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Prevention and risk Oral sex

Hi All,
   I was hoping one of the long time experts (teak, lizzie etc.) could confirm my understanding of risk regarding oral sex , outside my relationship, in my case giving cunnilingus and receiving oral.  Never intercourse of any kind. Am I completely safe to the extent that it doesnt require HIV testing? I do understand there are other STD's possible to test for. I am having a couple things go on a few months after said oral and may be worrying needlessly.  But what sticks in my mind and what I have seen here specifically "stick with oral and protected intercourse and you will avoid HIV".  This is a powerful statement. The issue is when they (some docs) give odds for male to female oral , I know its really really low , is it really theoretical odds? no confirmed cases? or what they have seen as 1 or 2 cases?  Some of this is guilt I know. I have a longtime girlfriend and am afraid to have intercourse for just this reason of straying orally.  Knowing the only contact was oral sex is it safe to resume sex with my girlfriend regarding HIV?   I cant thank you enough for this resource and the time you donate , it is very much appreciated.
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Avatar universal
How about next time you focus on this--HIV is only transmitted via unprotected penetrative vaginal or anal sex,sharing needles,mother to baby.That's it.
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Avatar universal
Sorry Teak, I get it , please dont be upset with me.  Thank you hangon for your time.  i know you guys cant carry on conversations with those concerned about what if's, they are not facts.  Your time and service is invaluable and I appreciate the information greatly.

Thank you.

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Avatar universal
No incident HIV infections among MSM who practice exclusively oral sex.
Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WePpC2072)??Balls JE, Evans JL, Dilley J, Osmond D, Shiboski S, Shiboski C, Klausner J, McFarland W, Greenspan D, Page-Shafer K?University of California, San Francisco, San Francisco, United States

Oral transmission of HIV, reality or fiction? An update
J Campo1, MA Perea1, J del Romero2, J Cano1, V Hernando2, A Bascones1
Oral Diseases (2006) 12, 219–228

AIDS: Volume 16(17) 22 November 2002 pp 2350-2352
Risk of HIV infection attributable to oral sex among men who have sex with men and in the population of men who have sex with men

Page-Shafer, Kimberlya,b; Shiboski, Caroline Hb; Osmond, Dennis Hc; Dilley, Jamesd; McFarland, Willie; Shiboski, Steve Cc; Klausner, Jeffrey De; Balls, Joycea; Greenspan, Deborahb; Greenspan
Page-Shafer K, Veugelers PJ, Moss AR, Strathdee S, Kaldor JM, van Griensven GJ. Sexual risk behavior and risk factors for HIV-1 seroconversion in homosexual men participating in the Tricontinental Seroconverter Study, 1982-1994 [published erratum appears in Am J Epidemiol 1997 15 Dec; 146(12):1076]. Am J Epidemiol 1997, 146:531-542.

Studies which show the fallacy of relying on anecdotal evidence as opposed to carefully controlled study insofar as HIV transmission risk is concerned:

Jenicek M. "Clinical Case Reporting" in Evidence-Based Medicine. Oxford: Butterworth–Heinemann; 1999:117
Saltzman SP, Stoddard AM, McCusker J, Moon MW, Mayer KH. Reliability of self-reported sexual behavior risk factors for HIV infection in homosexual men. Public Health Rep. 1987 102(6):692–697.Nov–Dec;

Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990 Nov;108(3):339–362.

There is no debate (among experts) about the HIV risks associated with oral sex. The risk is so low that almost nobody who cares for HIV infected patients has ever had a patient believed to have been infected that way. Among experts, it's a semantic issue about using terms like "no risk" and "very low risk". There is no difference between my or Dr. Hook's use of "low risk" and other experts' "no risk".
DR. HANSFIELD

"And oral sex is basically safe sex -- completely safe with respect to HIV and although not zero risk for other STDs, the chance of infection is far lower than for unprotected vaginal or anal sex. Please educate yourself about the real risks. If you stick with oral sex and condom-protected vaginal or anal sex, you have no HIV worries and very little worry about other STDs. " DR HANSFIELD

