[Question #8821] Is this a risk for HIV?

39 months ago

Hi Dr Hook/ Dr Handsfield ,

I made an impulsive and rash decision.

I received an unprotected blowjob from a sex worker. I then proceeded to use a condom for the intercourse. I noticed there was a cut near the scar line (I am circumcised) after the deed was finished. The cut was a day or two old and not bleeding at all, it was so minor I did not even notice it before. Yet, one could see the reddish-pink skin in the cut, not sure of the medical terminology. I am sure the cut remained within the condom during intercourse as the condom was tight and firm and the cut is situated 1 cm from the ending of the glans so it is far from the base.

I could not see any visible blood from her mouth on my penis after she was finished with the blowjob, I did not even get erect during the blowjob and I did not ejaculate as well. I want to know at how much of a risk I am at for HIV.

I was put on PEP at 82 hours post exposure.

I have uploaded an image that I took just after the exposure, the cut is encircled with the blue marker, not sure if it has been uploaded, I can provide a link to the image for further inspection.

Edward W. Hook M.D.

39 months ago

Welcome to our forum. Thanks for your questions. I’ll be glad to provide some information which I hope you will find helpful. By and large the encounter you described was a no risk event. Most commercial sex workers do not have HIV. Even if your partner did, there are no proven cases when an individual has acquired HIV from receipt of oral sex. This is the case even for persons who have cuts or abrasions on their penis at the time of exposure as you did. Similarly, as long as the condom this word throughout the encounter, condom protected sex is safe sex.

Regarding your receipt of postexposure prophylaxis (PEP), if you had approached me requesting PEP, I would not have prescribed it in that the risk of the exposure you describe is virtually nonexistent. In addition, I regret to inform you that most experts would not recommend use of PEP following more than 72 hours after a risky exposure. The value of PEP beyond 72 hours is minimal.

I hope the information I provided you is helpful. Please don’t worry. If any part of my responses unclear or you have continuing questions, please feel free feel to use your up to two follow ups for clarification. EWH

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38 months ago

Hi Dr. Hook,
Thank you very much for your detailed reply.
Even though I am very assured after reading your explanation, my girl friend had forced me to take the PEP medications.
I continued with the medication for 25 days, I stopped the course on 28th May 2022 as it was not bearable anymore.

I did a Rapid finger prick test today on 6/4/22 and it has shown me the result is negative. Is this an encouraging result? 6/4/22 is 34 days after the incident. Even though I am content now, can I tell my girlfriend that this is a good sign and we can continue with our normal activities in the bedroom?

Thanks and regards,

Edward W. Hook M.D.

38 months ago

While your recent test is certainly good news and, had you had an exposure which put you at risk, would be encouraging, PEP delays the time until a person can be entirely confident of follow up HIV test results. As I’ve already informed you, the exposures you described were virtually no risk and you began PEP later than is recommended and so it may have had no effect other than to give you side effects. Thus you can tell you GF this is good news.

I would have no hestitation to return to unprotected intercourse with your GF related to the exposure you described. EWH

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