Semen Exposure

[chanson12]

Hello, doctor!

Thanks in advance for your advice. I'm a little concerned about a recent event and would appreciate expert opinion. I'm honestly not sure how you two can sift through all these extremely personal questions all the time without getting depressed. Doctors are made of tough stuff.

Anyway, I'm a gay guy. I was giving a blow job to a guy my age and he ejaculated onto my face. He started rubbing his glans over my cheek where he ejaculated and he managed to open up a cut that had healed over, which then started actively to ooze blood. Now, I know that HIV cannot penetrate intact skin and that blow jobs are pretty safe. What's got me a little jangled is that the semen was MIXING WITH BLOOD on my cheek.

Can you tell me what theoretical risk this poses to me? I did ask the guy about his status beforehand (of course!) but he seemed a little dodgy when he answered me. I should have ended it then and there, but alas, I did not.

Thanks again for your time.

[Edward W Hook, MD]

Glad to help. EWH

[chanson12]

That's reassuring. Thanks.

[Edward W Hook, MD]

I'd assess your risk as beig just slightly higher than the risk associated with unprotected oral sex- very low. EWH

[chanson12]

Doctor,

Thanks for your response. Unfortunately, I cannot find out if the individual has HIV. I can only tell you that he claimed to be HIV negative and refrained from unprotected anal sex. He was a twenty-one year old Asian male in the San Francisco Bay Area.

I will do as you suggest and get tested. I am already past the point at which PEP would be effective, so that is of no concern.

As far as the risk goes: I imagine you can't actually quantify it, but where would you put it on a spectrum between oral sex and unprotected receptive anal sex?

[Edward W Hook, MD]

Welcome to the Forum. the risk for HIV form the events you describe is quite low but not zero.  It would be most helpful if you really knew if he has HIV or not.  Can you find out?

Even if you cannot, the risk remains low, even if he has HIV.  I say this because:
1.  This was surface contamination, not introduction of his ejaculate deep into a cut or wound.
2.  Presumably his actions displaced or otherwise opened up a pre-existing cut. As a result, the direction of the blood was outward and opposed to him having introduced material deep into a cut.

That said, future testing is probably reasonable if you had not planned to already.  I would not personally suggest PEP in this situation but that, of course, is a personal choice.  

I hope this is helpful. EWH