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HIV Concerns
As a gay man, 25, I have concerns regarding HIV. Just for the record - I ask my partner's their status and don't pick up dates at bars (don't even go to them) or shady locations. Dating situations. Also, just for the record - I always wear condoms for anal sex with all my partners (even in past monogamous relationships - you never know who may cheat. My concerns center around Oral sex. While sometime ago I have read that Dr. Bob say's the risk is minimal - I don't understand why it is. So I have a few questions - that I think may help other forum users, especially gay men.
1. How low is low for oral sex? I give it, not often, but never allow partners to ejaculate in my mouth. I still worry about precum exposure. And I make sure there are no sores or cuts in my mouth. However, I have heard microscopic cuts in mouth is all it takes
2. Since the mouth is a mucus membrane isn't easy for the virus (say in precum) to be absorbed through the membrane?
3. I know condoms probably are not really necessary for oral sex - try getting a guy to wear one! But is oral sex a measurable risk? Would it be rare to aquire HIV from giving oral sex as many experts say it is.
4. Finally, I know your friendly with Dr. K. He has gotten a lot of flack in the gay community for his comments on oral sex (something like - its very, very low risk - my advice, enjoy it). Probably because their are so many "claims" out there in the community that people say they aquired HIV from strickly oral sex and for that matter, precum alone. Should one take these claims with a grain of salt?
Thanks for the good work, and for answering my questions. I tried to make my questions more generalized so the benefits would apply to many forum users.
1. How low is low for oral sex? I give it, not often, but never allow partners to ejaculate in my mouth. I still worry about precum exposure. And I make sure there are no sores or cuts in my mouth. However, I have heard microscopic cuts in mouth is all it takes
2. Since the mouth is a mucus membrane isn't easy for the virus (say in precum) to be absorbed through the membrane?
3. I know condoms probably are not really necessary for oral sex - try getting a guy to wear one! But is oral sex a measurable risk? Would it be rare to aquire HIV from giving oral sex as many experts say it is.
4. Finally, I know your friendly with Dr. K. He has gotten a lot of flack in the gay community for his comments on oral sex (something like - its very, very low risk - my advice, enjoy it). Probably because their are so many "claims" out there in the community that people say they aquired HIV from strickly oral sex and for that matter, precum alone. Should one take these claims with a grain of salt?
Thanks for the good work, and for answering my questions. I tried to make my questions more generalized so the benefits would apply to many forum users.
MEDICAL PROFESSIONAL
I'll try to help. Also search this forum for "HIV transmission risk", "oral sex", and "fellatio" for more detailed discussions--some of which in fact have been quite generalizable.
1) The most commonly cited figure is 1 chance in 10,000. The true risk undboutedly varies widely in various circumstances. Most likely it is much lower in your circumstances, and higher with intra-oral ejaculation, gum disease, oral or penile lesions due to herpes or syphilis, etc. Your "all it takes" statement reflects a general misconception about HIV infection. In general, getting HIV requires large doses of virus, not just "any exposure".
2) The biological reasons HIV transmission is uncommon by oral sex aren't fully understood. Not all mucous membranes are equally susceptible. For example, the linings of the rectum and cervix are only one cell layer thick, compared with much thicker oral and vaginal membranes. Saliva contains HIV inhibitory substances. Even swalling HIV doesn't usually result in infection.
3) Condoms for oral undoubtedly would reduce the very low risk to zero, and some people use and/or recommend them. Public health officials shy away from such a recommendation because in the long run, it wouldn't prevent very many infections, and because there is fear it doesn't pass the "laugh test". People might say "If I have to use a condom even for oral sex, I just won't use one at all"--even for anal or vaginal sex. That could have the effect of increasing overall risk.
4) Jeff Klausner would agree with me that if you focus on professionally run website, and especially those where public comments are medically monitored, you'll actually see a pretty consistent perspective. Personal testimony from individuals about how they (or a friend) got HIV are the least reliable of all evidence. That's not to say it doesn't happen; it can and does. But the ones most likely to contribute to online conversations are those who believe it happened.
If all anal and vaginal sex could be abolished from the world and only unprotected oral sex remained, HIV would die out. Oral sex, either fellatio or cunnilingus, in either direction, simply is not a sufficiently efficient transmission mechanism to sustain transmission of HIV in any population.
I hope this helps. Good luck-- HHH, MD
1) The most commonly cited figure is 1 chance in 10,000. The true risk undboutedly varies widely in various circumstances. Most likely it is much lower in your circumstances, and higher with intra-oral ejaculation, gum disease, oral or penile lesions due to herpes or syphilis, etc. Your "all it takes" statement reflects a general misconception about HIV infection. In general, getting HIV requires large doses of virus, not just "any exposure".
2) The biological reasons HIV transmission is uncommon by oral sex aren't fully understood. Not all mucous membranes are equally susceptible. For example, the linings of the rectum and cervix are only one cell layer thick, compared with much thicker oral and vaginal membranes. Saliva contains HIV inhibitory substances. Even swalling HIV doesn't usually result in infection.
3) Condoms for oral undoubtedly would reduce the very low risk to zero, and some people use and/or recommend them. Public health officials shy away from such a recommendation because in the long run, it wouldn't prevent very many infections, and because there is fear it doesn't pass the "laugh test". People might say "If I have to use a condom even for oral sex, I just won't use one at all"--even for anal or vaginal sex. That could have the effect of increasing overall risk.
4) Jeff Klausner would agree with me that if you focus on professionally run website, and especially those where public comments are medically monitored, you'll actually see a pretty consistent perspective. Personal testimony from individuals about how they (or a friend) got HIV are the least reliable of all evidence. That's not to say it doesn't happen; it can and does. But the ones most likely to contribute to online conversations are those who believe it happened.
If all anal and vaginal sex could be abolished from the world and only unprotected oral sex remained, HIV would die out. Oral sex, either fellatio or cunnilingus, in either direction, simply is not a sufficiently efficient transmission mechanism to sustain transmission of HIV in any population.
I hope this helps. Good luck-- HHH, MD
You are right when you say the post may help other users, I had similar questions. However I notice mention is made of saliva properties but I can't help but wonder about cuts on the outside of the mouth (cracked/split lips etc) which could get vaginal or semen fluids on/into them & which I assume would have no saliva protection.
Thanks for your time and detailed information. I did do a search in the forum - thanks for the tidbit. Would you put oral sex risk in the same category as protected anal sex or protected vaginal sex?
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