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Known Positive, Though Undetectable Partner, Oral Sex Slip-up: Risky Encounter? (ORAL SEX AND HIV/STD RISK, 2010)
Aug 4, 2010

A few weeks ago I hooked up with a guy I met online; he did not reveal his status on his profile. He told me later that, because of this, he assumed that I assumed he was positive - which in fact he was. I foolishly did not notice or ask. However, I always try to practice safe sex - with the exception of performing oral sex. I felt comfortable with this level of risk (up until now), as long as the guy did not ejaculate in my mouth. I never let guys do this.

With this guy, however, he partially ejaculated in my mouth - meaning, I didn't "hear" or "feel" the orgasm approaching (I usually can), and he didn't say anything to warn me. I tasted his semen, but most of it didn't get into my mouth before I pulled away. I spit in his sink about a minute later. I remember salivating heavily as I was walking home. I don't recall having any kind of cut or sore in my mouth at the time.

About a week later, he told me he had been positive for 15 years. Though he assured me he had been undetectable for most of that time, saying my risk was very low. He also told he had had two negative boyfriends in the past, and that he had ejaculated in their mouths on several occasions, and they never tested positive - or so they told him.

I found this somewhat reassuring, however he is not a doctor. I know no doctor would advise me to do what I did. I suppose my question is: did I expose myself to a legitimate risk? I know the one and only way to find out is to get tested. My last test was 4 months ago, so I suppose I should be getting one anyway... I'm just so scared this time because I KNOW my partner was positive and I slipped up when it came to my safer sex practices with him. Can you offer any insight?

Response from Dr. Frascino

Hi,

So you are freaking out because you now "KNOW" your partner is virally enhanced. So what if you had sex with this dude and he didn't tell you his status? Would you be at any less risk for acquiring HIV right now if you didn't know? Of course not. That's why you must always remember Dr. Bob's Two Cardinal Rules:

Cardinal Rule #1: Consider all sexual partners could be HIV positive and take all the necessary precautions to prevent transmission of the virus (and other STDs as well).

Cardinal Rule #2: Always remember Cardinal Rule #1!

So you, in essence, broke both of my rules!

Oral sex is considered to carry only a low risk for HIV transmission/acquisition. You can read much more about this in the archives of this forum. We have an entire chapter devoted to oral sex! Have a look. I'll reprint below a small sample of what can be found there.

Regarding HIV testing, you'll need to wait until the three-month mark to get a definitive result.

Good luck. Play safe to stay safe, OK?

Dr. Bob

Oral sex and STD (ORAL SEX AND STDs) Jun 9, 2008

The truth is that most of my friends don't even think of oral sex as sex and is no good talking with them about this subject - Im really ignorant about this: what's the likelihood of getting AIDS or other diseases with oral sex?

Response from Dr. Frascino

Hi,

Your friends don't think of oral sex as sex??? Hmm . . . one wonders how they would classify it. Penis Popsicle high-protein snack, perhaps? To get an answer to your question, I'd suggest you read the information in the archives. We have a whole chapter dedicated to oral sex (or high-protein snacks, if you wish). Briefly, there are different levels of risk, depending on the STD and the type of oral sex. For instance, STDs that cause sores and blisters (like syphilis and herpes) are quite easy to get from all types of oral sex (getting or giving). Common STDs, like gonorrhea, chlamydia and NGU, can be contracted from sucking and getting sucked. Hepatitis A, intestinal parasites and herpes can be quite easily passed through rimming without a barrier. It's much easier to transmit or acquire STDs when sores, blisters or discharge ("the drip") are present.

HIV is not easy to transmit or acquire via any kind of oral sex. However, there have been well-documented cases of getting HIV from sucking ("giving head"). The message here is that "low risk" does not mean "no risk!" Bleeding gums, gum disease and sores in the mouth can facilitate HIV transmission through oral sex. There have been no "well-documented" cases of getting HIV from getting sucked. There are no recorded cases of HIV transmission from rimming or getting rimmed. It is much, much, much easier to get HIV from unprotected anal sex than from oral sex.

