Kissing during PEP

Question

Dear Dr. Frascino,

Let me start by telling you how much I appreciate what you are doing, as well as your input. I truly respect you--as a gay man, doctor, and human being. :)

My question regards kissing during post-exposure prophylaxis. I experienced an unfortunate incident--unprotected anal sex (I was the receptive partner/"bottom")--with a gay European male, who informed me after the incident that he liked unprotected anal sex because "it adds to intensity of sex". I asked him about his last HIV test, which was in January and came back negative (according to him).

Worried about my high risk for exposure, I made my way to a local health clinic and spoke to them about receiving post-exposure prophylaxis. Approximately 43 hours after exposure, I started taking a combination of Combivir (2 tablets per day) and Viread (1 tablet per day). I have followed the regimen every twelve hours since. The day after I started taking Combivir and Viread together, I had a date with a male, whom I abstained from sex with. Nevertheless, I engaged in very deep kissing for several hours, and I felt a slight stinging sensation on my lips. Being the hypochondriac that I am, I kept wiping my lips to check whether there was any blood, but there was none. Still, when I got back home, I used a tissue to wipe my lip several times (just to make sure), as I saw chapped/cracked lips, and, after several wipes, saw a small spot of blood the size of a period at the end of a sentence. I am incredibly, incredibly worried about having transmitted HIV to my date via deep kissing.

-What do you think my chances were/are of having transmitted HIV to my date (hypothetically speaking)? I don't need a definite number--any kind of answer would serve me well.

Thank you! :)

Answer

Hi,

What do I think? Well, even with your having PEP onboard and chapped lips I feel the words to "As Time Goes By" still apply: "You must remember this, a kiss is just a kiss, as time goes by."

Your HIV-transmission risk? Nonexistent. So pucker up and smooch away, OK?

Dr. Bob