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Insertive Oral Sex, Is PEP warranted?
Mar 1, 2009

Dr. Bob,

Thank you for taking the time to answer my question. I formerly had a partner who smoked meth and cheated on me behind my back (I am a gay male) and caught HIV. Since that time, and going through all of the tests (which were negative, Thank God) I have only participated in unprotected insertive oral sex and always ask hiv status. Well, yesterday I met someone in a bar, things got carried away, and he ended up giving me a bj. Before the bj I asked him his status - he said it was negative. However, after, he admitted to being HIV positive!! There was a lot of spit involved, a lot, but I didn't see any signs of blood. My questions are 1. Should I seek out PEP? If so where would I go - no insurance. 2. For futures sake - how safe are my sexual activities? 3. Have you ever seen or heard of someone becoming HIV positive from getting a bj?

Thank you in advance for answering my questions!! I will send a donation to your organization,

Worried IN CA

Thank you

Response from Dr. Frascino

Hi Worried in CA,

Your story is another poignant reminder of how meth can ruin relationships, health and both present and future happiness.

Addressing your specific questions:

1. PEP is generally not recommended for unprotected insertive oral sex unless there are extenuating circumstances, such as trauma or bleeding, etc. Although PEP would not be warranted for your particular exposure, if you were to need it in the future, it can be accessed at any emergency room, urgent care center, HIV specialist physician's office and some city and county health departments. Your "no insurance" status is shamefully all too common. Hopefully President Obama will be successful in remedying this unconscionable travesty.

2. Oral sex is considered to be a very low-risk activity for HIV transmission/acquisition. Check the archives of this forum for additional information. We have an entire chapter devoted to oral sex.

3. Yes, but only with extenuating circumstances, trauma, bleeding, concurrent oral STD, etc. Overall it's extremely rare. If despite my reassurance and the information in the archives you remain concerned, get an HIV test at the three-month mark.

Thanks for your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org).

Be well. Stay well.

Dr. Bob



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