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Cunnilingus Risks
Jun 17, 2002

Hi. Eight weeks ago I performed unprotected oral sex on a female of unknown status for five minutes and tried to avoid getting fluids in my mouth. One week ago my neck lymph nodes became swollen, I developed a sore throat, a few light pink circular blotches popped up on my chest, and my ears and head felt as if they were stuffed. I have become extremely nervous. I went to my doctor four days after the symptoms started and told him about my symptoms and my possible risk. Instead of testing me for HIV he felt I may have mono and drew blood for mono. When the results came back it showed elevated liver enzymes, but was negative for mono. He said my white blood cell count was normal and my CBC was normal. I'm do in next week for a second mono test.

Should I insist on an HIV test?

Is it warranted based on my possible exposure/symptoms?

If the person you are "going down" on turns out to have HIV and their fluids get in your mouth, is it very likely that you will then contract HIV?

Response from Mr. Kull

It is not likely that HIV would be transmitted to be a person performing oral sex on an HIV infected woman. In fact, there are only a few documented cases of transmission occurring to a person through cunnilingus.

The risk of HIV transmission through oral sex is low when compared to unprotected vaginal and anal sex. The reasons for this, in part, have to do with biological differences: simply put, HIV seems to have a more difficult time causing infection when introduced to the mucous membranes of the mouth (saliva may provide additional protection and the cells in the mouth may not be as prone to infection). Secondly, the concentrations of HIV in vaginal secretions seem much lower than the concentrations of HIV in cervical secretions and menstrual blood. When performing oral sex on a female, the mouth is more likely to come into contact with vaginal secretions, which have lower concentrations of virus.

It is important that you do not perform unprotected oral sex on a woman when she is menstruating (blood has a much higher concentration of HIV), and if you are experiencing any problems with your oral health (sores, abrasions, inflammation). If you would like to decrease the risk of transmission even further, you can use a latex barrier--like a dental dam or a condom cut into a square--between your partner's vagina and your mouth.

For more about transmission through oral sex, see the CDC's fact sheet on oral transmission.

RMK



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