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Still going crazy, oral sex question
May 16, 2006

Dear Dr.: The more I read the more I realize the need for your services. Will donate please answer. I had oral sex with a woman. No open soars. I tested negative with a blood test at 9 days, negative with a urine test at 5 weeks and negative with a blood test at 14 weeks (3 1/2 months). I had sore throat at 18 weeks and what I think is a slight pain in my groin &armpit. Going so crazy my Dr. put me on Zoloft but I stopped it at 5 days. Do I need to test again? Please answer. In addition, I have a comment. Believe it or not I am a 36 year old man who has never, and I mean never, had unprotected sex, not even oral until 12/3/05. I did not know you can get infected through oral sex. All the prevention ads, commercials say use a condom for protection. I believe this presents a false sense of security regarding performing oral sex on a woman. What are your thoughts? Thanks a million!!!!!

Response from Dr. Frascino

Hello,

Repeatedly negative HIV tests out to 3 months following a low-risk exposure, such as cunnilingus on a woman of unknown HIV status, are definitive and conclusive. HIV is not your problem. No way. No how. OK?

The risk of acquiring HIV from cunnilingus is remarkable low. I'll repost below a question from the archives that addresses that topic.

Thanks for your donation (www.concertedeffort.org).

Stay safe and you'll stay well. Really you will.

Dr. Bob

+woman/-man risks--Please help! I need some sex! Mar 29, 2006

Hi. I am a woman and my potential partner is a - man. I read in a magazine at my doctors office that the risk of infection for a neg man from a pos woman is ridiculously low with both vaginal intercourse and oral sex, assuming no sores, rough play, etc.. I was diagnosed about 6 months ago w/ AIDS (not just HIV) but I am now healthy my viral load in undetectable.

Specifically, how safe is oral sex without protection--me giving it to him, him giving it to me, assuming, again, no sores, cuts, vampire action going on?

Also, I realize the infection risks are very low for sex if we are careful w/ condoms, and I have already read the other responses and can see that oral risk is low too, but can you reccommend a place I can get actual statistics? Or can you just tell me? Because although this question may have already been answered, I have not been able to find it in this forum or the mixed couples forums or any other on this website. I have already searched. And searched. And searched.

I have found conflicting info on this website--yes I have--and whenever I almost find what I'm looking for, in the end you guys say "search blah blah blah forum". Which, again, I already have. I have spend hours, days, months searching and I am about to have a breakdown! Your advise seems closest to what I need. Besides sex. Please help!

Response from Dr. Frascino

Hello,

I would not agree with what you read in that magazine pertaining to the risk of an HIV-negative guy contracting HIV from an HIV-positive woman through (unprotected) vaginal sex. "Ridiculously low???" What???

As for your searching and searching and not finding information about estimated HIV-transmission risk, I can't believe you were searching all that hard. I just did a quick search and located about a gazillion posts with the information clearly spelled out. But, nonetheless, here it is once again:

1. Latex condoms are protective for all types of sex if used properly and they don't fail. HIV cannot penetrate, permeate or cha-cha-cha through intact latex. No way. No how.

2. The estimated per-act risk for acquisition of HIV from unprotected insertive penile-vaginal sex with a partner confirmed to be HIV positive is 5 per 10,000 exposures. (This is not "ridiculously low" by any standard!)

3. The estimated per-act risk for the acquisition of HIV from unprotected insertive oral sex (i.e. HIV person performing oral sex on HIV- man) is 0.5 per 10,000 exposures.

4. There are no published estimated-risk statistics for cunnilingus. The risk is extremely small. You can read my comments about that in the post from the archives (below).

Finally, regarding "actual statistics," please note what we are quoting are estimates based on epidemiological studies. The best way to think about HIV risk is to first decide if there is a risk and if so, then to decide if the risk is high (unprotected receptive anal), medium (unprotected vaginal) or low (oral sex). To get more detailed than that isn't really all that helpful.

However, if you insist on fact and figures, I'd suggest you review the HIV InSite Knowledge Base chapter on safer sex. It has over 124 references and lots of statistics for you to ponder. The site can be accessed at http://hivinsite.ucsf.edu/InSite?page=kb-07-02-02.

If that doesn't satisfy your info quest, I suggest you "search blah, blah, blah forum," OK?

Dr. Bob

Oral Sex and HIV Feb 18, 2006

i have just stumbled on this site, and would like your opinion, on jan 1st 2006 i had protected vaginal sex with a prostitute, but i performed unprotected oral sex on her, before i performed she whiped her virgina and when performing oral sex i could taste no secretion or menstural blood, immediately afterwards i realised what a rediculous thing i had done and became increasingly paranoid about the possibility of HIV infection, on the 3rd of Jan i started on 28 PEP course, what do you think my chances of having HIV are, alot of other sites i have been on say Cunnilingus is Low risk, some say no risk, quantatively what is this risk? i am due to go for an HIV test at the end of march and am petrified of the result,

many thanks

Ben C

Response from Dr. Frascino

Hello Ben,

She "whiped her virgina?" Would that be "whiped" as in whipped or "whiped" as in wiped? And would that be "virgina" as in Virginia or "virgina" as in vagina? I would assume "whipped" and "Virginia" are out, because nothing kinky ever happens in that state. The risk of HIV transmission from cunnilingus is extremely low. I'll post a question from the recent archives that addresses this problem. (See below.)

I do not believe PEP was warranted for your potential exposure. There is no reason to be "petrified" of your HIV test results. I see nothing but good news heading in your direction. I suggest you begin practicing your WOO-HOOs!

Good luck.

Dr. Bob

Cunnilingus - no blood, good oral healt Jan 12, 2006

Dear Dr. Bob,

Just sent a donation of 200 dollares - thanks fo you help - people need it and now i feel i need too You had answered a number of questions related to the risk of cunnilingus. I was engaged in one 2 months ago but no blood was involved and my oral helth is ok. The experience was with the mistress and when i asked her afterwards she told me she is DD free .What concerns me that you mentioned once that the probability of getting HIV in this case 0.5 per 10000 cases. doest it mean that there is 1 possible transmission in 20000 cases. a number of cunnilinguses given is much more then that and there are no documented cases so far. How do these 2 things reconcile? I am still concerned although i understand i should not be....you know... How is it possible generally to get HIV via giving cunnilingus in case when there is no blood and my oral health seems to be in order. Appreciate your reply. I have another general question re the symptoms... It seems that in case there are symptoms there are ususally more then one should be present based on the statistics you posted earlier. Appreciate your reply

Thanks for the help

Response from Dr. Frascino

Hello,

The estimated statistical per-episode risk of 0.5 per 10,000 exposures for unprotected oral intercourse refers to fellatio (oral sex performed on a man), not cunnilingus. The cunnilingus figure would be much less. In fact, it's so small it's difficult to quantitate. There are only very few cases of HIV transmission resulting from performing oral sex on a woman that have been reported to the CDC. Considering we've been monitoring this epidemic for over two decades, that alone is excellent evidence that the HIV-transmission risk through cunnilingus is extremely low. There are a number of scientific hypotheses as to why this is true, but the bottom line remains the same: it's an extremely low-risk activity. (Note: the risk increases if the woman is menstruating and/or the person performing cunnilingus has oral mucous membrane sores, abrasions or inflammation.)

Regarding your second question, ARS can be quite variable in scope, number and severity of symptoms. However, yes, generally more than a single symptom is present. Thanks for your generous donation!

Stay well.

Dr. Bob



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