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Oral sex, Ejaculate in Mouth, PEP
Aug 13, 2011

Dear Dr Bob Thank you for a great and informative site.

Im sure this question has been answered before on this site, but after some perusing I have not been able to find a thread that satiates all my questions.

On Sunday morning I had protected insertive intercourse with a man of unknown hiv status. The condom did not come off, nor break. Afterwards I gave the guy a blowjob without the condom.

In a moment of inebriated indifference I allowed him to ejaculate into my mouth and I swallowed.

Later on Sunday morning I did gargle with salt water to see if I could feel any stinging in my mouth (signs of cuts / wounds). I did not feel any stinging sensation anywhere. Since then I have spoken to the guy in question and he assured me that he had a HIV test recently (about 3 weeks before the incident) and that he is negative.

Nevertheless, I went to a doctor on Tuesday, she said that I was at risk and prescribed PEP. I started to take it approximately 59 hours after possible exposure.

Now, I know that oral sex is overall a low risk activity, but in my case I had a tooth pulled about six weeks ago (the wound seems to have healed quite well) and I had a sore throat due to a cold.

My question is: do you think that PEP was warranted in this case, if you assume that the guy is indeed positive?

Thank you Werner (South Africa)

Response from Dr. Frascino

Hello, Werner.

Do I think PEP was warranted in your case? No, I would have advised against it. You are correct: Oral sex carries only a very low risk for HIV acquisition. Your partner's HIV status is unknown, although he claims to have tested negative three weeks ago. One option would be to ask him to retest now with a rapid test. If he is indeed negative, I'd advise you discontinue your course of PEP, because your HIV risk would be reduced to the remote risk that your partner was very recently infected and still within his seroconversion window.

Your well-healed tooth extraction from six weeks ago would not increase your HIV-acquisition risk.

Good luck.

Dr. Bob



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