Dr. Ryan, I was searching for more information related to transmission by oral sex and I found 2 studies that kinda contradict mostly everything I constantly read. The studies are "109. Spitzer PG, Weiner NJ. Transmission of HIV infection from a woman to a man by oral sex [letter]. New Engl J Med 1989;320:251." and "110. Quarto M, Germinario C, Troiano T et al. HIV transmission by fellatio [letter]. Eur J Epidemiol 1990;6:339-340.". Both of them have reported cases of infection through insertive oral sex. Im all confused and desperate again. I beg you to comment on those studies... are they reliable? why doesnt anyone talk about them and say that there are no reported cases? I thank you from the bottom of my heart.

If you really look hard for the exceptions to the rule, you'll probably find them. However, the two cases you cite are probably NOT the exception to the rule, and there is still no confirmed, reliable data that supports transmission to the insertive partner in oral sex.

The available information regarding oral sex overwhelmingly agrees that risks associated with insertive oral sex are negligible.

The evidence of transmission through insertive oral intercourse in the two cases you cite have not been confirmed. This means that the findings are primarily anecdotal, and that they are not conclusive. It is possible that transmission occurred through other routes (like receptive cunnilingus) and that infection did not occur in the route described.

Please, be careful with what you read. While you might find one case that suggests the exception, that does not mean that the finding was accurate or is applicable to the majority.

RMK