Does female ejaculate during Cunninglingus increase HIV risk?

[Nolefan486]

My question is whether or not female ejaculation, "squirting" would increase HIV risk during oral sex.  I last had a HIV/STD test in Dec 2013 and had a clean bill of health.  Since then I have had 2 sexual experience.  Both times we had unprotected oral sex both giving and receiving and protected vaginal sex.  I did not finish in either episode, but the women did have multiple orgasms while I was performing oral sex and I swallowed vaginal fluid/female cum.  I am not sure if swallowing the fluids increases risk from oral sex?

The first woman had testing after our exposure which came back clean so I am not worried about that.  The second lady is married but has an open relationship.  I know that she has multiple sex partners and offered to have unprotected sex with me after she asked if I was std free, which I replied yes.  I did not feel comfortable with that so I wore a condom.  It did worry me later though as she presumably has unprotected sex with other people as well.  Both women do not do drugs.  I have had a sore throat, muscle weakness, trouble sleeping but not fever and rash.

It has been 39 days since the first encounter and 24 days since the last.  Do you recommend testing based on the information provided?

[Edward W Hook, MD]

Welcome to the Forum.  There are several layers to your questions.  Your performance of unprotected oral sex on your partners was very low risk.  On average, in the U.S. fewer than 1 in 10,000 women have HIV and while there are no good estimates of the risk for getting HIV from performing oral sex on an infected female partner, the risk is likely lower than for performing oral sex on an HIV infected man and that risk is calculated as being less than 1 infection per 10,000 acts of fellatio.  Thus this is a very low risk event.  There is likewise to evidence, nor any reason to think that swallowing genital secretions increases risk of infection over not swallowing- the stomach is a hostile environment where HIV is likely to die quickly.  

Your symptoms are not at all suggestive or recently acquired HIV.  On the other hand, the severe flu-like illness your partner had does have many characteristics of the ARS.  it is probably not since when studied, less than 1% of persons with a "typical" ARS, flu-like illness turn out to have HIV. The rest have the sorts of viral infections most people get from time to time.

for the reasons I mentioned, your exposure is very, very low risk.  I would not worry if I were you but of course testing is a personal decision and there is no harm to testing.

I hope my comments are helpful. EWH

[Teak]

HIV is not transmitted by oral sex.

[Nolefan486]

The second woman came down with what she called "the worst flu ever" about 10 days after our meeting and it stayed for about 10 days.  High fever are throat etc.  I was not too worried until this happened but the timing seems right in line with ARS.