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Avatar universal

Receptive oral swallow semen of hiv positive

Dr, I was very very drunk and ended up doing mutual oral with three transexuals at a party in brazil.... I swallowed partial semen of all, then ran and washed out with soap in my mouth and drank and gaggle coca cola. There was no other risk, I did anal insertive with condom briefly. When sober up, totally freaked and got PEP, started 18 hours after. This happened 5 DAYS ago and been unable to close my eyes to sleep. Wish I knew how much I messed up and the actual risk, I found out that one is positive, the others I still dunno. What are my chances of surviving this without infection? I was put on Combivir and efavirenz
7 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.  Thanks for your question.

Since you are under care with PEP drugs, that doctor or clinic really ought to be the primary source of information about your risk, follow-up plans, etc.  Therefore, my comments are brief.

Based on HIV infected persons' sexual histories of when and how they were infected, a CDC study calculated a risk of 1 HIV infection for every 10,000 episodes or performing fellatio on infected partners.  That's equivalent to performing oral sex on infected men once daily for 27 years before infection might be likely.  On that basis, your risk obviously was low; many experts would not have recommended PEP for such an exposure.  Other unknown factors may have made your risk lower still -- for example, if your infected partner was taking anti-HIV therapy, there may have been no risk at all.  And now with PEP, you can be very sure you won't become HIV positive.

For those reasons, you can relax and not worry.  I hope this has been helpful.

HHH, MD
Avatar universal
Dr, I appreciate your comments as there is some peace of mind. To clarify, there were three parties, all prostitutes, one positive, the other two unable to reach therefore unknown, lets assume the same. Hence, three episodes per say. I'm very scared since I tend to bleed a little when brushing my tooth, but after incident I did not sense any blood. In case there was any infection, would the PEP take care of it, how reliable is it?
Avatar universal
correction, the Pep was started 28 hours later
239123 tn?1267647614
MEDICAL PROFESSIONAL
In most places, under 1% of sex workers have HIV -- so the chance all three were infected is very low.  But even if all 3 were infected, the risk would only be 3 times higher -- i.e. 1 chance in 6,700 instead of 1 in 20,000 -- still so low that I would not have recommended PEP.  Nobody in the world has ever been proved to have caught HIV from receiving oral sex; you are not going to be the first.

That you have slightly inflamed gums might elevate the risk, but when the risk is so low to start, this really doesn't matter.  The "reliability" of PEP isn't known for sure, but it's probably more than 90% effective when started within 2-3 days after exposure.

Therefore, this additional information does not change my opinion or advice.  Do your best to stop worrying about it.  Follow up with the docot or clinic who prescribed the PEP if you have any further concerns.
Avatar universal
Dr, I was performing/receptive the oral sex, so like you said before 1 in 10,000 for a single case or 1 in 3,333 for this case..
My last question, how reliable is Combivir and Efavirenz as PEP when compared to Kaletra and Truvada... I am in another part of the country without STD access.  I was giving the pills and traveled the next day. You are my only resource.
Thank you so much
239123 tn?1267647614
MEDICAL PROFESSIONAL
Three are no data by which to compare these two PEP regimens.  There has never been research on the effectiveness of PEP in humans -- only the educated judgment of HIV treatment experts.  Both regimens are believed to be effective.

No online forum is ever an appropriate source for direct medical care. Individualized medical advice must always come from in-person care. (MedHelp's standard disclaimer makes it very clear that we do not provide personal medical services.)

Accordingly, that will end this thread. I will have no further comments or advice of any kind. Good luck.
Avatar universal
Dr, thank you for your comments and support, i just received the negative results of a fourth generation antigen test performed one week after exposure which Dr mentions to be 99% accurate of proving there was no exposure to the virus. I'll probably test again at 12 weeks for additional peace of mind. Thanks
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