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Risky Activity, Pep, Testing

Question: 

Hi,
I had an experience that is causing me great concern. I received unprotected oral and rubber her vagina on the outside. Did feel the wetness on fingers. May have had a small cut on the underside of the head of the penis. Greatly freaking out. Im especially worried cause I saw something that would make me think she is possibly in acute phase of infection post the unprotected oral. Should I get tested? Should I try and start pep? It is about 60 hours post exposure.

Answer: 

Hello there,

Thank you for your inquiry. From what we gather from the question, you were asking about your risk of HIV acquisition from unprotected oral sex and genital rubbing.

From the information given, this scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission. However, there is a theoretical possibility).

Receptive oral sex is considered to be of negligible risk because it hypothetically involves avenues for transmission of HIV. However, as mentioned, there is no evidence or no documented cases of transmission for this given act. Although your partner may have been suffering from an 'acute infection', there is a small risk of transmission through this particular act (1).

Our Transmission Equation does consider genital rubbing (docking) to be a method for HIV transmission. As you'll see, the exchange of fluid is required to be involved in the transfer, as well as direct access to the bloodstream. In this exposure, because there was the presence of bodily fluid, there is risk involved. Rubbing is not generally known as an activity known to be involved in the transmission of HIV, yet rubbing of genitalia with the presence of bodily fluid does provide direct access to the bloodstream (2). For this reason, this scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission. However, there is a theoretical possibility).

In the future, if you think you may have experienced a possible exposure, PrEP and PEP are both biomedical approaches that help lower your risk of acquiring HIV. PEP must be started within 72 hours after a recent possible exposure to HIV, but the sooner you start PEP, the better (3).

Recommendation: There are no evidence or no documented cases of transmission refer to Physician for more personalized answers.

Best, AIDS Vancouver Helpline/Online, Cody