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Why was I denied PEP?
May 14, 2007

Hi Doctor,

I had my first and last "four way." It was all oral sex. I gave them all oral but not to ejaculation - One of the guys is positive. I went to the clinic to get PEP but they refused me. I actually went to another clinic and they said no. Why? I was exposed. Not to full ejaculaton but to lots of his precum. I don't understand why they said no. I demanded it and they still said no. Do you think I will ok?

Carlos

Response from Dr. Frascino

Hey Carlos,

So four-ways are out. Does that mean that ménages a trois are still acceptable?

Regarding PEP, I, too, would have counseled against taking it for the type of exposure you describe receptive oral sex four ways without ejaculation, but with pre-cum and knowing that one of the dudes was positive because the risk of taking any medication must be weighed against the possible benefit of taking it. In this case the risk of HIV transmission would be so slight that the risks associated with PEP outweigh the benefit. In situations like yours, PEP may be "offered" by some HIV specialists and medical facilities, because you know one of the guys is indeed positive; however, most HIV specialists would advise against taking PEP. Testing at the three-month mark is generally the most that would be recommended.

Good luck, Carlos.

Dr. Bob



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