Herpes + HIV Positive partner = ????

Hello Doctor:

I had a sexual encounter with a HIV+ male.  This involved oral sex being performed on him, and on me(69 basically).  No ejaculation but definetly precum was shared. Kissing as well.  Now the thing is, I have HSV-2(Genital Herpes).  I have had sores in my mouth before, as well as penis.  Did not have any sores during intercourse, but who knows if I did and they were really small.

I have had HIV scares before, and by now I don't really care.  But I do want to know if it's safe to have sex with my girlfriend without worrying for her?  That's pretty much my question.  Can I have unprotected intercourse with my girlfriend without worrying about HIV.

Thank you so much for your time.

[Edward W Hook, MD]

You are taking chances of acquiring HIV through unprotected exposure to a partner who you know to be infected.  You know that.  What you are really asking is how much risk are you taking.  The answer to that question is not much.  The overall risk of giving oral sex to another, infected peron is less than 1 in 10,000, on average   (1/100th of 1%).  Within that average figure there are obviously some who are at higher or lower risk.  Seperate studies suggest that persons with herpes are at about 3 times higher risk for getting HIV than persons who don't have herpes, Thus, applying the math, for receivng oral sex from a partner, your risk is about 3 out of 10,000 (actually it is lower for a number of complex reasons).

Having said all of this, are you at risk? -yes.  Is it high?- no.  Is it perfectly safe for you to have sex with your GF?,  No not perfectly safe but also not very risky,  Should you worry - you have the sex with her?  Now you have the information, it is your decision.   The risk is very low.  EWH

[badday103]

Very small risk from the receptive oral ( rare way to get hiv but it has happened)

No risk from the insertive oral ( no documented cases of this ever happening)

[Thatguy300]

Here's the thing.  I didn't know the person was HIV+.  I asked if they were and they said, "No" but couldn't look me in the eye.  So I went home and called them up and decided to say, "Hey, I'm HIV+!"  That way, by their reaction I would know.  Believe it or not the person was all calm and cool about it like, "Whatever, why should I worry about something that I can't do anything about."

That's when I decided to get them tested.  And they didn't want to go with me, I had to bribe them.  And that's when I found out they were positive!

Now, What I'm assuming is that those people who get HIV through oral sex have other factors besides average oral sex, like huge cuts in mouth, etc?  Am I right?  I mean, I did spit out the precum, that's got to count for something.  Only factor I had was herpes.

[Edward W Hook, MD]

As I already said, your risk is very, very low.  Getting HIV after inly oral sex is so rare that there are few if any well described cases in the literature and niether Dr. Handsfield or I have ever seen a case in our combined over 50 years of caring for persons with and at risk for HIV.  Does that make it no risk, no.  What are the variables that increase or decrease risk - hard to say.  cuts of the mouth, bleeding gums, swallowing have all be proposed but their true impact is unknown.  Good luck.  EWH

[badday103]

Actually the insertive oral according to the CDC carries a 1 in 20000 chance so if you triple that it comes out to a 1.5 per 10000 exposures.  I have even been tolsd that this figure might be high since there still are no documented cases from insertive oral and this estimated risk is based more on a guess.  As far as the receptive oral I would say you still have a very small risk.  The doc answers a bunch of these questions and I think he might have lost track of insertive and receptive oral.

[Edward W Hook, MD]

Actually,as a governement agency,  the CDC's estimates ARE and must be conservative.  The mechanics imply that there should be a difference but the are no data proving that that is the case.  EWH

[badday103]

The CDC does imply a difference hence the 1 in 10000 for receptive and the 1 in 20000 for insertive oral.  There is no data to back even this up because they dont have any cases from people getting hiv from insertive.  The CDC just assumed that it was just less than receptive.