[Question #6026] Help

18 months ago
Hello

I am a college student and did something very stupid last night after drinking too much.  I hooked up with 3 different guys over the course of a few hours and engaged in sex with all of them. I’m now scared to death. I had oral sex with all 3 of them. They performed oral sex on me and we kissed a lot. All 3 lasted for 10 minutes or more each. One of them I tried to have insertive anal sex with but I stopped after a few seconds. I had a condom on when that happened. I did ask each about their hiv status and all 3 said they were negative but I’m now worried about 1 of them specifically that I heard from some people today who may be hiv positive.  So I’m scared and here are my questions 

1) how much at risk am I based on the oral sex and kissing?

2) should I go get Prep now? I think it has to happen within 48 hours from what I’ve read on line. 

Please help me. I’m really scared 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
18 months ago
Welcome back to the forum.

These exposures are very much like the ones you described in your previous thread a year and a half ago. As we discussed then, oral sex and kissing are risk free in regard to HIV -- or such low ris that these events can be ignored. The attempted anal sex with a condom also was free of any HIV/STD risk. And I'am very happy to see you took the advice I gave last time, about discussion HIV status with your partners. Most people don't lie when asked directly, so it is unlikely any of these men has HIV. (Rumors of HIV positivity by third parties generally can be ignored -- but I stress that even if one of more of these guys has HIV, you didn't have any sorts of contact that risk catching it.

Those comments directly address question 1. As for PEP (post-exposure prophylaxis, not pre-exposure or PrEP), there is no need. Your risk of HIV was not nearly high enough, and most experts would not advise it and I do not. In addition, you might not have thought of an important downside to PEP:  if it doesn't work, it may still delay development of positive blood tests. If you take PEP, you'll need testing as late as 3 months to know you weren't infected (and some experts recommend testing out to 6 months), greatly prolonging the period of uncertainty and anxiety. Without PEP, you can have conclusive testing in 4-6 weeks. 

This exposure was zero risk and you don't even need HIV testing, let alone PEP.

I hope these comments are reassuring, as they are meant to be. Let me know if anything isn't clear.

HHH, MD
---
---
18 months ago
Thank you Dr Handsfield

I appreciate your help.  I know I need to quit reading stuff on line about people who have been infected that way mainly because of blood in someone’s mouth that can get into mucous membranes in the mouth or urethra. Does saliva really disable the HIV virus?  You mention testing in 4-6 weeks for a definitive result. Is that with the 4th generation test or should I consider the PCR test if I want to go that route?

Thank you 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
18 months ago
Stay off websites run by and for people with HIV or at risk. Stick with professionally organized or moderated sites, like this one, academic medical centers, or public health departments or CDC. Trust me on this:  even the busiest HIV/ADIS clinics never see infecgted patients who did not have traditional risk factors. Among men having sex with men, that just about always means unprotected anal sex.

The PCR test is expensive and given your essentially zero risk, I suggest you not spend the money. Just have an AgAb (4th gen) test at 6 weeks. However, if having conclusive results by 4 weeks is crucial to you, you could have PCR at around 2 weeks and an AgAb test at 4 weeks. That combination would be conclusive. But if it were me, I wouldn't be tested at all and would continue sex with my wife without fear of infecting her.
---