Dr. Atishay Bukharia
Dermatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a 29 year old male. I had a very brief unprotected encounter with an escort. I do not know her HIV status. I did ask her afterward and she told me she was clean of STDs (Sexually Transmitted Disease). I offered to pay her well just to get an HIV status and she has not responded. I do not know if this is because I annoyed her or because she is hiding something. I am not someone who participates in high risk sexual activities. I understand that this situation is low risk. I have spoken to an HIV (Human Immuno Deficiency Virus) specialist. I am on PEP (Poat-exposure prophylaxis) because of nervousness. I cannot sleep or relax. I am in a constant state of panic. I would like to know your personal experience on this subject. How would it be possible to get HIV from a positive person performing oral sex for a man? Do you think I will be fine based on what I have told you? Will fourth generation Ag or Ab (Antigen or antibody) test immediately post PEP a good indicator of my status? In the past I did have anxiety and may be considered a hypochondriac. Please help. Thank you.
Hello, Welcome to icliniq.com.
Your exposure was not sufficient enough to acquire human immunodeficiency virus (HIV virus). Frankly speaking I have not seen a single case of HIV (Human Immunodeficiency Virus) with such a short exposure. Oral sex particularly from the donor point of view is considered as safest sexual practice as far as HIV is considered.Various studies have shown the amount of HIV in saliva is almost nil. Therefore, in many countries it is not even considered as a potential exposure for post-exposure prophylaxis. I am quite sure that you will not acquire HIV with such a brief exposure. Further, you are taking post-exposure prophylaxis (PEP), which will also decrease the chances. But, personally I would not have prescribed the one for such exposure. So, be assured of yours being HIV negative. Go for fourth generation test if you want. Two fourth generation tests from two different laboratories in a gap of two weeks are considered as confirmatory.
Patient's Query
Hi doctor,
Thank you for your response. Do you think I should stop taking PEP (Post-exposure prophylaxis)? It was only given to me because I was very nervous and felt like my world was over. My main question is in response to what you said about saliva. I was always told that saliva could not transmit HIV (Human Immunodeficiency Virus). So in regards to receiving penile oral what in your opinion would it take for one to be infected? When should I get the fourth generation test? If I continue with PEP will it affect the tests? Please explain.
Hi, Welcome back to icliniq.com.
I said that in my country we do not provide PEP (Post - exposure prophylaxis) for such exposure with urine, nasal secretion, saliva, sweat and tears as these secretions contains negligible HIV virus. Once PEP started, you should continue the course. I have already explained that there is nothing absolute in medical science. It works on probability. So, your chance of acquiring HIV is negligible. Yes, it does affect the virus proliferation so testing is done after two weeks of completion of Post-exposure prophylaxis (PEP) and the next one after three months (according to guidelines).
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Dermatology
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