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Freaking Out About Exposure to HIV
May 27, 2011

I had been talking with a friend and finally got together with him last night. I was attracted to him and he gave me oral sex to completion. In talking afterward, he told me that he was HIV positive. I almost died there at the scene in shock! He informed me that he had been positive for about 5 years and took medicine for it. He said he had an undetectable viral load, so not to worry. Well I am worried and pissed that he didn't inform me before giving me oral sex. I called my doctor today and he prescribed me Truvada and Isentress for 30 days. He said it is low risk to be the recipient of oral sex and even lesser risk if someone is on medication for HIV and has a undetectable viral load. He said that with the medication also, that my risk is virtually zero. Is that the case, and do I need to be worried about getting the HIV virus? What do I tell those that I may date in the near future? Thanks for your advise!

Response from Dr. Frascino

Hello.

I agree your buddy should have disclosed his HIV status before chowing down on your big bopper; however, why freak out and "almost die at the scene in shock" because he did disclose he's positively charged? What if he did know his HIV status, chose not to disclose, or simply lied about his status. Would you be at any less risk right now for HIV? No, of course not. We have to assume all our sex partners could be HIV infected and take all the necessary precautions so that the virus is not transmitted. By doing so it really wouldn't matter what your partner's status is or what you find out after the deed has been done. It's also worth noting that one out of every five of the over-1,100,000 HIV-positive Americans has absolutely no idea he is infected with the virus.

I absolutely agree with your doctor. Unprotected insertive oral sex carries a very low risk for HIV acquisition. If your poz-buddy is indeed on effective combination antiretroviral medication, which has driven his HIV plasma viral load to undetectable levels, your already very low theoretical risk would be significantly further reduced. In essence it would become so remote as to be nearly nonexistent. PEP is generally not recommended for such a minimal risk. However, taking it will even further decrease any potential HIV-transmission risk.

As for what to tell your future dates, you don't need to tell them anything, as long as you follow the safer sex guidelines. I'm quite confident your post-PEP HIV testing will reconfirm your negative HIV status.

Good luck.

Dr. Bob



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