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Why receiving oral sex(felattio) has no lower risk than performing oral sex

I have read through some studies and so happened all only covered for the risk of the girl/guy performing oral sex to another guy(felattio). As i got to know from this STD that the risk for the receiver is 1/20,000 while the partner who perform is 1/10,000.
As i know if the partner is infected by HIV and her/his mouth/saliva will have HIV virus and why this virus very hard/won't infect the receiver through urethra?
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Avatar universal
I have to disagree here with some comments about "zero risk". The only zero risk is having sex with your hand.

Althought receptive fellatio is extremely low risk, is not "zero risk". Many of the studies quoted don't take in consideration the case of persons that just got infected. In such cases, the person (who maybe is unware of an infection) has a VERY HIGH viral load and thus the transmission probability increases for the person giving the fellation (the person sucking). That's the reason why many sites advice people not to let their partner eyacute in his/her mouth. Here's a very interesting article about this, and you can see, none of the experts say this is a "no risk" situation:

http://hivinsite.ucsf.edu/insite?page=pr-rr-05

About the insertive oral sex, there's only a theoretical risk as far as I know (in other words, you would need Dracula's daugther performing a fellatio on you to get infected). I hope this is really theoretical as I am having my test results this Thursday due unprotected fellatio on me. Fingers crossed...
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480448 tn?1426948538
I've been an RN for 18 years, and have worked with countless HIV patients and ID docs who treat HIV every day.  NOT ONE case was caused by oral sex as a transmission method.

What is your formal educational background with HIV?  I'm sorry, but for you to go against what the highly educated and esteemed doctors who specialize in HIV say, it is just silly to me.  With all due respect, you are just wrong.  Oral sex is NOT an HIV risk and we will not continue this conversation with you.
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Avatar universal
HIV is not transmittable via Kissing but to me, kissing is similar to receiving oral sex as the receiver only expose to saliva. Most of the people ulcer/little tiny wound(cause by brushing teeth) in their mouth . So, existence of blood from receiver's partner could possibly pass to the receiver regardless of to Penis/Mouth.

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480448 tn?1426948538
As Vance stated, we don't debate this.  There will always be the great debate about oral sex being a risk or not.  On this forum, our stance is that oral sex is ZERO risk, based on very thorough studies that cover long periods of time involving serodiscordant couples who only engaged in oral sex.  In a few of these studies, the infected partners were at different levels of their HIV infection (some newly infected, some infected for a decade or more), and the result were ZERO new infections for the negative partner.

You have to thoroughly READ these studies like we have and have enough of an educated background about HIV and understand the mechanism of transmission like we do to FULLY understand why we insist that oral is no risk.  The doctors on this site also share the same stance as we do, with the only difference being the verbiage in how the info is delivered.  Many doctors, due to liability, are reluctant to ever use the terms "never", "always", "zero", "100%", and so forth.  The difference in our risk assessments stating "zero" risk and their statements stating "low' is explained very well in Dr. HHH's statement below:

"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

If you read the above statement, you'll see that the expert doctor assessments and our assessments are actually exactly the same.

If oral sex was truly a risk, nearly the entire human population would be infected by now.
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Avatar universal
This is not a debate.
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Avatar universal
HIV and saliva
http://www.mcld.co.uk/hiv/?q=HIV%20and%20saliva
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Avatar universal
I don't think there are any studies with people in the acute HIV infection (when the viral load is VERY high), it would be impossible to make such studies. Also, I don't think anyone here would think there's no risk to perform a fellatio with someone who is in this case, and receive his cum on his/her mouth.

Again, I agree this is very or extremely rare, but I wouldn't call it "no risk". One might be SO unlucky and end up performing a fellatio on someone who happen to be in the acute HIV infection in that very moment, and in that case, the probability definitely increase.

From the article above:

"I think there are at least six different cofactors, which may be involved in increasing or decreasing susceptibility to HIV infection through oral sex and they all appear in different contexts but all involve trauma, sores, inflammation, allergies, concurrent sexually transmitted diseases, ejaculation in the mouth (...) And then obviously, partner infectivity--we haven't talked about that. It's possible that in the Spanish study, a large portion of those folks were on antiretrovirals and it's certainly hypothetically possible that many of them may have decreased infectivity because of decreased viremia, and so stage of HIV infection may be a very important component in this, too, that we don't know about. But certainly, people rarely go around asking their partners about their viral load, although they might nowadays. Acute viral syndrome is something that we think about, and so these are all possible cofactors..."

By the way this was said by Kimberly Page Shafer, one of the authors quoted by Teak before.
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Avatar universal
Several studies done show no risk.
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Avatar universal
It's NOT transmittable by oral sex.
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Avatar universal
Hi Teak,

   Thanks for the reply. I've read all these from your post but there is no explanation why it is transmittable via oral sex. I truly trust the Expert here but my curiosity ask me to know more.

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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
So the Protein is able to neutralize the HIV? Sorry, would you mind to explain in more details joggen?
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Avatar universal
Saliva has over a dozen proteins that inhibit HIV.
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Avatar universal
Hi Joggen,

    Yes. I know Oral risk is zero risk. i am just wonder why infected person's saliva is not contagious.
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Avatar universal
They are both zero risk for HIV.
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