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Insertive Oral Sex
Oct 28, 1996

I recently engaged in insertive oral sex with a lady in the UK who I didn't know. She told me that she was just coming out of a steady relationship and that I was only the second person she slept with in 8 years. She was definately NOT menstruating but, although I definately had no opn sores or bleeding in the mouth or gums, I DID have an small apthous ulcer on the inside of my cheek just above my front chin. I would have thought that it would be unlikely that the virus could have had direct access to my bl oodstream, but would like to know what you would feel is my risk. Thanks for you help.

Response from Mr. Sowadsky

Thank you for your question. Anybody could be infected with the HIV virus these days. Even if you were only her second partner in 8 years, she could still be infected. If her previous partner had multiple sexual partners (or if she had a history of drug use), that would put her at high risk of infection with this, and other Sexually Transmitted Diseases (STD's). If you had unprotected sex with her, that would then put you at risk of infection.

In regard to the risks for HIV infection for oral sex:

If you are GIVING someone oral sex, there is a risk of infection since pre-cum, semen, vaginal secretions, and menstrual blood can get into your mouth. The more of these body fluids you are exposed to, the greater the risk of infection there would be. If you have any open sores (including apthous ulcers/canker sores), cuts, abrasions, or gum disease in the mouth, the virus can get into your bloodstream. The risk is less than vaginal or anal intercourse, but the risk is real, and transmission can occur. There have already been reported cases of HIV infection specifically through giving oral sex. In addition to HIV, while giving oral sex, you could also be at risk for other Sexually Transmitted Diseases (STD's) including herpes and gonorrhea.

If you are RECEIVING oral sex from someone else, you are only being exposed to saliva. The concentrations of the virus in saliva are so low, that nobody has ever been infected from saliva. Keep in mind however that you can get other sexually transmitted diseases (like herpes) by receiving oral sex. However, as far as HIV is concerned, receiving oral sex is extremely low risk.

In your specific case, since you had an open ulcer in your mouth, your risk of infection would increase, since the HIV virus would have an easier access to your bloodstream (this assumes she was infected). Since she wasn't menstruating, your risk would be lessened, but not eliminated. There would still be some risk of infection since you could still be exposed to vaginal secretions, which also contains high concentrations of the virus. Simply put, the more of her body fluids you're exposed to, and the more openings in your mouth for HIV to enter, the greater your risk would be. Keep in mind that you don't have to have visible cuts in the mouth to be at risk. Because HIV is so small, it can enter cuts in your mouth that you may not be able to see. The mouth is especially likely to have small cuts/abrasions. This is because the mouth is comprised of mucous membranes, which are especially prone to small cuts or abrasions.

So overall, we can say that (assuming she was infected), you would be at some risk of HIV infection, although the risk would be less than that of intercourse. If you think you may have put yourself at risk, you may want to consider getting tested for HIV 6 months after your last possible exposure to the virus for the most accurate test. So all I can say at this point is that you may have put yourself at some risk, depending on the factors discussed here. If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide). Rick Sowadsky MSPH CDS



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