Hello Dr Bob,
Thank you so much for this wonderful site. I have gained some valuable knowledge from the variety of questions. One thing I noticed is that we need to change the sex education programs in our public schools. After reading some of the questions posted here I am inspired to find a way to promote HIV/AIDS education and prevention to students in my area. I have also noticed that you are quick to notice the typos:) (A lot of fingers have traveled to Virginia). My question is this: You note that the transmission risk of receptive oral sex is 1 per 10000 exposures. Does that risk increase if ejaculate is swallowed? Also, am I understanding correctly that receptive means you are the person performing oral sex on a male? Thank you for taking the time to not only anwer my question but for taking the time to answer the millions of questions you must receive each and every day. Godspeed!
Thanks for your kind comments and your support for promoting age-appropriate science-based sex education for our youth and, for that matter, for "all cummers!!!"
Turning to your questions, you are correct the receptive partner for oral sex is the one who has to decide whether to spit or swallow. Regarding the estimated statistical risk for unprotected receptive oral sex, the 1 in 10,000 statistic refers to all cummers. We don't have statistical estimates for swallowers versus non-swallowers. I'll repost some questions form the archives that address the spit versus swallow quandary.
forced to swallow
Mar 16, 2007
i performed oral on a guy i met on the internet. he said he was hiv-. i told him to let me know when he was going to cum so he wouldnt cum in my mouth. instead he came in my mouth and i couldnt pull away because he held the back of my head. i ended up swallow half of it before i spit out the rest. he said if i was worried about hiv i should have swallowed all of it because its safer. not sure why that is. assuming he was hiv+, is it harder to get hiv if i swallow or spit it out? thanks dr. bob for helping everyone out here.
Response from Dr. Frascino
You told the dude not to cum in your mouth and yet he held the back of your head while you gagged on his tallywhacker and spunked down your throat??? Nice guy. Bet he doesn't get many second dates.
The spit or swallow controversy has yet to be definitively settled. As Samantha on Sex in the City said when being questioned on the topic, "I only swallow when surprised." Gosh, whatever happened to the full-throated yelps of "Oh God, Oh God, Ohhhhhh God, I'm gonna shoot, I'm gonna shoot, Oh God I'm gonna . . . Ahhhhhhhhh . . . ." Everyone should give at least that well recognized warning that "something's coming!" I'll reprint a post from the archives that addresses your spit/swallow dilemma.
Oral Sex with HIV+ & Swallowing Mar 11, 2007
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!
Response from Dr. Frascino
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?
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
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.