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having unprotected oral sex with my hiv positive partner

Jun 29, 2011

Hi Dr. Frascino,

I am currently the hiv negative counterpart in a new electric and magnetic couple. My boyfriend and I are currently engaging in oral unprotected sex. I have given him very sensual and deep oral sex and we are not sure whether he precums during the act. Also, I am a smoker and I currently suffer from EM minor and I am on strict regimen of Vacyclovir (1000mg/ qd co). I dont have any sores in my mouth and my partner does not ejaculate in my mouth ever. We would like some detailed information about the risks of transmission of HIV through oral unprotected sex.

Here are some details of my partner's status:

He has been HIV + for 7 years. His viral load is undetectable. It is currently 39. His CD4 is 748. His last CD4s, which were assessed three months ago, were 821.

Please note, that we are Canadian and our health care professionals are in Canada and more specifically in Montreal.

His regimen currently is: Norvir sec (100mg/qd co), Reyataz (300mg/qd co), Truvada (200mg/300mg/qd co)

My partner also performs oral sex on me but he does not have any mouth sores. He is also a cigarette smoker and so we are concerned about minor cuts in the mouth and gums. He bleeds occasionally after flossing, which is also a concern in this scenario.

We would like to re-assess the risk factors involved in unprotected oral sex. From the information above, do we need to have protected oral sex at all times or are my chances of seroconversion minimal to non-existant?

Thank you for this wonderful resource. It has made our lives much happier. We love each other very dearly and we want to protect each other's well-being.

P.S. We are both circumcised and free of all other STIs. We are monogamous as well.

Anis and Derek

Response from Dr. Frascino

Hello, Ansi and Derek.

Regarding your primary question related to the HIV-transmission risk associated with oral sex, see link below, and also review the information in the chapter in the archives of this forum dedicated to "oral sex." That the positively charged component of your magnetic couple is on effective combination antiretroviral therapy and that this therapy has driven his HIV plasma viral load to undetectable levels significantly reduces the already very low HIV-transmission risk associated with oral sex.

Perhaps the most important piece of medical advice I can provide to both of you is to quit smoking! If you don't, cigarettes will kill you in a most undignified and painful fashion. If you truly want to "protect each other's well-being," you'll help each other kick this incredibly dangerous addiction.

Good luck.

Dr. Bob


Chances of seroconversion after 8 weeks: update
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