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Is PEP HIV treatment warranted after 72hour window?

Resolved Question:

Hello

This passed Sunday I had a sexual encounter with a man. He said his hiv status was negative but I am unable to confirm that.

He preformed oral sex on me till I ejaculated. I preformed oral sex on him for no longer that 30 seconds. He did not ejaculate as far as I could tell. We did nothing else of risk whatsoever.

I am just outside of the 72 hour windows, would any PEP treatment be warranted?

Category: HIV- AIDS Specialist

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Category: HIV- AIDS Specialist
 28 Doctors Online

Hello,
Thanks for your query at DoctorSpring.com
I understand your concern
Effectiveness of PEP decreases substantially after 72 hours. Because, you had oral sex you have minimal chances of getting infected with HIV. But you need to confirm your HIV status as soon as possible.
Hope this was helpful
Feel free to ask further
Regards


Patient replied :

Thank you, I guess my next question is how concerned should I be. How are my odds are there any documented cases of someone acquiring hiv through oral sex?


Hello,
There is no reason to worry. I asked you to get the test done because a lot of patients suffer from constant anxiety and hence seeing conclusive result is better.
Till the ejaculate comes in contact with some open lesion in the mouth, there is no way HIV can be spread through oral sex. As it is the chances are extremely low. And also there are no such documented cases or I have never come across such a case till now in my clinical practice.
So do not worry.
Regards.


Patient replied :

Thanks Doctor. Your absolutely right anxiety is what is getting the better of me here. I am extremely careful in the sense that I am always aware of my partners sexual background, which is why I'm essentially beating myself up here.
The only other thing I can possibly add (last question) is that I sometimes suffer from sensitive/bleeding gums, which is not constant or severe in anyway. I just hope that a condition like that will not play a factor?


No it won't provided you did not have any open lesion in your mouth.
The point is even if you did the chance of such transmission is only 0.5- 1% from such an exposure ( theoretically ).
Such a case has not been documented though.
Regards.


Patient replied :

Thanks again doctor, I have one more follow up question. I came across this previous response you have another individual, it seems to contradict what you told me. Have there been documented cases of this kind of transmission? This previous answer also gives saliva as a transmission route. Below is the article, just wanted to clear this up.

http://www.doctorspring.com/question-mobile/unprotected-oral-sex-and-concern-about-hiv-transmission


Hello,
In the article if you see the patient mentioned he has a lot of bruises from itching. Scrotal itching can very easily erode the skin leading to an open mucosal lesion.
Now in this case the chances of HIV transmission through oral sex will be slightly higher ( may be 0.5-1 % ) but not more than that.
There has been no such reported cases. Please do not worry.
Just for your reference, there is only one way HIV can be transmitted through oral sex. If the partner ejaculates inside the mouth, and there happens to be an open lesion in the mouth, the chances are higher. Ejaculate contains enough viral load which when comes in contact with the open lesion can spread the infection.
So please do not worry.
Hope this was helpful,
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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