Aa
Deeply concerned
Hello Doctor,
I checked the forum and didn't see this specific question answered before. Hopefully I didn't overlook anything. I am a gay male and today I received a massage from a man. Once I had turned over he proceeded to perform oral sex on me. At one point he tugged on my penis and the skin at the base of my head where the head and shaft meet tore and my penis began to bleed. This has happened to me in the past and I believe it is the result of a poorly performed circumcision.
The second he tugged on it I knew that the skin had torn and I immediately had him stop. Looking back I don't believe his mouth was completely around my penis at that point. He did not appear to have any cuts on his lips and he didn't appear to be obviously bleeding in his mouth at the time. Still I'm now sitting here working through it all in my head and am absolutely terrified. Unfortunately I do not know his HIV status as I was too afraid to ask after the incident. If it makes a difference this occurred in SLC, UT.
Any help with this matter
I checked the forum and didn't see this specific question answered before. Hopefully I didn't overlook anything. I am a gay male and today I received a massage from a man. Once I had turned over he proceeded to perform oral sex on me. At one point he tugged on my penis and the skin at the base of my head where the head and shaft meet tore and my penis began to bleed. This has happened to me in the past and I believe it is the result of a poorly performed circumcision.
The second he tugged on it I knew that the skin had torn and I immediately had him stop. Looking back I don't believe his mouth was completely around my penis at that point. He did not appear to have any cuts on his lips and he didn't appear to be obviously bleeding in his mouth at the time. Still I'm now sitting here working through it all in my head and am absolutely terrified. Unfortunately I do not know his HIV status as I was too afraid to ask after the incident. If it makes a difference this occurred in SLC, UT.
Any help with this matter
MEDICAL PROFESSIONAL
Welcome to the HIV prevention forum.
Oral sex is basically safe sex, especially for the insertive (penile) partner. HIV is rarely transmitted from someone's mouth, even when HIV is present, in part because saliva inactivates HIV. Some experts believe there is no risk at all; and another estimate suggests transmission once for every 20,000 exposures -- which is equivalent to receiving oral sex by HIV infected partners once daily for 55 years and maybe never catching the virus. The apparent injury during the course of exposure might elevate the risk, but even doubling an extremely low risk still leaves very low chance of infection (e.g. 1 chance in 10,000, equivalent to daily exposure for 27 years instead of 55.)
People with this level of risk really do not need HIV testing after individual exposures. Instead, it is best to simply plan on a regular HIV test every 1-2 years. If you haven't been tested recently, this would be a good time, since it is on your mind. But not because of this particular event.
Now I have to comment on "Unfortunately I do not know his HIV status as I was too afraid to ask after the incident". That was your first mistake, to not ask about HIV status BEFORE you got involved. Even though oral sex is basically safe, in the heat of the moment sometimes things go farther than intended, e.g. anal sex. It is very unwise for any male to ever have sex with another man without discussing and sharing HIV status together ahead of time, and either avoid sex entirely or be especially careful about safe practices for those who are positive, don't know, or seem evasive about it. Of course people can lie, but most do not; and of course someone could have caught HIV since his last negative test, but that also is statistically uncommon. Anyway, think how much less concerned you would be now if you knew your partner believed he doesn't have HIV.
Sorry for the lecture, but I take the chance to repeat this message every chance I get. Follow this advice -- plus condoms for anal sex with non-monogamous partners -- and you can expect to go a lifetime without catching the virus. Regularly ignore it and you're playing with fire.
Anyway, even now you should call your partner and ask his HIV status, if you know who he is and can locate him. You might find he is just as nervous about the event as you are and would appreciate your personal confidence you don't have HIV. After all, from a statistical standpoint he was at a lot higher risk for HIV from you than you were from him.
I hope this helps. Best wishes. And please get into the "do ask, do tell" habit.
HHH, MD
Oral sex is basically safe sex, especially for the insertive (penile) partner. HIV is rarely transmitted from someone's mouth, even when HIV is present, in part because saliva inactivates HIV. Some experts believe there is no risk at all; and another estimate suggests transmission once for every 20,000 exposures -- which is equivalent to receiving oral sex by HIV infected partners once daily for 55 years and maybe never catching the virus. The apparent injury during the course of exposure might elevate the risk, but even doubling an extremely low risk still leaves very low chance of infection (e.g. 1 chance in 10,000, equivalent to daily exposure for 27 years instead of 55.)
People with this level of risk really do not need HIV testing after individual exposures. Instead, it is best to simply plan on a regular HIV test every 1-2 years. If you haven't been tested recently, this would be a good time, since it is on your mind. But not because of this particular event.
Now I have to comment on "Unfortunately I do not know his HIV status as I was too afraid to ask after the incident". That was your first mistake, to not ask about HIV status BEFORE you got involved. Even though oral sex is basically safe, in the heat of the moment sometimes things go farther than intended, e.g. anal sex. It is very unwise for any male to ever have sex with another man without discussing and sharing HIV status together ahead of time, and either avoid sex entirely or be especially careful about safe practices for those who are positive, don't know, or seem evasive about it. Of course people can lie, but most do not; and of course someone could have caught HIV since his last negative test, but that also is statistically uncommon. Anyway, think how much less concerned you would be now if you knew your partner believed he doesn't have HIV.
Sorry for the lecture, but I take the chance to repeat this message every chance I get. Follow this advice -- plus condoms for anal sex with non-monogamous partners -- and you can expect to go a lifetime without catching the virus. Regularly ignore it and you're playing with fire.
Anyway, even now you should call your partner and ask his HIV status, if you know who he is and can locate him. You might find he is just as nervous about the event as you are and would appreciate your personal confidence you don't have HIV. After all, from a statistical standpoint he was at a lot higher risk for HIV from you than you were from him.
I hope this helps. Best wishes. And please get into the "do ask, do tell" habit.
HHH, MD
MEDICAL PROFESSIONAL
This situation does not warrant PEP. However, if you contact your partner and learn he has HIV, you might contact a local physician who understands HIV prevention. Opinions and guidelines about PEP vary from place to place and I cannot take responsibility for that decision in the event your partner is actually infected. (This is not "code" to suggest that I really think there was high risk; I do not.)
Thank you for your feedback Dr. The lecture is appreciated as I definitely acted stupidly. So I take it I should not seek out PEP after this incident?
You are reading content posted in the HIV - Prevention Forum
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
Can I get HIV from surfaces, like toilet seats?
Can you get HIV from casual contact, like hugging?
Frequency of HIV testing depends on your risk.
Post-exposure prophylaxis (PEP) may help prevent HIV infection.
