A worried (hopefully well) lady from the UK
Dec 24, 2017
I am writing in today for some reassurance. A month ago I went to America and had a holiday romance with an American guy. We had protected sex but I performed unprotected oral sex on him however there was no ejaculation.
I felt fine about the situation as I had used a condom for the sex bit however after recently learning that HIV can be transmitted through oral sex I have been so anxious and stressed. I took a 4th Generation HIV test at 4 weeks and 6 weeks and they both came back negative. Can these tests provide me any form of reassurance? I have servere muscle aches and joint pain - my arms are so heavy, I cannot stop thinking that what if it is related to hiv. As I had this joint pain when taking the last 2 tests surely they would have picked it up? Is this a symptom of ARS?
I appreciate the work you do and its great that this website provides fact based information as google can be a very scary place! My worrying about this is out of control and effecting my job and everyday life.
Please offer some words of wisdom and put my mind at ease until the 90 day mark when I can take the final test. I have learnt my lesson about oral sex and will use a condom for this in future!
A very worried British girl from across the pond
Response from Mr. Jacobs
Hello Very Worried British Girl,
Thank you so much for reading TheBody.com and trusting us with your question. I'm sorry a holiday romance has ended with such disturbance and confusion. I hope we can help.
I feel very confident in reassuring you there is zero chance of acquiring HIV from oral sex with no ejaculation. The only hypothetical risk factor here is how much precum he leaked. And although there are medical theories that suppose that precum can contain HIV if the person is HIV positive and detectable, there are no real world studies or experiences that have ever shown this to be a reality.
After 36 years of research, we understand a lot about how HIV is transmitted. The fact that there are no examples of precum as a credible variable in over 70 million transmissions tells you a lot.
So where is this information you are seeing about oral sex and HIV? As you stated, Google can be a very scary place. That's why I make sure I'm only reading and learning from credentialed and respected sources of information like TheBody.com, or an internationally acknowledged branch of facts. The U.S. Center For Disease Control places oral sex as a "little to no risk" category on par with touching and kissing (https://wwwn.cdc.gov/hivrisk/estimator.html#-sb). Another study has shown us that there is 0% - 0.4% risk with oral sex with ejaculation (https://www.poz.com/article/HIV-risk-25382-5829). No data exists for HIV transmission without ejaculation because it simply hasn't been reported.
The other thing that can reassure you is that you've already taken a 4th Generation test at four and six weeks. 4th generation tests are considered fairly reliable, as most new infections with show up within 14 days. Pretty much everyone would show as HIV positive after 28 days (http://i-base.info/qa/2363). So if you're testing negative after four weeks, after zero risk, I'd say there's your answer.
I can't help but notice that used the term "learnt my lesson" to describe the outcome from this experience. I wonder if there is a part of your mind that feels it is necessary to be punished, condemned, or shamed into learning a lesson about engaging in pleasurable sexual activities. That would not be at all unusual given women and men on both sides of the pond are conditioned to believe that condomless sex is something dirty, immoral, flawed, bad. If these core beliefs are active then they can affect your physical health and the aches and pains you are experiencing in lieu of HIV or a diagnosed medical condition.
So I invite you to consider another perspective. What if sexual expression was something that was beautiful, celebratory, and healthy? What if the joining of two bodies was a vital and meaningful contribution to the experience of being alive? And what if we used science and medicine to guide us in making sexual decisions that maximize pleasure while minimizing risk?
I'd argue that the decisions you made were rational, science-based, and effective. You used a condom for penetrative sex, you didn't use a condom for oral sex, you stopped him before he ejaculated. That's as pretty close to safe as sexual play can be.
I hope these facts and ideas allow you to breathe, relax, and consider ways that you can enjoy the kinds of intimacy and connection and you desire, without all the worry.
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