[Question #9144] Cunnilingus risk - PEP recommendation

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35 months ago
Hello, health anxiety gotten the better of me once more.

I performed vigorous cunnilingus for a hour on a cis-gender female (30’s, white, two kids) for approximately an hour, unknown HIV status.

I’m still within PEP window so just looking for advice on whether you recommend it for this situation. 
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Edward W. Hook M.D.
35 months ago
Welcome back to the forum. This question is quite similar to your previous question related to risk of HIV from cunnilingus. 

The answer has not changed. The CDC, which is by nature conservative, estimates that the risk of acquiring HIV from cunnilingus on an untreated, HIV infected person is less than one infection for every 10,000 acts of cunnilingus.  In addition, HIV is decidedly uncommon in cis gender woman. The chance is 99.99% that, if your partner had HIV, which is unlikely, you would still not be infected. Taking PEP is a personal decision although your risk is quite low and I would not recommend it. EWH 
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35 months ago
Tnwnke doctor. Would you bother testing for HIV for this scenario and what’s the windows for testing? 
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Edward W. Hook M.D.
35 months ago
Further testing is a personal choice.  Nothing you report above suggests a need for testing.  EWH---
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35 months ago
Thanks again doctor. I’ve spent a fair bit of time perusing similar threads and what comes through is that cunnilingus is virtually a no-risk act for HIV based on an absence of documented cases. 

My mind has now unfortunately shifted to looking for symptoms over the next 3 weeks. Seeing as I have 1 follow up question left I may as well use it…..In your opinion, based on the exposure described, am I fine to ignore future potential HIV ARS symptoms (real or perceived) regardless, or should I take symptoms to act as a prompt to test specifically for HIV? Hopefully that question makes sense???
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Edward W. Hook M.D.
35 months ago
Final response.

Your risk for HIV will depend on the the partner and the type of exposure you engage in.  Thus far, the exposures you have asked about her have been low risk.  Remember, most women do not have HIV and that kissing, cunnilingus and receipt of fellatio are all virtually no risk events.   Anxiety tends to amplify the detection of normal sensations so that they are perceived as symptoms.  In at least some of the instances you have posted about this seems to be the case.  Once you experience "symptoms", my sense is that your anxiety will tend to increase and for that reason, I think that in the presence of symptoms testing to prove that the symptoms are not due to HIV is advised.

Hope this helps.  This thread will now be closed.  Take care.  EWH


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