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Oral sex.
Nov 7, 2001

Hi, I performed oral sex on a man and I did not know his HIV status. He did ejaculate in my mouth and I spit it out. If he was HIV positive, how high are my risks? I've read that oral sex can transmit HIV and I've also read that the chances of transmission are nil. I am fairly certain that my oral hygene was in fairly good health at that time. Am I at great risk of infection, or should I forget the whole thing?

Response from Mr. Kull

The risk for infection through performing oral sex on an HIV positive man is low. If you do not have any cuts or sores in your mouth, have good oral health, and do not get any ejaculate in your mouth, then your risk is even lower. There is increasing evidence that people are infected by performing oral sex on men, but the numbers are still relatively low when compared to unprotected anal sex.

There are two recent studies that speak to the risks of performing oral sex on a man. In the most recent study, which was conducted over two years, researchers attempted to identify the likelihood of HIV transmission by interviewing men who engaged in receptive oral sex with men. Participants were recruited in testing clinics in the San Francisco area. Out of 194 men who have sex with men who reported having no anal or vaginal sex in the prior six months and engaging in multiple oral sex encounters, only one was HIV infected (which could be attributed to transmission through anal sex prior to the six month window). 89% did not use a condom for oral sex and 40% swallowed ejaculate (cum, semen). 20% knew that they had contact with an HIV infected man. The study's conclusion is that the risk for infection through receptive oral sex with men is practically zero. Another study examined the risks of infection through oral sex in a different way. Researchers asked about the sexual behavior of gay men who recently became infected with HIV. It was estimated that approximately 7-8% of the men were probably infected through performing oral sex on other men. All of them had contact with ejaculate or pre-ejaculate.

Your risk for infection may be increased when an HIV infected man ejaculates in your mouth because potentially more HIV is coming into contact with the mucous membranes of your mouth. Swallowing may also increase your risk because HIV infected fluid is coming into contact with your throat.

Some sources suggest that spitting out ejaculate is better than swallowing; there is no scientific evidence to support this. While common sense may dictate that spitting out semen reduces the amount of time fluid is in contact with your mouth, this may not translate well into science.

For more about oral sex, see "Oral Sex" (http://thebody.com/safesex/oralsex.html).

RMK



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