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1 Thing Never Mentioned
Nov 13, 2010

I've read the whole chapter on oral sex very thoroughly, highlighting important points as I read. One thing I was looking for was never mentioned. That is, whether there is any evidence or theory as to *how much* risk increases for oral sex when the various risk-increasing variable are present.

The archive states:

"The CDC's estimated per-act statistical risk for acquiring HIV from unprotected receptive oral sex (including getting a mouthful of high-protein baby-batter) with a partner confirmed to be HIV positive is 1 per 10,000 exposures."

Another of your early responses was very clear, stating:

"Unfortunately, there is no straightforward answer! You're looking for a "line" when in reality what exists is more of a "zone." All reasonable HIV experts will agree the risk of oral sex is very low, but not completely nonexistent. There can also be a number of confounding variables, including: (1) concurrent STDs; (2) oral membrane trauma, bleeding gums, gingivitis; (3) differences in HIV plasma viral load and viral strains; etc., etc., etc."

So, for a scenario where an hiv-negative person performs oral sex on an hiv-positive person, has some form of throat or mouth infection present, and takes ejaculate into the mouth, does this increase the risk from 1 in 10,000 to 1 in 5,000, for instance? Or to 1 in 1,000? Or 1 in 100? Or 1 in 5? Etc.

Have any of the studies shed any light on the *degree* to which risk is increased under these kinds of circumstances? Or would you be willing to offer you professional guess?

Thanks in advance for you thoughts on this.

Response from Dr. Frascino

Hello,

Thanks for reviewing the information in the archives before posting countless frantic questions. Too often in this forum, the latter occurs before the former, if the former happens at all.

The answer to your specific question is no. Studies have not and will not be done to address levels of risk resulting from the variables you mentioned as such studies would not only be impossible, but also completely unethical. They would be impossible, because you could not control for a single variable and keep all other conditions constant -- viral load (how high?), risk of concurrent STDs, local trauma, viral strain, host immune integrity, etc., etc., etc. It would be unethical to knowingly exposure someone to an HIV-transmission risk. Can't you just see the advertisements for study participants? "HIV-negative study participants wanted for clinical trial. Must be willing and adept at swallowing loads of spunk from hunky positively charged dudes with high viral loads. Study participants with untreated gonorrhea, syphilis or chlamydia in their throats are particularly welcome." See what I mean? Perhaps now you realize why such information was not in the extensive archives.

Regarding my making a professional guess, what good would that do? It would only be one man's guess. I suggest we stick to the scientific facts as clearly delineated in my archival quotes you noted in your question.

Dr. Bob



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