"I am sure you can find lots of people who believe that HIV is transmitted by oral sex, but you will not find scientific data to support this unrealistic concern..." DR HOOK

"HIV is not spread by touching, masturbation, oral sex or condom protected sex."- DR. HOOK

in the public HIV Prevention forum of MedHelp, TEAK and the other moderators maintain that oral sex in all forms is a zero risk activity. Would you agree with this assessment?
I TOTALLY AGREE / DR GARCIA
"HIV is not spread by masturbation, through oral sex, through kissing or other casual contact." Dr. Hook
"The observation on thousands and thousands of observations is that HIV is not spread by oral sex (of any sort)." DR HOOK
"I would not say your risk ,if he had HIV is "slim to none"- that's too high.  I would say they are effectively zero.  How much of his ejaculate or other genital  secretions you may have swallowed makes no difference.  EWH "
"As far as HIV is concerned, there is no known risk of getting HIV from performing oral sex on an infected partner, even if that person's genital secretions get into your eyes or if you swallow." Dr.Hook
HIV is not spread by oral sex, giving or receiving, even if sores, gum disease or blood is present
DR HOOK
The fact is that there are no cases in which HIV has been proven to be transmitted by oral sex, including fellatio..  EWH
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Avatar universal
What I mean by "it can't be proven" was that it can't be proven that oral is a risk. In a courtroom it would be called "hearsay" and not admissible as evidence.
Controlled studies have been done with sero-discordant couples where they had unprotected oral and always protected vaginal/ anal sex. The largest one in Spain I believe. Not one became infected.
The mechanisms for transmission  can not be adequately met in the oral cavity in as much as the oral cavity is inhospitable to the virus due to the presence saliva and the depth and scarcity of receptor cells.
It is difficult for the virus to transfer to another host even with penetrative  receptive anal sex... the highest of risks.....about 1 in 100 episodes...statistically speaking...throw in the oral cavity , with it's inhospitable environment and more robust linings and you should realize that oral sex just is not a risk factor.
In my opinion it ain't and never will be a risk.



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Avatar universal
How many times do you have to be told that HIV is not transmitted by oral sex? Repeating the questions is not going to get a change in the answer. NO RISK.
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Avatar universal
Thank you hangon for your answer , I understand your point, but if it cant be proven 100% why dont they err on the side of caution and recommend test or is it just so low a risk , its an acceptable risk? I am only mentioning because I see "no risk" as the answer to oral. And trust me I want that to be the case , believe me.. Am I just letting my fears get the best of me or is any risk at all of HIV from oral not good? Would you have unprotected oral knowing what you know today? Thank you for taking the time to answer it is greatly appreciated!  
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Avatar universal
Well said.
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Avatar universal
"is it really theoretical odds? no confirmed cases? or what they have seen as 1 or 2 cases? "

Odds and a handful of so-called reported cases of HIV transmission through oral sex are very difficult, if not impossible  to prove.
These reports rely almost exclusively on the events as told by the person in question.
Imagine someone having unprotected anal or vaginal sex, then testing within the window period....lets say at 8 weeks(too early) and getting a negative result and feeling good about him/herself and then he/she goes out and has oral sex.
She/he is positive because of the earlier experience  (anal or vaginal)but will erroneously think he/she got it from oral.
That will be recorded and charted...hence  the "some" recorded cases of HIV through oral sex.
That is but one example why nothing can be proven 100%.
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Avatar universal
Yes you are thinking clearly--no risk--no test required.
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Avatar universal
Thank you Teak, I guess I will have to apply the statement from Emily to my questions and realize its safe sex , and no risk = no test required.  Please teak, am I thinking clearly?

Best regards to you,
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Avatar universal
by Emily_MHModerator,
And to clarify, it is this site's stance, based on studies and our own MedHelp experts (all of whom are world-renowned for their work in this field), that oral sex carries no risk for HIV.  
Emily
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