I am so afraid, cant sleep at night, etc

[I_Am_Terrified_Wow]

Hello, first let me apologize because I am sure you guys are burdened enough by these post already, but I don't know where else to go.

Some background, I was drunk the other night and received head from a random girl from a house party. I know this was a non-risk event so that's not what I'm worried about. Things were going alright yet this is where the scary part starts. For a second we almost initiated intercourse, our genitals made brief contact for a moment, and since she was menstruating, some blood got on the head of my penis. There was NO insertion, but blood did get on my penis, and our genitals did make contact unprotected. We both agreed that we shouldn't without proper protection, and she returned to oral. I woke up the next morning and realized that the blood could have gone up my urethra. Afterwards I asked her if she had any STI's, and she claimed she only had sex once and given head one other time, and had no STI's. (she obviously could be lying, idk, can't just go off of trust).

I described this to my primary care doctor and after 65 hours of the initial exposure, I was prescribed PEP. I am a nervous wreck when it comes to my health. A lot of people have told me that they are surprised I was prescribed PEP, but to me it makes sense.

I am deathly afraid and I am not sure what to do besides post here. Some things I wanted to ask

-Is it possible that because she was on her period, I should be more concerned?

-Am I freaking out over nothing?

-Was this an actual exposure?

Thank you

[Jim Allen]

Hiya,

Read your post three times; if what you posted is true and you are not leaving anything out like brief penetration there wasn't an HIV risk to you.

No drama needed, move on with your life.

Here's what you need to know to reduce your HIV risks:
Use condoms for anal or vaginal intercourse correctly and consistently, with no exceptions. Consider talking to your healthcare provider about PrEP as an additional layer of protection against HIV

Keep in mind that some sexual practices described as safe in terms of acquiring HIV still pose a risk for other easier-acquired STIs. So please do get tested at least yearly for STIs, including but not limited to HIV, and more frequently if condomless intercourse occurs.

Also, note that it is possible to have an STI and show no signs or symptoms; testing is the only way to know.

Kind regards

Jim

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[I_Am_Terrified_Wow]

Hello, thank you so much for the quick response, I see how active and helpful you are on this forum and I think its wonderful you do this first of all.

Really quickly, not to be redundant or keep asking, but if her menstrual blood did make contact the tip of my penis, and she returned to oral, is there any chance that the act of oral would have therefore pushed the blood up my urethra? or if I had micro-tears from oral, would that still pose a threat? thank you again.

[Jim Allen]

No.

And I have a lot to say but you need to wait an hour because I'm cooking dinner

[I_Am_Terrified_Wow]

I'll wait, hope the dinner is good !!

[Jim Allen]

if her menstrual blood did make contact the tip of my penis, and she returned to oral, is there any chance that the act of oral would have therefore pushed the blood up my urethra?

It's not an HIV concern. HIV is fragile, and the receptors needed to infect corrode outside the confines of the human body, leaving it unable to infect you before she blew you; your penis was exposed to the environment, it was even when whatever fluids touched it got on it and saliva is also hostile towards HIV.

Anyhow, receiving a blowjob lacks the conditions required for acquiring HIV; thus, it makes sense that after 40+ years of this pandemic in terms of BJs, there hasn't been a single documented case of HIV transmission to an insertive partner (the person being "sucked"). Nothing you posted here is unique or changes anything, so you will not be the world's first.

if I had micro-tears from oral

It's not a direct route to the bloodstream for you to acquire HIV, and during a blowjob, there was no exposure to viable HIV. The same can be said for any contact your penis had with fluids unless you had anal or vaginal condomless penetration.

thank you again.

You're welcome. As I said, no drama is required; what you posted here doesn't require or warrant HIV testing, let alone PEP.

Move on with your life, use condoms for any intercourse, and as you are sexually active, get a yearly screening out of routine for STIs & HIV.

[Jim Allen]

A lot of people have told me that they are surprised I was prescribed PEP

I'm not. studies have shown PEP is prescribed when it's not required.

A mix of reasons; most people lie about their potential exposures. Every second poster here wants me to believe they are innocent and a 40-year-old virgin I mean, plenty of studies show people claiming to have had no HIV risks despite not using condoms or not considering sex with friends a risk because they are friends  Long story short, whatever someone claims, a doctor needs to take it with a massive pinch of salt. 

Also, most doctors generally will not have any in-depth knowledge about HIV. Why would they? I mean, HIV isn't very common at all, thankfully.  And some also prescribe PEP to calm people down or to get rid of them even if they have had no HIV risk, so mental/emotional health reasons.

Anyhow, my point is plenty of reasons to give PEP, even if the person says their concern is about an activity that isn't an HIV risk.

*Few references as example:

Decisions About PEP in the ER Are Not Always by the Book
https://www.poz.com/article/decisions-pep-er-always-book

In one Swiss emergency room, 22 percent of decisions about prescribing post-exposure prophylaxis against HIV did not follow guidelines.

For 12 percent of these visits, the hospital staff prescribed PEP to people who were not considered at risk for HIV. Ten percent of the visits involved people who were at risk for HIV but did not wind up receiving PEP.

2018
https://doi.org/10.1016/j.eclinm.2018.08.001

STI Risk Perception in the British Population and How It Relates to Sexual Behaviour and STI Healthcare Use: Findings From a Cross-sectional Survey (Natsal-3)

We have identified falsely optimistic views of personal STI risk among a substantial proportion of those at risk of STIs in the British population, which could have a negative impact on efforts to promote safe sex and STI testing, and the control of STIs.

