HIV PREVENTION EXPERT FORUM
Worried Oral

Worried Oral

Doctors:

I was hoping you’d address a concern of mine involving oral sex. The other night I gave and received oral from a guy of unknown status. Normally, I would not be concerned, but while I was giving I noticed a slight irony taste. Being that I have a past history of bleeding gums I stopped giving him the oral and we masturbated together. Afterward I went into the bathroom and noticed my gums were very red. They were not really bloody, just a deeper red color around the front gum line of my bottom row. Being that the blood wasn’t streaming, I wanted to test if it really was bleeding so I blotted the area with a tissue. Blotting resulted in a faint pink spot (I’m guessing some blood) on the tissue. This brought my mind spinning, as I remember tasting some pre-ejaculate while giving. Of course, he did not fully ejaculate in my mouth. Regardless, I basically gave him oral sex with bleeding gums where pre-ejaculate was present. I have read in some older posts that you both consider giving and receiving oral “safe” as far as HIV is concerned. I even found a few posts where you noted that bleeding gums, gingivitis, etc…make no difference. Has your assessment recently changed? Should I be concerned over this incident and does it warrant testing? Would you recommend any preventive measures while I am still in the window period for meds?

I have read conflicting information on different websites, so wanted to get your final word on the manner. From what I read, you both are the absolute experts on HIV.
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I'll be pleased to comment.  The issue of the safety (or risk) of HIV relating to oral sex is a topic we receive many questions about.  The fact remains that despite intensive research and the vigilance of many health care providers taking care of literally millions of persons with and at risk for HIV, there are NO instances in which HIV has clearly been transmitted through oral sex.  I repeat, none. And this is the case despite that fact that there are many, many persons who only practice oral sex with new or infected partners.  The presence of oral sores, gum disease, cavities, etc does not change this fact.  The oral cavity is a hostile environment for potential pathogens being full of antibodies, enzymes and other infection fighting elements of host defense.  When material passes from the mouth to the stomach, the environment for the pathogen only becomes more hostile due to stomach acid, etc.  thus my assessment remains the same- this was a no risk encounter and there is no need for concern or testing despite your gum disease.  You may however want to do more flossing and work with your dentist to improve your gum problems

Take care. EWH
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Dr. Hook:

I apologize for asking this question a few days after my original, but I was unable to reach a computer. Would razor burn/irritation from shaving a few hours before engaging in frottage and kissing/licking of the body, increase the chances of infection? What if bodily fluids of any sort got into the razor burn? After this occurred, It caused the irritation to increase and become red and inflamed. Thanks, again.
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