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For 100 another oral sex question - crazy information!
Apr 28, 2003

Hi Dr. Bob

Your doing a great job on this board!! I know you get a ton of oral sex questions so sorry if this is a little repetitive.

I (male)performed unprotected oral sex on a person (female) who's HIV status I did not know. No noticable wounds in the vagina or my mouth. I have been doing some research on the internet and have read your responses to questions posted on this board as well. During my internet research I was very surprised to see the disparity amongst so called experts and studies on the risk of transmission by performing oral sex both fellatio and cunnilingus. Its crazy. One guy, a doctor from the San Francisco Health Department who appears highly qualified says there is virtually no chance of transmission via oral sex (2001 or 2002) and then other experts repute that voraciously. Additionally numerous tests prior to 2000 seem to prove that it is relatively easy to pass the virus via oral sex, yet in a 10 year Spanish test ending in 2002 it seemed impossible to tranmsit orally. Others when estimating the risk lump receptive oral sex as very low risk right along the lines of deep wet kissing and/or PROTECTED vaginal or anal sex and still others rank it as moderate risk or high risk. I know the short answer is that no one really knows for sure the true risk but how could various studies come up with such different results and risk estimates. Do some people have political agenda's or something. Also it seems like statistically, this virus is fairly difficult to transmit, even through risky behavior. Why is it so difficult to transmit? (0.1-0.3 for receptive anal or vaginal) Some (for example the liberated or liberal christians in Arizona - can't remember for sure)suggest that the only way to transmit the virus is through repeated exposure because they argue that your immune system needs to be repressed (from various other health issues) in order for exposure to result in transmission. What's a guy or gal to believe with all of this information circulating around the place.

Any clarification would be appreciated!! Again - great job on the site. You have a great demeanor and attitude!!

Yours, Stupid White Man (at least for the few minutes of cunnilingus, and now guilt ridden)

PS Answer it and 100 goes to your foundation. Thanks again!

Response from Dr. Frascino

Hey there,

Your question points out just how much misinformation is flying around out there. Let me start by saying that multiple recent large-scale well conducted studies have all come to the same conclusion that the risk of contracting HIV from oral sex is much, much lower than was originally estimated. Thats why there is a discrepancy between the newer data and the older studies you mentioned. Now let me address a few issues you raise in your question:

1. " . . . numerous tests prior to 2000 seem to prove that it (HIV) is relatively easy to pass via oral sex" No, thats not true. I guess it would depend on how you defined "relatively easy," but these older studies merely projected possible cases of oral transmission. They indicated oral transmission was a potential risk and therefore advised caution. The risks were always "low," even in these early studies. 2. " . . . in a 10-year Spanish test ending in 2002, it seemed impossible to transmit orally." Well, thats not exactly accurate either. The Spanish study, like several others, did not find any cases of orally transmitted HIV, despite significant exposures. This does not mean it is "impossible." It just means the risk is a lot lower than previously thought. None of the recent studies claim transmission via oral sex is "impossible". In fact they all state that the theoretical risk remains --- and that risk could change with specific circumstances oral ulcers or cuts in the mouth, etc. 3. The "liberated Christians in Arizona?" Who are they? And what medical school did they attend? Like a lot of religious folks, I'm sure this gang has their "beliefs." Thats what religion is all about believing in something that cant really be proven scientifically. I would doubt this cult has a good working knowledge of the functioning of the immune system. Their belief that transmission can only occur "through repeated exposures" is wrong dead wrong. When it comes to viruses and health-related issues, Id strongly recommend you and our readers stick to scientific fact, and not a "belief system."

The new studies, done in various countries, are all coming to the identical conclusion. That adds significant weight to the validity of these scientific findings. Bottom line: Oral sex does carry a theoretical risk of possible HIV infection; however, that risk is extremely extremely low and much lower than was estimated years ago. Hope that clarifies things a bit. Stay tuned to The Body. Well keep you up to date as additional information evolves. Thanks for your donation!

The Robert James Frascino AIDS Foundation 779 Altos Oaks Drive, Suite 200 Los Altos, CA 94024

Stay well.

Dr. Bob



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