Among those classed as having ‘unsafe sex’ in the past year (comprising approximately 1 in 5 sexually-active 16–44-year-olds), 39.2% of men and 51.0% of women rated themselves as not at all at risk of STIs

2018
http://journals.sagepub.com/doi/abs/10.1177/0032885517753163

Underreporting in HIV-Related High-Risk Behaviors: Comparing the Results of Multiple Data Collection Methods in a Behavioral Survey of Prisoners in Iran

Participants reported more sexual contact in prison for their friends than they did for themselves. In men, NSU provided lower estimates than direct questioning, whereas in women NSU estimates were higher. Different data collection methods provide different estimates and collectively offer a more comprehensive picture of HIV-related risk behaviors in prisons.

2018
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5268760/

Socially desirability response bias and other factors that may influence self-reports of substance use and HIV risk behaviors: A qualitative study of drug users in Vietnam

The accuracy of self-report data may be marred by a range of cognitive and motivational biases, including social desirability response bias

2018
http://emj.bmj.com/content/35/1/46
Self-perceived risk of STIs in a population-based study of Scandinavian women

Subjective perception of risk for STI was associated with women’s current risk-taking behaviours, indicating women generally are able to assess their risks for STIs. However, a considerable proportion of women with multiple new partners in the last 6 months and no condom use still considered themselves at no/low risk for STI.

2018
https://www.tandfonline.com/doi/abs/10.1080/09540121.2017.1384787

Social desirability bias and underreporting of HIV risk behaviors are significant challenges to the accurate evaluation of HIV prevention programs for orphans and vulnerable children (OVC) in sub-Saharan Africa

2018
https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(18)30062-6/fulltext

Non-disclosed men who have sex with men in UK HIV transmission networks: phylogenetic analysis of surveillance data

Jim: In short they analysed the genetic code of the virus from HIV-positive people and came to the conclusion that some of the self-reported heterosexual mens HIV was more than likely actually non-disclosed MSM.

2017
https://www.ncbi.nlm.nih.gov/pubmed/28509997

Social Desirability Bias and Prevalence of Sexual HIV Risk Behaviors Among People Who Use Drugs in Baltimore, Maryland: Implications for Identifying Individuals Prone to Underreporting Sexual Risk Behaviors.

2017 --In regards to STI's
https://journals.lww.com/stdjournal/toc/2017/07000
Sexually Transmitted Diseases: July 2017 - Volume 44 - Issue 7 - p 390–392

Is Patient-Reported Exposure a Reliable Indicator for Anogenital Gonorrhea and Chlamydia Screening in Young Black Men Who Have Sex With Men?

Among 485 young black men who have sex with men recruited in Jackson, MS, 90-day anal sexual exposure significantly predicted rectal infection, but 19.4% of rectal infections would have been missed among men denying receptive anal sex. Reports of consistent condom use were associated with lower infection rates only in men reporting insertive anal sex.

2016
https://www.sciencedirect.com/science/article/pii/S0010782416305418
Could misreporting of condom use explain the observed association between injectable hormonal contraceptives and HIV acquisition risk?

Jim - Not a conclusive or in depth study but under the study participants it did find: 9 out of every 20 sex acts reported with condoms are actually unprotected

2013

Rollins School of Public Health, Emory University, and the Kensington Research Institute, Silver Spring, MD 20910, USA https://www.ncbi.nlm.nih.gov/pubmed/14655794

"At risk" women who think that they have no chance of getting HIV: self-assessed perceived risks.

more than one-half of the "no perceived risk of HIV" sample had engaged in at least one risky practice during the preceding year and more than one-quarter had engaged in at least two such behaviors


2009
The Validity of Teens’ and Young Adults’ Self-reported Condom Use
https://jamanetwork.com/journals/jamapediatrics/articlepdf/380711/poa80067_61_64.pdf

A significant degree of discordance between self-reports of consistent condom use and YcPCR positivity was observed. Several rival explanations for the observed discordance exist, including (1) teens and young adults inaccurately reported condom use; (2) teens and young adults used condoms consistently but
used them incorrectly, resulting in user error; and (3) teens and young adults responded with socially desirable answers

BMC Public Health 2007
https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-7-60

Analyses of data from the Demographic and Health Surveys, Sexual Behaviour Surveys and from other countries show a similar pattern indicating under-reporting
It is probable that as HIV campaigns encouraging delayed sexual debut and abstinence before marriage reach the population, people will report behaviour
assumed to be more socially desirable.

there are some signs of differential reporting bias in our study. We found that controlling for less risky sexual behaviour substantially reduced the association between HIV and survey time among urban men, but less so among women; this may suggest that self-reports from men about sexual behaviour are more reliable. Studies suggest that respondents, especially women, tend to under-report the number of lifetime sexual partners . Therefore, analyses of associations with, and changes in, self-reported sexual behaviour should be interpreted with caution.

2010
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2957626/

Self-presentation bias (wishing to be viewed in a positive light) may result in patients underreporting behaviors they perceive to be stigmatizing

Approximately a third of the men in the sample reported that they did not disclose all of their risk behaviors to the HIV counselor during the face-to-face risk assessment. These results echo similar studies of risk disclosure to medical providers

[I_Am_Terrified_Wow]

Thank you so much for you advice and in-depth response! I appreciate it immensely. I wouldn't be surprised if the doctor prescribed it to help ease my anxiety, and in complete honesty I will most likely finish the 28 days of PEP (just for my own anxiety, even though I DO believe you when you said it was a non-risk encounter. I just know that without it, id panic even more than I was previously). Again, thank you so much, hope dinner turned out well

[Jim Allen]

You're welcome.

You don't need PEP; I will not pretend you do because it doesn't help you long-term or with your real/underlying issues, and it would be a disservice to you and the community to pretend otherwise. If your irrational fear is that bad or you keep having these fears during future no-HIV-risk situations, I recommend you consider talking to a qualified therapist instead.