[Question #7617] Kissing risk

3 months ago
Dear dr ,

Hope you are doing well.

I am a 30 year old gay male . I don’t haven’t had anal sex ever . My recent exposure was kissing an man of Unkoen hiv status . 
He had braces fixed and he said his gums were sensitive and bled at times .
We didn’t kiss deeply just regular kissing but now I’m a bit worried about hiv or hepatitis .

Is it possible to fry hiv from kissing if blood is present ? Request you to please advise . Thanks 

Also I really haven’t even had oral sex ever without a condom and never had anal sex at all coz of the worry of hiv ?

Would you recommend prep to be taken just so that I don’t get anxious and worry about getting tested everytime I have an exposure ?

Request you to please advise .  Thanks 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
3 months ago
You were warned in your last thread (and in an earlier one as well) about the policy about repeated anxiety driven questions. 

HIV is not transmitted by kissing, even if small amounts of blood are present. It would appear you're anxious and stressed about your sexual attractions in general, and it's a shame that your disease fears are preventing full sexual expression. Based on this and the other sexual events you have described, PrEP isn't needed. But perhaps you should indeed discuss PrEP with a senstivie, caring physician. Maybe that would not only help you be less frightened after your zero-risk exposures, but also permit you to have normal sexual experiences with other men. Other than that, perhaps you should consider professional counseling to deal with all this, perhaps including anxiety, shame or guilt you may be experiencing because of your sexual attraction to men.

HHH, MD
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3 months ago
Thanks dr,

Just wanted to check with you , I had read about a case online where hiv was spread bcoz of bleeding gums. Have you ever seen a case where it has been spread through kissing ?

Also I have been seeking counselling hiwvwer my therapist suggested I don’t take prep bcoz the long term side effects are Unknown . Request you to please advise on the same .

Finally , do I need to use condoms during oral sex as well ? I see  most ppl not using condoms however I have read that oral sex does have a small risk in terms of hiv .

Thanks doc .
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
3 months ago
Whenever a single case of anything is reported in the medical literature, you can assume it's rare. They're reported because they're unusual; there's no need to report an everyday event. So this single report confirms my advice that this is too rare to worry about.

If "therapist" means a non-MD counselor, I would not rely on that advice about PrEP; perhaps s/he is very familiar with it, but PrEP decisions and advice should come from a physician with HIV expertise. On this forum we don't give directly advice for or against treatment; I'll just say that PrEP drugs are very safe and side effects are uncommon, either short or long term.place holder

Condoms are optional for oral sex. HIV risk is extremely low, but STDs are more common; for example, urethral (penile) gonorrhea is pretty common after oral sex. On balance, I would recommend you use condoms for either giving or receiving oral sex.
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3 months ago
Thanks dr handsfield .

So I don’t need to get tested based on this exposure right ? 

Do I need to test for any other std based on this kissing exposure .  Thanks for all ur advise .
3 months ago
Also can I have oral sex without a condom ? What would be the risks ?
In your experience have h seen anyone contracting hiv through oral sex ? Please advise thanks 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
3 months ago
These final questions have already been answered, or the answers should be obvious, if you read my replies both in this thread and previous ones:

Get tested? No need from a medical/risk standpoint. But anxious persons often get tested anyway. Feel free if you will trust a negative test more than my advice. For kissing, never any need to test for any STD.

Oral sex and condoms:  Discussed above; see the last line of my reply yesterday. I haven't changed my mind since then.

I have never seen a patient who, as far as I know, was infected by oral sex. But what does that matter? I've also never taken care of a patient struck by lightning. Whether or not I have had a patient with a rare risk or illness makes no difference in the low risk for you.

That concludes this thread, and it's definitely your last. Any future similar ones WILL be deleted without reply and without refund of the posting fee. There is little chance you'll ever think up a new scenario that would change our opinions or advice, so please do not be tempted. Instead, if and when further issues come up, just go back and read all your threads so far. The answers are there.

Best wishes and good luck.
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