Oral Sex with Known HIV partner

[LotsofWorry]

Hi Dr. H,

Within the past year and a half, I've had sexual encounters with four people.

The first was my best friend. We had protected anal sex and unprotected oral sex about 5 to 7 times (I was always insertive). I trust him a lot. He was just recently tested about a week ago and has no diseases...so no worries there.
Persons 2 and 3 (both a few months ago): Both were oral sex, where I was only the insertive person (without condom.
Person 4 (10 days ago):
I met a guy. We french kissed for a while. He performed oral sex on me. I did not reciprocate.
Now I usually make a habit of discussing status prior to engaging in sexual acts. However, with Person 4, I didn't ask until after. He then informed me that he was HIV+. He's was infected about 2 years ago. He said his T-cell count is high (somewhere near high 900 and 1000) and his viral load is undetectable.
At first I was mad at him for not telling me from the start. But he was so honest with me that I could only be mad at myself for not asking first.
I know that generally oral sex is considered safe. I am uncircumcised, so I know that poses a higher risk. Assuming worst case scenarios (bleeding, sores, etc not likely though)...how worried should I be?

It just doesn't feel so safe when you find out the other person is infected.

Your thoughts would be greatly appreciated.

[H. Hunter Handsfield, M.D.]

As others responded before me (below), there is no realistic risk you acquired HIV in this situation.  The higher risk from being uncircumcised is irrelevant:  doubling a zero risk still leaves zero risk.

That said, I understand very well that 'It just doesn't feel so safe when you find out the other person is infected.'  It is partly for that reason that I disagree strongly with your partner's failure to inform you of his HIV infection before the exposure, and I do not believe you should give him a pass on it because 'he was so honest about it'.  Honest maybe, but very late!  In addition to the simple humanity of not putting people through the fears you are feeling, intentions for safe sex often go by the boards in the heat of the moment.  HIV infected persons have an absolulte ethical obligation to inform their potential partners, even when condoms, oral sex, or other safe sex practices are planned.

Bottom line:  You truly can relax in the confidence you weren't infected, and from a risk assessment perspective you do not need testing.  But if your anxieties will be further relieved by knowing you have a negative test result, have an HIV test 6 weeks or so after the event.

Good luck--  HHH, MD

[LotsofWorry]

Just a continuation...

Now I don't think there were any sores or bleeding. But it's weird how your mind plays tricks on you.

I saw on this site that insertive oral sex was pretty much completely safe, slightly higher if you're uncircumcised.

But somehow, it just doesn't feel as safe when you find out the other person is infected.

I'm kinda freaking out now. Everyone I talk to says I'm overreacting...I have nothing to worry about...it's all in my head. Deep down I believe them, but it's still scary.

I plan on getting my usual annual test (in September). But i'm just a lot more freaked out this time around.

[monkeyflower]

Receiving a blowjob, even from someone you know is HIV positive, is only a theoretical risk. No worries. I can understand why you'd be concerned, but you're okay.

I mainly just wanted to say that this post is quite the refreshing change from the usual "I kissed a girl...But it was with tongue...Yes, but I'd brushed my teeth that morning!" You seem to have a very realistic and reasonable perspective, and you practice safe sex. Seems to me you're doing everything right :-)

[DrStupid]

Getting head is considered "negligible" risk anyway.
But this guy has no detectable virus, he's on therapy!
There is just no chance, zero.
Don't worry!

[LotsofWorry]

Thank you Doc (and everyone else) for your comments.

My anxiety levels are much lower.

To Dr. H:
------------------------------------------------------------------------------
Believe me, I did not give him a free pass. I clearly let him know that he should've let me know before we did anything. That way I could have the option of whether or not I wanted to/didn't want to do anything sexually. I just appreciated the fact that he was honest when asked (which made me even more upset I didn't ask first).

But I know in life you can't always expect people to do for you what you can do for yourself. I should've have asked first (lesson learned for me). No matter how ethically sound notifying me is, he's not technically required to say anything if he doesn't want to.

I'm just thankful that I at least kept to my safe sex practices.


Thank you all again. You guys are great.