sex is safe sex, with low risk for all STDs and zero risk for some, including HIV. The risk probably is even lower for such a brief exposure as you had. There has never been a proved case of HIV transmission mouth to penis -- despite the billions of such exposures that have occurred over the years. (One estimate several years ago, from CDC, was that if the oral partner has HIV, the chance of transmission by oral-penile contact is once for every 20,000 exposures. That's equivalent to receiving BJs by infected partners once a day for 55 years before transmission might be likely.)

For those reasons, most STD experts would not have even recommended testing, let alone preventive treatment of the kind you received, and certainly not PEP against HIV. An important downside of PEP is that if it doesn't work, it might extend the time until valid testing can be done -- according to some experts, as long as 6 months. As a result, the period of anxiety goes on much longer, because without treatment a valid 4th generation HIV test can be done at 4 weeks. However, this forum doesn't provide specific medical advice, and you should not stop PEP based only on my opinion. I recommend you find an HIV/STD expert for additional evaluation, including advice on whether to stop or continue treatment. In the meantime, stay mellow. The chance you caught anything is extremely low, and really zero for HIV, for all practical purposes.

I hope this has been helpful. Let me know if anything isn't clear.

HHH, MD
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43 months ago
Thank you, just extremely anxious and although it was protected and didn't last long, you rack your brain recounting the situation to make sure the condom didn't break, there was no other touching other than her briefly touching my chest, and it wasn't deep oral or aggressive, feel really stupid and stressed about taking pep. Just worried that I've caught somethong!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
With apology, I missed "protected" and didn't realize a condom was involved. And of course skin contact (chest or anywhere else) carries no risk at all. For sure this was a zero risk event for HIV and all other STDs. It was ridiculous for you to be given preventive treatment against gonorrhea or chlamydia (the shot plus oral antibiotic) and frankly unconscionable to prescribe PEP against HIV. I have to assume you either insisted very strongly and talked the tourist clinic doctor into it, or the clinic is ripping you off, if you paid anything more than a few dollars.

While I'm going to stick to my guns about providing direct care -- i.e. I'm not backing off on my statement that you should not interpret my comments as instruction to stop the PEP -- you should at least phone the travel clinic and ask whether they really think it is necessary or wise.


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43 months ago
The tourist dr was thai and insisted that pep was necessary as the status of the massage girls sexual health was unknown and pep would possibly prevent hiv taking place. Should I be stressing doc? The tourist dr insisted that hiv could be caught via oral, is that at all truthful? Still stressed!!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
I'm not going to get into a second hand debate with your Thai doctor. But my guess is that he knows a lot less about oral sex risks, HIV transmission, and other STDs than I do.

As for still being stressed, there's nothing more I can do. You have had highly expert, reasoned, science-based advice that there is no cause for concern and worry. The rest is up to you. I'll just add that you need to separate your guilt, shame, and anxiety over a sexual decision you regret from concern about STD/HIV risks from it. They aren't the same. Maybe try going to a mirror, look yourself in the eye, repeat "You don't have HIV" 20-30 times, then mellow out, prop your feet against a frangipani bush, and have a beer. Truly, you have nothing to be worried about.

That completes the two follow-up comments and replies included with each new question, and so ends this thread. Best wishes and stay safe (as you did this one time!).

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