Is PEP required after unprotected oral sex?

Question

Hello doctor,

I am a 25-year-old male. Recently, I went for a trip and ended up engaging in sexual activity with a female sex worker. I first did vaginal intercourse with a condom and then oral sex using the same condom (with the vaginal fluids). After 15 minutes, I got unprotected oral sex from the worker. Could this lead to HIV (human immunodeficiency virus) transmission because the initial vaginal fluids may be present in her mouth? Before the act, both had a shower and mouthwash. Should I start the PEP (post-exposure prophylaxis) medication?

Kindly guide.

Answer 1

Hi,

Welcome to icliniq.com.

First, protected sexual activity carries negligible risk. Protected or unprotected oral sex carries no risk, as HIV transmission through oral sex is none, considering she has no oral bleeding or ulcers, and you have no ulcer on the penis. A shower bath will not protect from HIV, and vaginal fluids in the mouth during oral sex carry no risk, as these fluids will be neutralized by lipases in saliva. PEP (post-exposure prophylaxis) is indicated only within 72 hours of the act and is not effective after that period. You have a very negligible risk (0.01 %) of transmission, considering she might be reactive.

I hope this helps.

Thank you.