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Is Inner Cut On Lower Lip After Deep Kisses And Unprotected Blow Job A Sign Of HIV And Which Is The Best Test To Confirm HIV?

Posted on Thu, 9 Jan 2014

Question: Hi dr 3 days back I was in a strip bar , got drunk and picked one female stripper back home , we had deep open mouth kisses and then she game me un protected blow job . I inserted my finger in her ass . 2nd day I remembered that I had a cut in my inner part of my lower lip about 1 day or 2 before the kissing . The cut was due my own lip bite My finger had a burn also a day before the insert . Skin seems intact . I am going home after 10 days My questions what was / is my risk of hiv ? How good p24 anti genes / anti body after 10 days from now I.e after 13 days from possible exposure . How good PCR after 10 days from now ? If all above tests well and negative can I sleep with my wife without condom ?

Answered by Dr. Dr. Ivan Romich (52 minutes later)

Brief Answer: Hi and welcome to XXXXXXX Detailed Answer: Considering all this,the risk is very low,almost negligible. The only risk in your case was unprotected receptive oral sex and it is about 3-4 per 10 000 exposures. transmission through open wounds is possible only if there is bleeding wound in both partners which are in close contact. it doesnt include burns or 2 days old wounds. So you dont have to be worried,but for your satisfaction you can do HIV testing,especially if you suspect that your partner had HIV. Hiv P24 Antigen Test is around 90% accurate at this point while PCR is 98%. If you do this test and it is negative,considering very low risk of transmission and more than 90% accuarcy of this test,I think it is safe to have sex without condom,but it is your decision Wish you good health. Feel free to ask. Regards So it

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ivan Romich (13 minutes later)

Dear dr. Many many thanks for the quick answer . I need just to clarify Quote The only risk in your case was unprotected receptive oral sex Unquote are you referring here to the kisses ? Or to the blow job ? If the blow job she sucked my dick which I guess here I am not receptive . I doNt know her status therefore I am sorry to say but she becomes suspect When you referred to accuracy of test AT this point do you mean as on today date I.e 17th dec when the exposure was on 15th or you meant after 13days of exposure . Sorry dr I just needed to understand these 2 point God bless you Dear dr Sorry but another dr. Seems my exposure was high due to the burned finger , he also suggested me I start pep Quote of contact of finger with break in continuity due to burn and getting exposed to anal secretions which may contain high load of virus in case she is infected. I would suggest you to start with post exposure prophylaxis at earliest. First dose can be taken from the emergency department of any government or private hospital. Unquote Having in mind the burn at my finger about 36 hours before exposure Should I start pep ? Any harm to start and use till a get tested after 10days and then stop ? Pls advise soonest

Answered by Dr. Dr. Ivan Romich (3 hours later)

Brief Answer: Hi Detailed Answer: I meant 13 days after exposure. I was referring to "oral sex",but i said receptive despite insertive,my mistake. Everything else I said was right. I disagree that 36 hours old burns (1st degree) with intact skin can increase the risk of hiv transmission even if it was in contact with contaminated anal secretions. If you still choose prophylaxis, you should take it within 3 days and 10 days is definitely too late. It would be very helpful if you could find was this girl HIV positive. So,generally there is very low risk of transmission and it is up to you to decide will you or not take prophylaxis. Such prophylxis is recommended after anal or vaginal sex with suspicious person. I cant give you better advice. But transmission through finger cuts or burns is reported extremely rarely,even in much bigger rand deeper wounds.and I told you about transmission risk for oral sex. If you think that this risk is enough to make you feel anxious,you should have prophylaxis but today. I dont think you should be worried,but take HIV test in 2 weeks just to be sure.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ivan Romich (2 hours later)

Thanks Dr. I do trust your advice , going extrem cases , is it not better to take pep ? If pep taken in 4 days will it kill the hiv ? Will the pep give false test results after some time I.e show +ve while negative or vise versa ? It is not better to take pep for 10 days from 4th day and get tested and if results fine stop the pep ? It's not 10 days yet , it's 3.5 days .

Answered by Dr. Dr. Ivan Romich (7 hours later)

Brief Answer: Hi Detailed Answer: Well,5 days postexposure is maximal upper limit for PEP, but you should take it as soon as possible. It will not give false results. if HIV test is negative after 4 weeks,even if you use PEP, then you are not infected and you dont have HIV virus in your body. PEP is taken usually for 4 weeks since this is standard PEP course. So I suggest to take it for 4 weeks from now and then do testing. This will rule out even this minor minor possiblity of HIV transmission.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ivan Romich (21 minutes later)

Thanks a million dr . I am sorry for all troubles I caused . Just wanted to start by saying my specialist here is same opinion of yours about the risk , but frankly dr I didn't want to take further chance and he gave me Odivir kit 400mg . I started an hour back ie at the 82 hr of risk of exposure 3.3 days I hope that's not late , I hope even their is no need to it . I asked that female to do her check finally she promised to do it today . I hope she will so and she will be fine . I did 2 tests at 36 hrs one is p24 and the other is PCR . P24 came negative , PCR results yet to come ( expected today ) I know 36 hr just too early specially for p24 correct me if I am wrong . How good PCR at 36 hrs ? Thanks again sir

Answered by Dr. Dr. Ivan Romich (4 hours later)

Brief Answer: hi Detailed Answer: I understand your concerns and I hope you ll use protection in future. But risk is really minor and you just must not think about it and dont allow to be anxious. Also, dont hurry with tests and dont spend money on unnecessary testing. PCR and p24 testing is really too early after only 36 hours. be patient for 5 more days and then do it. it will be almost 100% accurate then. If you do test now,it cant effect on your HIV status. It will be the same after 3 days or 3 weeks. So just be patient.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ivan Romich (3 minutes later)

Thanks dr . Appreciated