cunnilingus STD risk -- in summary

[BobLA]

I've gone through a lot of different entries both in the STD Community, and in Dr. HHH & Dr. Hook's expert forum. My question/issue is not at all an uncommon one, a mistake many of us have made it seems: performing cunnilingus on an escort/stripper/CSW in the United States (Las Vegas in my own case) without protection (dental dam).

Below I will list what I believe I have learned. If those on the forum who are particularly knowledgeable (auntiejessi, monkeyflower et al) can confirm I've got this right, it would certainly be appreciated by me -- and I think would be a useful search result for people like me, who've been looking for "one-stop-shopping" questions answered about this issue, without getting sidetracked on all the very detailed bits people usually put in their questions that are typically relevant only to them (i.e. "I performed unprotected cunnilingus AND got a ********" or "I had a cold sore at the time and I gargled after and then watched the Lakers-Celtics game for 2 hours, does this put me at a higher risk?" etc etc).

What I think I know:

1) The risk of HIV infection is DEFINITELY almost non-existent, and may in fact actually be zero risk.

2) The risk of contracting an STD is higher -- but generally speaking, very low as well. It is somewhere between very, very unlikely and close to flat-out impossible. In particular, it is worth noting that Dr. HHH states that in his 30+ years of working in the field, he's never seen one confirmed/highly plausible case of contracting an STD by performing cunnilingus.

2a) The risk *can* be higher, if you have extenuating circumstances (i.e. open cuts in the mouth, etc). However, worst-case, this is perhaps a doubling or tripling of odds that were very low to begin with.

3) The most likely/plausible STDs that could be contracted are oro-facial herpes and oral gonorrhea. However, both of these incidences are rare. Syphillis is also possible, but highly unlikely due to the low % of the population carrying syphilis to begin with (including CSWs).

4) Bottom-line: STOP PANICKING! Cunnilingus is not exactly "safe sex," and you're an idiot if you do this repeatedly (or in my case, ever again). However, there is ZERO chance you've contracted HIV from a one-off encounter like this, and an ALMOST ZERO chance you've contracted any other STD. And even if you're somehow the unlucky lottery-winner-in-reverse and you caught something, the odds of you passing this on to any other partners are very, very low.

5) So why is there all sorts of information/sites out there saying otherwise? Partly due to moral/political motivations or pressure, partly due to ignorance/outmoded thinking about STD spread, and probably mostly due to covering-your-*** vis a vis legal concerns. STDs theoretically CAN be spread by cunnilingus, yes, so for doctors (and lawyers for that matter), that fact trumps the fact that in practice it is VERY RARE. An overabundance of caution.


As I said, if the community experts can weigh in simply to confirm my summary is correct, I would really appreciate it, and I'd bet others out there searching MedHelp would too.

[always_worried1234]

So does the same go for a woman receiving cunnilingus? What's the likelihood that something would be passed from a mans mouth to a woman's vagina via cunnilingus?

[auntiejessi]

The only thing I've ever seen transmitted via cunnilingus was an oral hsv1 infection to the female, to give her genital hsv1.

I've never had a case where a person got an oral infection from oral sex on a female.  I'd say its possible, but its not at all likely.

Aj

[BobLA]

AJ, a follow-up if you're comfortable with it. One of the things that really struck me when I was reviewing articles in the expert forum was the Dr. HHH citation I mentioned: "[C]unnilingus is particularly low risk.  Except for rare cases of herpes, in 30 years I have never seen an STD transmitted in either direction--to either the oral or the genital partner--by cunnilingus."  {see final response on this thread: http://www.medhelp.org/posts/show/248345}

When the director of Seattle/King Co's STD control program from '78 to '04 says that, it grabs your attention.

Does your own experience mirror that -- have you ever seen/worked with cases where STD transmission was confirmed or plausibly connected to cunnilingus, and if so, could you throw out a rough outline of what types and which have been more frequent?

[auntiejessi]

Don't get me started on scare tactics.

Glad you've gotten some good stuff from this site - that's why we do it.

Aj

[BobLA]

Thought you might like that.  ;)  Have to say, it's pretty incredible some of the unnecessary detail some people go into when they're posting their stories. Not that I am not sympathetic: people do something stupid, they don't have all the facts, and they are scared witless they've screwed up their own lives and (usually) are even more frightened about hurting their partners/loved ones. But all the same, I'd be willing to bet that at least 10% of your day involves rolling your eyes!

Thanks for your reply AJ. This site, you, monkeyflower and the others, and the Dr's are an absolute godsend in an online world filled with what seems all too often to be outright fearmongering about STDs. If only everybody was primarily concerned with just telling it like it is, for good or bad, instead of the overcautious/scare tactics approach you find so often. xoxo

[auntiejessi]

"I had a cold sore at the time and I gargled after and then watched the Lakers-Celtics game for 2 hours, does this put me at a higher risk?"   Oh that's awesome.

1 - Correct.

2 - Correct.

3 - Oral gonorrhea is correct, but herpes almost very rarely goes from the genitals to the mouth, regardless of gender.  Syphilis risk varies depending on the incidence of syphilis in your area.

I would say that if you've given a woman oral sex, I wouldn't worry at all unless you get symptoms.

Aj