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Oral sex without ejactulation
Oct 2, 1996

a few months ago I gave another man oral sex, but there was never any ejaculation. How much risk am I at?

Response from Mr. Sowadsky

Hi. Thank you for your question.

When we're talking about the risks of HIV while giving oral sex to a man, we can say several things.

There have now been documented cases of HIV transmission through giving someone oral sex (but no cases have been reported by receiving oral sex).

When we're talking about the levels of risk, there is no one answer to how risky this is, since several variables actually determine the true level of risk.

Both pre-cum and semen contain high concentrations of HIV. Semen is however a riskier body fluid because you are normally exposed to a greater quantity of semen as compared to pre-cum. Does that mean that pre-cum is totally safe? No! But we can say that the more infectious body fluids you are exposed to, the greater the liklihood of transmission. So, you can become infected by pre-cum alone, but you are much more likely to become infected if the guy ejaculates in your mouth, since you're exposed to a much greater quantity of his body fluids.

Of course, the virus must also be able to get into the bloodstream through some type of open sore, abrasion, gum disease etc. The more openings that HIV has to get into your bloodstream, the greater your risk would be.

Without ejaculation, there still is some risk of getting infected through giving oral sex, but the risk would be much greater if the man ejaculated in the mouth. So rather than saying that oral sex is high risk vs low risk, it's actually a spectrum of risk.

NO EXPOSURE TO PRE-CUM OR SEMEN: very low/no risk as far as HIV is concerned.

EXPOSURE TO PRE-CUM ONLY: low risk (but still possible). The more pre-cum you get exposed to, the greater the risk would be.

EXPOSURE TO BOTH PRE-CUM AND SEMEN: Risky, especially if there are cuts/open sores in the mouth. The more semen you're exposed to, and the more cuts/abrasions/gum disease in the mouth, the greater the risk. But overall, although risky, it is still generally considered less of a risk than unprotected intercourse.

So again, we're talking about a spectrum of risk. This is why there will be no absolute answer of high vs low risk of giving oral sex. But we can say that HIV has now been found to be transmitted by GIVING oral sex (but not receiving).

And by the way.....A VERY IMPORTANT THING TO REMEMBER is that there doesn't necessarily have to be ejaculation to be infected with other Sexually Transmitted Diseases (STD's). For example, if you give a man oral sex, and that man has gonorrhea, you could get infected with gonorrhea in the throat, whether the man ejaculates or not. Gonorrhea can cause a discharge that can be very infectious if it gets into the throat (or penis/rectum/vagina) of another person. So things that may be lower risk for HIV (giving oral sex without ejaculation) may be high risk for other diseases, like gonorrhea.

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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