Please feel free to share this information with your friends sometime when they are not distracted by their high-protein snacking.

Stay safe. Stay well.

Dr. Bob

What You Should Know about Oral Sex June 2009 (CDC report)

Oral Sex Is Not Risk Free

Like all sexual activity, oral sex carries some risk of HIV transmission when one partner is known to be infected with HIV, when either partner's HIV status is not known, and/or when one partner is not monogamous or injects drugs. Even though the risk of transmitting HIV through oral sex is much lower than that of anal or vaginal sex, numerous studies have demonstrated that oral sex can result in the transmission of HIV and other sexually transmitted diseases (STDs). Abstaining from oral, anal, and vaginal sex altogether or having sex only with a mutually monogamous, uninfected partner are the only ways that individuals can be completely protected from the sexual transmission of HIV. However, by using condoms or other barriers between the mouth and genitals, individuals can reduce their risk of contracting HIV or another STD through oral sex.

Oral Sex is a Common Practice

Oral sex involves giving or receiving oral stimulation (i.e., sucking or licking) to the penis, the vagina, and/or the anus. Fellatio is the technical term used to describe oral contact with the penis. Cunnilingus is the technical term which describes oral contact with the vagina. Anilingus (sometimes called "rimming") refers to oral-anal contact. Studies indicate that oral sex is commonly practiced by sexually active male-female and same-gender couples of various ages, including adolescents. Although there are only limited national data about how often adolescents engage in oral sex, some data suggest that many adolescents who engage in oral sex do not consider it to be "sex;" therefore they may use oral sex as an option to experience sex while still, in their minds, remaining abstinent. Moreover, many consider oral sex to be a safe or no-risk sexual practice. In a national survey of teens conducted for The Kaiser Family Foundation, 26% of sexually active 15- to 17-year-olds surveyed responded that one "cannot become infected with HIV by having unprotected oral sex," and an additional 15% didn't know whether or not one could become infected in that manner.

Oral Sex and the Risk of HIV Transmission

The risk of HIV transmission from an infected partner through oral sex is much less than the risk of HIV transmission from anal or vaginal sex. Measuring the exact risk of HIV transmission as a result of oral sex is very difficult. Additionally, because most sexually active individuals practice oral sex in addition to other forms of sex, such as vaginal and/or anal sex, when transmission occurs, it is difficult to determine whether or not it occurred as a result of oral sex or other more risky sexual activities. Finally, several co-factors may increase the risk of HIV transmission through oral sex, including: oral ulcers, bleeding gums, genital sores, and the presence of other STDs. What is known is that HIV has been transmitted through fellatio, cunnilingus, and anilingus.

Other STDs Can Also Be Transmitted From Oral Sex

In addition to HIV, other STDs can be transmitted through oral sex with an infected partner. Examples of these STDs include herpes, syphilis, gonorrhea, genital warts (HPV), intestinal parasites (amebiasis), and hepatitis A.

Oral Sex and Reducing the Risk of HIV Transmission

The consequences of HIV infection are life-long. If treatment is not initiated in a timely manner, HIV can be extremely serious and life threatening. However, there are steps you can take to lower the risk of getting HIV from oral sex.

Generally, the use of a physical barrier during oral sex can reduce the risk of transmission of HIV and other STDs. A latex or plastic condom may be used on the penis to reduce the risk of oral-penile transmission. If your partner is a female, a cut-open condom or a dental dam can be used between your mouth and the vagina. Similarly, regardless of the sex of your partner, if your mouth will come in contact with your partner's anus, a cut-open condom or dental dam can be used between your mouth and the anus.

At least one scientific article has suggested that plastic food wrap may be used as a barrier to protect against herpes simplex virus during oral-vaginal or oral-anal sex. However, there are no data regarding the effectiveness of plastic food wrap in decreasing transmission of HIV and other STDs in this manner and it is not manufactured or approved by the FDA for this purpose.

This article was provided by U.S. Centers for Disease Control and Prevention. You can find this article online by typing this address into your Web browser: http://www.thebody.com/content/art17166.html



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