Oral Sex with HIV+ & Swallowing


Dear Dr.

I just came across yuor website and found it very informative as well as at times amusing; not that I'm making fun of any situation, but you gotta admit it: "eyelashes enlargement" being a sign of HIV is a stretch.

Anyway, I'm reaching out to you because I'm HIV+ with undetectable viral load and my boyfriend is HIV-. Last week accidentally, he swallowed some of my cum. Now I'm being the paranoid freak only because I love him and care for him so much...

What are your thoughts, should we be concerned at all?

You are a very inspiring professionsl - great work!

Thanks. B



Should you be concerned? Well, are his eyelashes enlarging?

Relax, Max. Oral sex carries a very low risk for HIV transmission. The question about spit or swallow really hasn't been fully answered. There are components in saliva that deactivate the virus and stomach acids would certainly destroy any virus that landed there. See post from archives below. If you and/or your partner are concerned, a screening HIV rapid test at the three-month mark would put those fears permanently to rest, OK?

Good luck.

Dr. Bob

Different Aussie with Concerns Jan 24, 2004

Hi, While I was in Sydney over Christmas - I visited a restroom and gave oral sex to a man who came in my mouth. I spat most of it out but swallowed an ammount (not much). I understand that unprotected oral sex is not safe sex (though considered lower risk); my question is the old spit or swallow one - which is the most advisable in that situation. Since returning home to Brisbane - i have experienced 2 blisters on the roof of my mouth - How concerned should I be? Is this a sign of something? Or a reaction between my medication...as

I also have BiPolar Affective Disorder with Psychotic features - i'm on Lithium, Effexor, Avanza and Seroquel. Quite worried SGP

Response from Dr. Frascino

Hello SGP,

So you went down in the land down under? The spit or swallow controversy continues. Oral sex in general, as you point out, carries a very low risk for HIV transmission. The risk for other STD's is higher. Regarding HIV, the insertive partner has less risk than a receptive partner (oral, vaginal, or anal). Not getting spunked (no ejaculation) is, in general, also considered less risky. However, once you've got a mouthful of liquid protein, perhaps the best advice is to get rid of it either by spitting it out or swallowing it quickly. Is one method safer than the other? Most guides would recommend spitting over swallowing, but we really don't know for sure. Stomach acids would certainly quickly kill the virus very quickly. Theoretically, you don't want infected spunk to be in contact with mucous membranes (like the inside of your mouth and throat) for very long. Minimizing this contact decreases the risk that HIV will be absorbed. So spit when you can, swallow quickly when you must, and do not use someone's jiz as a trendy new mouthwash to gargle with, even if you do like the taste better than Listerine.

Dr. Bob