Unprotected Insertive Oral Sex and Risk/PEP

[Sat_Blue]

Writing because I’m scared and don’t know what to do.

The Facts:
Saturday night I was beyond drunk and went to a bath house type place in Tampa, FL. I do not frequent these places, but have been a few times before.

I did not participate in anal sex – insertive or receptive.

In a room with other guys, this older guys began to masturbate me (I’m 29.  He was a white male 45 – 55).  He then began to give me oral.  My head was leaned back so I did not notice when he first did this, but once I realized, I immediately stopped him.  It literally lasted less than 10 seconds (generous estimate.  Realistically 5 seconds) – no ejaculation.  As soon as I realized, I wiped the moisture from his saliva away with a towel.  I do not know his HIV status.

I’m concerned because I’ve heard conflicting information regarding HIV transmission and oral sex.  I was the insertive male and did not perform on anyone.  

I’m also concerned because I have an undiagnosed condition that my doctors are working out where there is trace amounts of blood in my urine, so there may be some damage to my urethra, which is causing this.

My Questions:
I’m still in the window period for PEP.  Should I attempt to get a prescription?

I’m concerned that the potential damage to the lining of my urethra may increase my risk of transmission.  Is this valid?

Is my concern ridiculous?  I’ve read so many conflicting information including the neutralizing effect of saliva, bleeding gums and mouth sores, etc.

Do I have anything to worry about?

I know I need to stop making bad choices and stop going to these places as it is unsafe.

Thanks for your time.

[Edward W Hook, MD]

Welcome to the Forum.  If you were my patient I would not recommend PEP for you.  The encounter you describe was virtually no risk and you are far, far more likely to experience side effects from the exposure than to develop HIV.  You do not know that your partner had HIV and even if he did, the quoted figure for HIV risk, if one has oral sex (receiving or giving) with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  

By the way, when men have trace amounts of blood in their urine, the blood is rarely is coming from the urethra.  Instead it typically comes from the bladder or the kidneys, thus again there is no reason to be concerned that the source of the red blood cells in your urine might represent increased risk for HIV.

In fact, your risk of HIV from this exposure is so low that there is not even a medical indication for testing, much less PEP.  I hope this comment is helpful.  EWH

[Edward W Hook, MD]

I agree, PEP is not only not a good idea. All things considered, it's probably a bad idea.

By "no medicasl indication" for testing I mean that some of our clients choose to get tested for their own peace of mind, despite the fact that there is no medical reason to do so.  EWH

[Sat_Blue]

Regarding the blood in urine - there is also some penile soreness when it happens.  I know it's not STD/STI related, so that's why the urologist suspects damage to the urethra lining.

Thanks for the advice.  It seems like PEP is not the best option.  I'm just worried sick.

Can you explain "there is not even a medical indication for testing?"  I pray that when I do test again that it is negative.

Thanks.