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exposure to HIV+ precum
Apr 18, 2002

Ryan,

Last year I dated a guy for about four months, and during that time I performed oral sex on him. I did not let him come in my mouth and I never let him perform anal sex on me. (I did on him, but only with a condom.) About two and a half months after we stopped dating, he came down with Kaposi's Sarcoma. I got an HIV test, which was negative, and I felt pretty good about it since I figured whatever we had done was minimally risky and nearly three months had elapsed since our last contact. I have continued to help this guy as he copes with meds etc. However, within the last few weeks I've been feeling tired myself, my performance at the gym has been slipping, my weight has dropped, and suddenly I'm terrified that I have HIV after all. I have a test in the works, results expected tomorrow. I'm angry because I felt like I was careful, and I remember reading that saliva neutralizes HIV and exposure to mucous membranes is really risky only if there's a cut or tear. As people have pointed out on these boards and elsewhere, it's a widely-held belief -- whether medically substantiated or not -- that oral sex without semen is pretty safe. In short, I thought I did everything right, but now I'm not so sure since my friend probably had an astronomical viral load at the time, and I feel tired and weak. What do you think?

Response from Mr. Kull

I think that your test result will give you a more definitive answer than I could, but it looks like you are HIV negative based on the negative result you received (as long as it was three months after your last exposure). There are a lot of things that can make you feel run-down (like STRESS!!), so don't jump to the conclusion that you are infected. Don't dismiss symptoms either; it's important that you have unexplained symptoms checked out by your doctor.

HIV can be transmitted through performing oral sex on an HIV infected man, even if you are only exposed to precum. Getting ejaculate in your mouth increases your risk, as do sores, inflammation, or cuts, but again, none of that is necessary for transmission. Saliva may neutralize HIV, but do not rely on saliva as a means of total protection (see Saliva as a Barrier ). HIV can be transmitted to a person when infected fluids come into contact with mucous membranes, period.

Transmission through fellatio is considered low-risk, primarily because the incidence of transmission through this route is quite low when compared to transmission through anal or vaginal sex. If you only engage in oral sex without ejaculation in the mouth, your risk for infection is going to remain low.

RMK



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