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fever blister and oral sex

Jul 23, 1997

My lover who is HIV+ had an open, but almost healed fever blister on his lip when he performed oral sex on me. I then masturbated to ejaculation. I didn't see any danger because there were no visible open sores or cuts on my penis. Should I be worried.

Response from Mr. Sowadsky

Hi. Thank you for your question. Your risk of infection for HIV was low, even under the circumstances mentioned in your question. This is because it was unlikely that you were exposed to his blood or semen. However, you were at possible risk for Herpes infection (see below).

When we are talking about HIV transmission, it is important to remember that there does not necessarily have to be visible cuts or abrasions in order for HIV transmission to occur. The HIV virus is smaller than a single cell. It can therefore pass through a cut or abrasion that you might not be able to see. The head of the penis is made of mucous membranes. Because mucous membranes are so thin, they are especially prone to small (even microscopic) cuts and abrasions. Mucous membranes are also found in the mouth, rectum, eyes, nose, (and in women, the vagina). The larger the cut or abrasion, the greater the risk. But because mucous membranes can have cuts or abrasions that are too small for you to see (but still large enough for HIV to enter), just because you do not see any cuts/abrasions, does not necessarily mean you are not at risk. In your specific case, your risk for HIV was low, not because you did not see any cuts or abrasions, but because it was unlikely that you were exposed to your partners blood or semen.

Although your risk for HIV was low, you were at significant risk for Herpes infection. A "fever blister" (also known as a "cold sore") is caused by the Herpes Simplex Virus. When a person has active lesions from Herpes, they are highly infectious, until the symptoms go away. When no symptoms are present, the chances of transmission exist, but are very small. If he was giving you oral sex while he was symptomatic for Herpes, you may now have a genital Herpes infection. For more information on how Herpes is transmitted, see the post, "How is herpes transmitted exactly...fluid mucosal contact?"

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).

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