Anonymous
A couple of days ago, I deeply kissed and had received oral sex from a transsexual that I Met online. She had braces and we were kissing very deeply. I woke up with a sore on my mouth the next day, but nothing on my penis. Could it be possible that I could have cut myself on her braces, and exposed myself to HIV or other stds? Am I at risk? Should I go get PEP (this happened 40 hours ago)?
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Anonymous
Hi there,

Thanks for contacting AIDS Vancouver for HIV/AIDS-related information.

The short answer is no, you do not need to access PEP because you did not place yourself at a high risk based on this episode alone. In most cases, PEP is an emergency prophylaxis offered when nurses have needlestick injuries, when people have unprotected anal/vaginal intercourse, or in cases of sexual assault (rape). The scenario you've described did not place you at a high risk.

Let me explain why: For a risk of HIV transmission, there needs to be body fluids (blood, semen, anal/vaginal fluids), plus a high risk activity (unprotected anal/vaginal intercourse, needle sharing) plus direct access to your bloodstream (vagina, urethra in the penis, other mucosal membranes, needles sharing) equals a risk of HIV transmission.

So because your activity was kissing and oral intercourse instead of unprotected vaginal or anal intercourse, your risk was negligible. This means that while there is a possibility of HIV transmission occurring because body fluids like semen or vaginal fluid are involved, there have been NO documented cases of transmission occurring in this way. This is also because there is an enzyme in saliva that inhibits the production of HIV, making it very difficult for transmission to occur when the mouth is involved.

As for your question about braces and cuts in your mouth, the only time where there would be a risk would be if you have actively bleeding gums or open sores in your mouth. Even then it would not be very great. Small scrapes from braces would not constitute a sufficient entryway to your bloodstream, and so I would not be concerned about HIV transmission.

When it comes to STDs, however, you can place yourself at risk because they can be transmitted during oral sex that involves skin to skin contact. Oral sex and kissing can place you at risk of herpes, chlamydia, HPV, gonorrhoea and syphilis. Fortunately, most are curable (except herpes and HPV) and all of them are treatable.

At AIDS Vancouver, we recommend that all sexually active people test regularly for HIV and other STDs (every 3, 6 or 12 months), depending on how often they have intercourse. So in your situation, you needn't run out and get tested immediately. But if at some point in a few months you would like to get tested, consider it a normal and routine part of taking care of your sexual health.

I trust I have answered your questions; however, if you have more, please don't hesitate to contact us again.

To your health,

Maggie

AIDS Vancouver Volunteer
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