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Received oral sex

Question: 

Hi Volunteer,

It has been 18 days now when I received oral sex (unprotected) in one of the massage parlours in East Africa. I am not sure if the lady had bleeding gums, sores, etc. in her mouth.

A day later (within 30 hours of exposure), I started PEP medication (Lamivudine 300 mg and Tenofovir 300 mg) for a course of 28 days with the doctor's consultation. I am still continuing the medication. Also, I got the HIV DNA PCR test done within 30 hrs of exposure and one after 2 weeks of exposure - both of which came negative.

I am still worried about my status.

1. Could I rely on the HIV DNA PCR test which was negative 2 weeks of post exposure?
2. Could the result have been negative since I am on PEP for 28 days and then turn positive once I stop the PEP after 28 days?
3. Also, I see some red spots (painless and non-itchy) on my right thigh. Is this something I should worry about?

Thanks in advance for your reply.

Answer: 

Hi there,

Thank you for choosing AIDS Vancouver for your source of HIV/AIDS related information. It's great to see you are taking initiative when it comes to your health and well being!

An individual's occupation, ethnicity, sexual orientation and other such sociocultural factors do not influence the risk of HIV transmission. It is the act which confers the risk, not the individual.

Based on the information you have provided, you are at a negligible risk for HIV transmission. This means that no one has ever acquired HIV from receiving oral sex.

According to the World Health Organization (WHO), all HIV testing is conclusive 12 weeks (or 84 days) post exposure - provided there have been no other exposures during that window period. However, when an individual consumes PEP, they will be required to wait 24 weeks after the last day of treatment in order to receive conclusive results. I would like to stress, nevertheless, that the situation you have described does not warrant the need for PEP, nor do you require HIV testing for this one specific situation.

There are no clinically defined symptoms of HIV. The fact that you have developed red spots on your thigh is by no means an indication that you have acquired HIV. The only way to know is through testing.

While this particular situation doesn't warrant concern for HIV transmission, at AIDS Vancouver we encourage all sexually active individuals to get tested for all sexually transmitted infections (STIs), including HIV, as part of their health routine. This can be in the form of testing every 3 months, bi-annually, annually or whatever suits your lifestyle.

I hope I have addressed all of your concerns, and if you have any other questions please feel free to contact us again!

All the best,
Greg