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Oral Sex Question
Jul 11, 2001

Hello. I performed unprotected oral sex on a man about four weeks ago. He did not ejaculate in my mouth, and I don't believe there was any pre-cum. I am unsure of his HIV status. Last week, I came down with a virus-like infection -- the main symptom being exhaustion. Yesterday, I got an oral ulcer. Essentially, I am really stressed out that I caught HIV and this is the early appearance. (Acute syndrome, I think they call it) I haven't been able to sleep or concentrate at all. Two questions. 1. Is it likely that I am infected? 2. Is there an HIV test I can take now to ease my mind?

Thanks.

Response from Mr. Kull

Most of the information about HIV transmission through oral sex that is published, including information that is provided on The Body, states that the risk of infection through performing oral sex on an infected person seems low, and is definitely lower than unprotected vaginal or anal sex. There are different reasons why this may be true:

1) Epidemiology: there is evidence that HIV has been transmitted through receptive fellatio (performing oral sex on a man), but the numbers are MUCH lower than infections occuring through vaginal or anal sex. If oral sex were as risky, the numbers would most likely reflect that.

2) Biology: saliva contains some protective factors that may inactivate HIV when it comes into contact with the mouth. The mucous membranes of the mouth may also be less prone to infection with HIV when compared to the mucous membranes of the rectum and genitals.

While oral contact with HIV infected pre-ejaculate is sufficient for infection to occur, infection is more likely to occur when a person ejaculates in the mouth. Your oral health and the presence of sexually transmitted infections will influence the risk of transmission. The likelihood of infection for you will also be dependent upon the status/risk factors of the person with whom you had oral sex. Gay men in the United States are more likely to be infected than heterosexual men.

As far as your symptoms go, I am not in the habit of diagnosing acute retroviral syndrome. It is an extremely complex task that should only be left to medical providers who are up-to-date with HIV research. Fatigue alone is not commonly experienced by people with acute retroviral syndrome. Fever, rash, and myalgia (muscle aches) are more commonly experienced symptoms.

RMK



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