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Help put mind at ease.

Sep 22, 2002

Hi Dr Kull, Please help. I recently performed oral sex on a male escort, only for about 5-10 secs. He didn't ejaculate at all and I don't think there was any pre cum on his penis as I looked before I took him in my mouth. No signs of any other sores etc on his penis, and my oral health is fine. About 4 days after this, I developed what seemed to be an ordinary, standard cold which has now almost finished. Would you say this was purely coincidental or should I seriously consider taking an HIV test. Please help ease my anxieties. Thank you. K.

Response from Mr. Kull

The risk for infection through performing oral sex on an HIV positive man is low. If you do not have any cuts or sores in your mouth, have good oral health, and do not get any ejaculate in your mouth, then your risk is even lower. There is increasing evidence that people are infected by performing oral sex on men, but the numbers are still relatively low when compared to unprotected vaginal or anal sex.

In a recent study which was conducted over two years, researchers attempted to identify the likelihood of HIV transmission by interviewing men who engaged in receptive oral sex with men (men who put other men's penises in their mouths). Participants were recruited in testing clinics in the San Francisco area. Out of 194 men who have sex with men who reported having no anal or vaginal sex in the prior six months and engaging in multiple oral sex encounters, only one was HIV infected (which could be attributed to transmission through anal sex prior to the six month window). 89% did not use a condom for oral sex and 40% received ejaculate (cum, semen) in their mouths. 20% knew that they had contact with an HIV infected man. The study's conclusion is that the risk for infection through receptive oral sex with men is practically zero.

Another study examined the risks of infection through oral sex in a different way. Researchers asked about the sexual behavior of gay men who recently became infected with HIV. It was estimated that approximately 7-8% of the men were probably infected through performing oral sex on other men. All of them had contact with ejaculate or pre-ejaculate.

Your risk for infection may be increased when an HIV infected man ejaculates in your mouth because potentially more HIV is coming into contact with the mucous membranes of your mouth.

For more about oral sex, see Oral Sex.


Relative risk

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