last night while receiving felatio i noticed a significant amount of blood mixed with the saliva of my partner.  i have been on prep since march of this year and diligent about taking it daily. i’m only writing because the presence of blood is always concerning to me. (there was enough to be seen on the bed and towel) not certain of it was his gums bleeding or blood mixed with vomit of some sort as it was an aggressive blowjob. 

this was a one time hookup in eastern europe. and i am wondering if there is anything i could or should do after this event. 

my partner says he is negative for hiv but i would like to make sure i’ve done everything i can to be safe and remain negative. 

thank you for continuing to be a valued resource. 

best

Oral sex is very safe in regard to HIV. A few infections have been transmitted penis to oral, i.e. throat exposure can result in infection. However, there has never been a well documented (i.e. scientifically proved) case of HIV transmission oral to penis. Being exposed to blood in a partner's mouth would seem to raise the risk, and perhaps it does. However, if you think about it, among the billions or oral sex events that have occurred since the start of the world wide HIV/AIDS epidemic, millions of them must have involved exposures when blood was present. And still no known HIV transmissions oral to penis. This doesn't mean there was no risk from the event you describe, but still it's very reassuring:  you're not likely to be the first such case!

In addition, people rarely lie about HIV status to their sex partners, at least not when asked directly. You're the only one who can judge the truthfulness of your partner saying he doesn't have HIV. But most likely he was telling the truth and you were not exposed at all.

So what to do now? Maybe nothing:  if you find this reassurance sufficient, I wouldn't even recommend testing in this situation. However, if you would like the additional reassurance, you could be tested in a few weeks. Or even better, you and he could both be tested now. If both are negative, you'll both know neither could have infected the other.

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

HHH, MD

i am on prep, i guess my only question would’ve have been does that add a sufficient layer of protection or would pep be something i should consider (is pep while on prep even a thing?)

i’ve been a fan of yours and dr hook for a while now.  i’ve read your work more than i’ve read proust. 

Thanks for your kind comments! Best wishes and stay safe.