QUESTION
I was getting a blow job from a guy and afterward I noticed I had brown blood on my penis and blotches of saliva mixed with brown blood on my white underwear. Fortunately I had no cuts or abrasions on my penis. Here are my questions: 1) Assuming the person giving me the blow job was in fact HIV+ (I know not), what is the likelihood of me being infected? 2) Also, if there was enough blood, couldn't it overcome the barrier that saliva usually offers?

A local infectious disease doctor started me on the P.E.P. combo of Combivir and Viracept about 20 hours after exposure. He said I need to take it for 6 months. Wow! I'm a wreck -- upset that I was so careless. Any advice would be greatly appreciated.

ANSWER
Current recommendations for PEP are 28 days, although it is not uncommon for doctors to use guidelines, but not follow them exactly in all situations.

That said, oral sex carries a very, very low risk of HIV transmission. At City Clinic we do not offer PEP to people exposed to HIV through oral sex regardless of the circumstances. One recent study has shown the risk to be as low as zero, but there are case reports out there of men who have gotten HIV from participating in oral sex only. Best to speak to your doctor, or get a recommendation to another local provider if you want another opinion for how to move forward.

Being exposed to HIV, even possibly, is a very anxiety-provoking experience. For some people, the anxiety leading up to the 3-month HIV test and its results is debilitating. They suffer from irritability, sleeplessness, fatigue, depression, personality changes, headaches, and more. If you are experiencing any of these symptoms, speak to a counselor who can help you work through them.

To your health,
Dr. K