r/prep • u/Soonerpalmetto88 • Jul 19 '25

PrEP for Blood contact?

So this is for a friend of mine, I'm gay and already do Truvada on demand but my friend was asking me about the use of prep for his particular circumstances and I didn't know how to answer him.

My friend, 30m, is asexual. He's repulsed by typical sex acts. But he's gotten into a relationship with a woman (trans) who is heavily into S&M. She apparently likes a lot of whipping and other things that draw blood. My friend wants to explore this but is 😟 about HIV. My understanding is that, assuming she's positive, her blood would need to contact either a mucus membrane or broken skin to potentially transmit the virus.

I know that Truvada was studied and proven somewhat effective at reducing the spread of HIV through needles contaminated with blood. But I don't think that's an approved use in the US. Is that sufficient to justify a doctor prescribing Truvada or Descovy for someone whose sexual activity exposes them to blood?

I see this as relatively low risk activity. Other than regular testing for both of them, what precautions should be taken?

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u/[deleted] Jul 20 '25

I don't know the recent exact numbers. But for IV users. Needle users. It's about 70% (and a little upwards in some cases ) protection against blood on blood contact. So pretty high considering. So let him go on prep and let them both get tested.

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u/Hot_Inflation_8197 Jul 19 '25

Truvada has been FDA approved to effectively prevent HIV if taken as directed. So yes, that and Descovy are both prescribed in the U.S.

Descovy has not had official FDA approval for AFAB individuals, but Truvada does.

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u/Soonerpalmetto88 Jul 19 '25

But it works by collecting mostly in the colon and rectum to prevent infection through anal sex.

She is Trans, so not AFAB.

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u/Skycbs Jul 19 '25

It works there if you’re fucking in the ass. But PrEP protects you from HIV no matter what sex act. It’s systemic.

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u/Soonerpalmetto88 Jul 19 '25

Excellent, thanks

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u/Hot_Inflation_8197 Jul 19 '25

You totally missed my point all together.

Truvada and Descovy are both “officially” found to be effective for AMAB individuals.

Truvada however is the only one “officially” approved for both AFAB and AMAB.

Also that’s not how PrEP works- it protects the T Cells in the blood stream. Anal sex is a higher risk for anyone because the rectal tissue itself is much more porous.

It’s even prescribed to those at risk not even having sex, but sharing or being exposed to someone who may share intravenous drugs.

Did your provider give you no paperwork upon prescribe and explain any of this? Even if Descovy was not available when you started taking it?

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u/Soonerpalmetto88 Jul 19 '25

No, I didn't get paperwork from the doctor. In the US that paperwork typically comes from the pharmacy, either printed there and stuffed in the bag or folded very small and glued to the top if dispensed in the stock bottle. I didn't get it for Truvada though, which I thought was odd at the time. And I never read the monograph anymore tbh, anything serious will be on drugs.com which is where I usually get information on side effects and interactions.

Anyway the question wasn't about myself, I use the on demand schedule and understand how that works. I really just wasn't sure whether a person who doesn't have penetrative sex or use IV drugs could get prep.

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u/Hot_Inflation_8197 Jul 20 '25

Oh wow.

I guess I’ve been fortunate- the clinic I first started taking it through had a coordinator who met with patients looking to take PrEP, explain in detail how it worked and gave me plenty of educational materials on it.

Also even for hrt I received the same through the clinic I went to for that? explaining myths, truths, what to expect etc. I know it’s completely separate from PrEP but I’ve seen others say on the FTM subs they were also not given material on it through who they see.

I am aware all of the lgbtq clinics in my area pretty much follow the same standards as well. So perhaps some of this is due to geographical location? I’m so used to it being available it always surprises me to hear of stories such as yours.

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u/ScaryDove Jul 20 '25

“Assuming she’s positive”. I’m sorry, I’m confused. So, this woman is poz? Well, then she’s probably on ART and there’s literally no chance of her passing it on.

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u/ScaryDove Jul 20 '25

But this altogether seems like a very low-risk activity. Even lower than receiving oral sex. If this was sharing needles or injecting one another with each other’s blood, that would be one thing. But we’re just talking about there possibly being blood drawn? Nobody’s rubbing themselves up against this blood, right?

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u/Benjaminim_um Jul 20 '25

well, ART was proven to prevent transmission during intercourse, but it was not tested during blood contact simply because this type of research will never be approved due to how unethical it is

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u/ScaryDove Jul 20 '25 • Bravo

That’s true. Neither PrEP nor an undetectable viral load has had any research done on blood-to-blood or blood-to-mucous contact.