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INSERTIVE ORAL SEX HIV RISK

Question: 

I had unprotected INSERTIVE oral sex with a prostitute. The following day i went to the Clinic and i was given PEP. Then i looked for the prostitute the day after starting PEP and took her for HIV 1/2 (Duo) serum test, Syphilis test, HBsAg and AntiHCV (rapid) which all came back Non reactive. I went back to the doctor after the results and he told me since the results were negative i should stop PEP and move on. so i stopped PEP on my 5th day. But am sick and worried of the fact that she might have been in her window period. Though she assured me that she is not sick because every 3 months she goes for check up and practices safe sex. The only time she does not use the condom is during oral sex.

Am i at Risk of contracting HIV from receiving unprotected oral sex on my penis? Was i wrong to stop PEP? Was the doctor right to ask me to stop PEP? and have read somewhere were it says insertive oral sex is negligible risk and no case has been documented. Am i sick.

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV after receiving unprotected oral sex followed by 5 days of PEP. From the information given, this scenario is determined to be Negligible Risk (there is no evidence or no documented cases of transmission. However, there is a theoretical possibility of transmission under certain extenuating circumstances).

The scenario mentioned above does not meet the three components of the Transmission Equation because saliva is not a bodily fluid that can carry the HIV virus. It is important to note that this scenario is determined to be of negligible risk due to the theoretical possibility that the saliva was mixed with large amounts of blood, which was then able to gain direct access to your bloodstream through the head of your penis. To prevent any concerns regarding oral sex in the future, make sure to always use a condom to protect both people involved in the activity.

PEP is the most effective when taken immediately after a risky activity as prescribed every day for 28 days (1). Since PEP was stopped on the 5th day it would not be very effective in preventing a possible HIV transmission. It is important to note that your physician was correct to stop PEP, as the person you received oral sex from is negative for HIV and you engaged in a negligible risk activity.

Recommendation: There are no evidence or no documented cases of transmission. Refer to a healthcare professional for more personalized answers.

Regards,

AIDS Vancouver Helpline/Online, Marie