Oral Sex Worries

Drs.  Thank you for your continued help and education on this website, it is always appreciated.

here is my concern- about 24 hours ago I engaged in unprotected sex with a gay man, I am a man as well.  We discussed his HIV status before hand and after hand and he is negative.  I briefly performed oral sex on him, however at some point my teeth must have come too close to his penis and cut him (WHOPS!)

He pulled out, and I briefly went back in and tasted something salty.  He immediately pulled out again and grabbed a towel, he was slightly bleed (smell red dots on the towel)  I was probably exposed to a few drops of blood.

Obviously I'm concerned here, should I see a doctor regarding PEP?  Thanks for the help.

[Edward W Hook, MD]

You have nothing to worry about.  Your partner told you he was not HIV infected and most people tell the truth. If for some reason he was not telling the truth, you chances of getting HIV from the exposure you describe is very, very low.  HIV is not efficiently transmitted to a person who performs oral sex on an infected person, even if there is blood or secretions exchanged.  You risk of having a reaction from the PEP is much greater than your chance of even being exposed to HIV.

The person who should be worried is your partner.  You could have exposed him to mouth bacteria through his broken skin and while not an STD, this could cause a skin infection in him.  EWH

[JonnyBGood]

Any help on this one?

[JonnyBGood]

Great, thanks for the advice, I was tested about 6 months ago (as part of regular check-up, given the exposure to blood I'm guessing this increases the risk somewhat.  Would it be wise to get tested in a few weeks?

[Edward W Hook, MD]

Having had a negative test six months ago, your concern is the exposure describe above.  Blood or no blood, gum disease or not, the odds of infection are lower than your odds of havng a false positive test.  I do not recommend testing for you.  EWH

[JonnyBGood]

Hate to sound like a Hypocondriac, but tonight about two weeks later I've developed a slight fever 99.0 - 99.1....if this gets higher should I seek medical treatment...could this be HIV?

[Edward W Hook, MD]

No.  EWH

[JonnyBGood]

Dr. Thanks again for your understanding and support through this scary time....I recently was reading about HIV and came across the CDC reccomendations for PEP

What is a high-risk exposure?

PEP is only recommended for high risk exposures to HIV that have occurred within the past 72 hours. A high risk exposure would include:
• Unprotected vaginal or anal sex with known (or likely) HIV positive partner.
• Injection drug use needle exposure
• Needlestick or other puncture/cut from a sharp
• Sexual assault survivor
• Non-intact skin (open cut or wound) or mucus membrane (eyes, nose, mouth, etc) contact with blood

The last bullet point concerned me, I was considering PEP after this exposure to blood in my mouth, however was assured it was low risk when I called a PEP clinic....were they wrong???

[JonnyBGood]

Any comment on this Dr. or anyone else?

[Edward W Hook, MD]

As was said in the very first post to your questions, your exposure is not high risk. First your partner was not infected.  PEP is for persons exposed to known infected persons.  Secondly gum disease, or possible gum disease does not make the grade either--the kinds of wounds they are talking about are open surgical wounds of similar large defects in the skin or large volumes in infected blood on mucous membranes.  As we say again, and again, and again -the virus is not efficiently transmitted through oral contact.  EWH

[NrvsGayman]

Thanks Dr. Appreciate it