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No pre-cum
Sep 24, 1996

I have discovered very recently that I am HIV positive. Just one week before my test, I had intercourse with a woman, with no condom. However, I did not ejaculate inside her vagina. I have never had any preseminal fluid emissions, either. What are the chances that I passed the virus to her? If there is no semen and no pre-cum, can HIV be transmitted just by the friction between penis and vagina? What about the same circumstances, but oral? If I do not ejaculate, since I have no precum either, can I pass the virus to someone who is giving me oral sex? Shall I tell her to take the test? Thanks

Response from Mr. Sowadsky

Hi. Thank you for your questions.

Pre-cum is released in the vast majority of men, prior to ejaculation. You may be producing pre-cum, but perhaps only in very small amounts. But it would be expected that you produce at least some pre-cum before ejaculation.

The more pre-cum or semen your partner is exposed to, the greater their chance of infection. If you did not ejaculate inside your partner, their risk would be lower, but there would still be some level of risk from pre-cum. You may be releasing pre-cum while you are inside your partner, without realizing it. But again, the more of your pre-cum or semen that your partner is exposed to, the greater their risk would be. If you were to ejaculate inside your partner, their risk would increase since they would be exposed to greater quantities of infectious body fluids. But not ejaculating in them does NOT eliminate their risk.

It's important to understand how HIV is transmitted, so you don't put others at risk of infection. The HIV virus must get from your body into their bloodstream in order for them to get infected. If it doesn't get into their bloodstream, they will not get the infection. Your blood, pre-cum or semen must have a direct access to their bloodstream in order to infect them. Activities where this can happen include vaginal intercourse, anal intercourse, having them give you oral sex, and sharing needles (IV, tattoo etc) with them. From hereon in, you should NEVER donate blood, semen, or organs. HIV is NOT transmitted through any form of casual contact. It has also never been transmitted from saliva, tears, sweat, or urine.

In summary, in order for you to expose others to the virus, 3 things must happen:

They must be exposed to your pre-cum, semen or blood.

The virus must get directly into their bloodstream through some fresh cut, open sore, abrasion etc.

Transmission must go directly from 1 person to the other very quickly.....the virus does not survive more than a few minutes outside the body.

No matter what the circumstances are, if you think about these 3 criteria for transmission, you'll be able to determine whether you are putting others at risk for HIV or not. But do remember that other sexually transmitted diseases (STD) can be transmitted easier than HIV, so what might be low risk for HIV may be high risk for other STD's.

It is VERY important that you tell ALL of your partners that you have HIV. It is EXTREMELY important that ALL of your partners be aware that they have been exposed. This gives them the opportunity to get tested. If you do not tell them, they may not know that they have HIV, and could unknowingly transmit the HIV virus to other sexual partners (or needle sharing partners) in the future.

Of course, it is also important for you to take care of your own health. And it is very important for you to avoid re-exposure to the HIV virus. If you get re-exposed to the HIV virus, you may get more virulent (or drug resistant) strains of the virus. You may also get more of the virus in you, which may lead to the disease progressing faster. You should also avoid exposures to other Sexually Transmitted Diseases (STD's) since these infections can be much more serious in persons with HIV infection.

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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