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Oral sex on HIV Pos+ partner
Apr 28, 2007

Hi,

I'm a gay hiv+ male, last counts : CD4:382/22%, VL 528. Not on meds.

I've been reading through the archive, and found several answers explaining that a blow job by a hiv- person on an hiv+ person bares minimal risk due to the saliva's and stomach acid virus killing capabilities.

However, my own hiv specialist states that this DOES have serious risks, as he seems to be having other patients that got infected that way.

I myself even believe to be infected by oral means, mainly because of bleeding gums.

I just wonder now who is right ? I always worry when, during "anonymous sex" my sexpartner(who does not know my serostatus)initiates a blow job. The worrying really takes the fun out of it ...

Response from Dr. Frascino

Hi,

As you can probably appreciate, sorting this question out scientifically is extremely challenging. Aside form the ethical considerations involved, how does one conduct a study that strictly and absolutely limits sexual activity to oral sex? What we do have are reasonably large-scale epidemiological studies that continue to suggest that the HIV risk of oral sex is extremely low. Yes, there can indeed be extenuating circumstances, which could increase the potential low risk. Perhaps that explains some of the "inconsistencies" in interpreting the available scientific data. My personal view corresponds to that of the vast majority of HIV specialists and published studies: oral sex carries a very low risk for HIV transmission. Certainly there are ways to further mitigate that already low risk, such as driving the viral load to undetectable levels; not ejaculating in the mouth; avoiding oral sex if there are bleeding gums, cuts or open sores; etc. You and your partner need to decide together what level of risk the two of you are willing to accept as safe enough to take the worry out of what should be a hot and satisfying, rather than anxiety-producing, activity.

Good luck.

Dr. Bob



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