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questions on performing fellatio

Hi Dr.
I am a female & enjoy performing oral sex on men. I have the following questions with relation to HIV transmission:

1) if I don't have sores or cuts in my mouth and don't allow the man to ejaculate in my mouth, what are my chances of acquiring HIV? Do you recommend being tested after an episode such as this?
2) If someone does ejaculate in my mouth and I spit out the semen, is the risk lower than if I swallow?
3) have you ever known of anyone to contract HIV through giving fellatio??
4) how long after an episode would you recommend testing? (I gave oral a few weeks ago to a man who I didn't know well. he did not *** in my mouth, but I'm concerned)

I'm just really confused about the risks involved in oral sex. I know that its theoretically possible for me to contract HIV by giving oral, but its also theoretically possible for me to get hit by a meteorite. CDC says it's "risky" but others say don't worry about it. What's the truth??
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239123 tn?1267647614
MEDICAL PROFESSIONAL
It is impossible to calculate such risks for any one person; it depends too much on things that are unknown to me, like partner selection (which you already know about) and so on; and which STDs (HIV and chlamydia very low risk; herpes and gonorrhea higher; symptomatic warts low, but asymptomatic HPV probably high; and so on).  My guess is the risk of HIV from unprotected receptive oral is in the same ballpark as with condom-protected vaginal sex, i.e. very low, perhaps in the air crash/lightning range.

HHH, MD
Helpful - 1
Avatar universal
What do you consider "very low risk?" Does that mean that the odds are along the lines of being killed in an airline crash? being struck by lightning??
Would you consider this a lower risk activity than protected sex? (taking into account the likelihood of condom breakage/slippage)

Thank you for your comment re: choosing partners wisely. That does help.
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
HIV infection can be acquired by performing fellatio.  It's not common, a lot less risky than vaginal or anal sex, but not zero.  (The opposite direction is very safe; HIV is almost never acquired by receiving fellatio.)  However, no research has been done to answer your questions in the detail you are seeking.  It makes sense that the risk is higher if there are open sores in the mouth or gum inflammation, and ejaculation in the mouth or swallowing semen might be riskier than spitting it out right away, but no data are available.

The main thing you can do to protect yourself is to know something about your partners.  If you avoid performing fellatio on gay/bi men or guys who inject drugs, you can consider yourself at very low risk.  In that case, I do not suggest HIV testing after any particular exposure; just get tested about once a year.  (You also should be tested for other STDs, especially oral gonorrhea.)  Of course you also could use condoms, but most people aren't keen on condoms for oral sex.

I hope that helps.  Good luck-- HHH, MD
Helpful - 0

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