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Avatar universal

Oral Sex, Rimming and Frottage

Dear Doctor,

I have a few questions if you don't mind.   I am quite happy that since I was 18 years old I have followed your motto - ASK your partners their status, Pick your partners wisely, and use condoms for anal sex.    I have never had a STD   That said, my concerns or questions are these:

Oral Sex:  I know its low risk, but I find the advice out there so confusing.   There are a number of websites that are peer reviewed with Doctors who are experienced in this field offering safe sex advice (Dr. Bob, Dr. K., to name a few). They say oral sex (GIVING TO MAN) is very low risk or for that matter, very minimal risk.  Then you have other doctors saying its medium risk and advise against it.  Even at the center where I go here in Boston (well known), one doctor will say its "pretty safe if you don't take ejaculate in your mouth" then another one will say "it's a pretty moderate risk, any fluid coming in touch with your oral mucus membrane is a risk, period - don't do it without a condom."  I know nothing in medicine is exact, but I find it all so confusing.  I have don't use condoms for oral sex,and don't take ejaculate in my mouth and while I always ask my partners their status, I have been told on two occasions by guys after I performed oral on them that they actually were positive.  I freaked out, actually tried to get PEP both times and was turned down. I am fine though.  I often wonder why condoms haven't caught on for oral sex in the gay community. Just looking for your insights/thoughts.

Next is Rimming:  There is very little information on rimming out there.  And what information is available, its totally confusing. I know you can get some nasty stomach bugs from rimming, but what is the real deal with HIV transmission?

I thank you for your time and I hope my questions have some value to other gay readers (and straight, transgender site users as well!)








6 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Congratulations for your commitment to sexual safety.  You can expect never to get HIV.  Your 'well known' Boston clinic presumably is Fenway Community Health.  It is one of the premier centers for HIV prevention and clinical centers, and for gay men's health in general.  So you are in good hands.

Most health experts believe that advising condoms for oral sex doesn't pass the 'laugh test', i.e. too many people would blow off such advice (no pun intended), with further risk that people would also disregard condoms for vaginal and anal sex.  Further, oral sex is so low risk that most health experts don't think that widespread use of condoms would make any measurable difference in the overall frequency of HIV infections.  However, when individuals desire absolute maximum safety, everybody tells them that condoms are OK for oral sex and will further reduce a very low transmission risk.

There simply are no good data on rimming and HIV transmission.  Since HIV is not believed to be shed in feces (at least not frequently or in large amounts) and oral exposure to infected secretions is low risk, rimming--either as rimmer or rimmee--is generally believed to be fairly low risk for HIV.  But as I said, no data are available--and absence of firm data always results in wide variations in advice from various sources.  As you say, the main risks from rimming (as rimmee) are for enteric infections and hepatitis A.

I hope this helps. Best wishes--  HHH, MD
Avatar universal
Hello,

i am straight married guy who occasionally (twice so far) also engaged in rimming women (escort). So i can only comment that part of your question.

I got worried last time i did it (and maybe still a little bit) and did LOT of research on the HIV risk associated with rimming.

To me the biggest confusion came from the fact that most expert claims that there is no reported case while CDC says there's been one reported case.

So if there is indeed no documented case then it means it's negligible risk, if there's one then it's considered low risk.

I made more research and couldn't find really about that documented case other than this report http://sti.bmj.com/cgi/content/abstract/68/4/254

But again all the counselors i spoke with (in US and Europe) told me the same thing:
"You don't get HIV from rimming, unless there is blood". They also told me that if there was, I (as the rimmer) would have noticed.

I wipe my *** everyday and rarely see blood (maybe once or twice in my life). So  i assume blood in the *** is rare unless it's been penetrated just before you engaged in rimming. Also there is risk if someone else left semen in there and you happen to rim then .... you get the idea.

The other part is that even if you're partner has HIV and blood in the rectum, your mouth needs to have some kind of open cuts/sores to let the virus in.

This document below made me feel better about it:

http://www.cdnaids.ca/web/repguide.nsf/pages/cas-rep-0307

Finally, my conclusion is that is not likely to happen but it's not zero. So in my case i decided to get tested since i'm in a relationship and i need to be 100% certain, not 99,9999%.

Hope this helps.




Avatar universal
Thanks so much for your response, and you guessed it, the center is the Fenway.

I had a final question that was actually mentioned in my subject line but was unable to ask due to the space issue.

My question involved Frottage - gay frottage that is.  I use this as an alternative to anal sex when not in a relationship and was wondering the HIV risk/  My concern is the rubbing of a mans penis against the anus with NO entry.  Is this very low risk?   I just ask  because the issue of precum (every guy precums, every guy) and since it contains the virus and the anus is the start of a mucus membrane and the possibility of it getting into the anus/or rubbed on the outside of the anus.  Not sure if this is strictly a remote risk.  I know many gay men who do this and for that matter, my straight friends too.

Just thought I would ask since it is in my headline.

Thanks so much - the way I found this site is by the Fenway.  When I had all these questions for the counselor - they mentioned this website and you!  So I guess your now an official celebrity!

With appreciation.
Avatar universal
I live in the Cape Cod area and I agree, the Fenway Community Health is a wonderful center.   We are lucky to have them in Boston.

I just had a quick question, I noticed in Bostonman's post that he did have oral sex with two positive men, he performed oral on them.   Wouldn't that have been an exposure where he should have gotten PEP?   Or is it such an amazingly low risk that PEP wouldn't be advised?   I just wonder when one should get PEP?

I saw it in his post and thought I would follow up.  If this is thread high jacking, forgive me.

239123 tn?1267651214
MEDICAL PROFESSIONAL
There are no data on frottage and no serious suspicion of any transmission risk. Can I envision a small risk if infected blood or semen comes in contact with an open lesion of the anus or elsewhere? Yes, of course.

As long as we're talking about Fenway, I'll tell a story that someone posted on this forum a year or so ago.  He had been concerned about some fairly low HIV risk--I forget, maybe oral sex.  He described his Fenway provider as an older, mature (volunteer?) doctor, who answered his concern by taking him outside the clinic, pointed at the traffic, and told him his risk of dying from crossing that street was 100 times higher than the chance of catching HIV.

As I have said 100 times myself, safe sex means 1) selecting partners with thought and care (use brain as well as hormones), 2) sharing HIV status, and 3) using condoms for anal or vaginal sex outside committed relationships.  That's it, nothing else, nothing about frottage, oral sex, etc.  In other words, do not get hung up on convoluted, "what if" scenarios.

massguy:  Oral sex is too low risk; nobody would recommend PEP.  The risk of serious side effects from the PEP drugs is much higher than the chance of catching HIV.

HHH, MD
Avatar universal

I need to ask a very important question to help get my life back and i really need ur help guys ..

I am an American girl living in Kuwait .. I have had oral sex several times in Feb. ( dont know the exact date probably Feb, 16th .. ) and then i met my Fiance' who's from Kuwait and we're supposed to get married soon .. maybe May the 16th and all I read about is to have the test between 6 to 8 weeks, is there a reason for that and can i take the test now???? I mean it has been  over 2 months .. I need to know if i am negative .. My man is asking why i am avoiding any sexual relation? so Can i take the test any time soon???? or does it have to be an exact 6 - 8 weeks  or 3 months.???

Is two and a half months ok to detect HIV ???????????
I know it's a very low risk but i need to think of my fiance' 2 ..
Pleaaaaaaaaaaaaaaaaaaaaase help me so i can take the test as soon as possible to get my life baaaaaaack
THAAAAAAAAAAAANX aloooooooooooooooooooooooooooooot
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