The doubt about fellatio and HIV transmission risk

[wildhorse]

Dear friends,
the only unprotected type of sex that I practice is receptive fellatio without ejaculation. When I practice penetrative sex (anal) I always use strong condoms and water based lubrificant.

I also submit to HIV test every year, and the test result has always been negative, as well as other STD tests (Siphilys and epathitis).

I have read other answers about oral sex in your forum, and it seems that you do not consider oral sex as a risky practice for HIV.

This is also the opinion given by the Swiss Health Authority on their forum.

(see http://www.aids.ch/e/fragen/index.php)

However there are many other important sources of information, that explicitely consider oral sex in general and receptive fellatio in particular as a risk for HIV transmission.
(see http://www.cdc.gov/hiv/resources/qa/transmission.htm)

Further, I have found a recent document that summarizes the results of many studies :

http://www.aidslaw.ca/EN/lawyers-kit/documents/2a.McLay2010_s.3update-Dec2011.pdf

In the document, at page 8, you can read the following :
"...A systematic review of the literature identified three estimates of per-act risk based on results from three studies involving 2497 people. Two studies reported no new HIV infections resulting from oral sex. The 0.04% value quoted in the table is from a single study of almost 2200 men who have sex with men (MSM) and involved oral sex where a man who is HIV positive or of unknown status ejaculated in the mouth of the HIV- negative partner..."

In the end, I do not feel safe at all when I practice unprotected receptive fellatio with unknown partners of unknown infective status : although I always avoid receiving ejaculation, I always have fears about the possible HIV contamination through pre-cum fluid, or sometimes I think that the partner could have ejaculated just before meeting me...

I would like to receive from a senior member of the forum a position about the real risk of practicing receptive fellatio without ejaculation. Thank you so much for your useful support.

Wildhorse

[RapidRod]

Oral sex is not a risk of HIV transmission.

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.

[wildhorse]

 RapidRod,
 i've read the following in the safer sex guide of this forum :

"...Because unprotected fellatio can mean that body fluids from one person can (and do) come into contact with the mucosal tissues or open cuts, sores or breaks in the skin of another person, there is a "theoretical risk" of HIV transmission. "Theoretical risk" means that passing an infection from one person to another is considered possible, even though there haven't been any (or have only been a few) documented cases..."

Are there documented cases (although few) of HIV transmission due to receptive fellatio ?

Thanks,

Wildhorse

[RapidRod]

There are no verified documented cases.

[wildhorse]

There are no verified documented cases.

So I guess that means the documented cases where not verified by others than the source that reported them...(pardon my english, it is not my native language).

Wildhorse

[Andy Velez]

That's right. And claims remain unverified for a number of reasons.

You are worrying needlessly. Really.

[wildhorse]

OK, I stop my questions and my worries here.
 
Thank you RapidRod and Andy, and many thanks to those who are constantly contributing to this forum.

Wildhorse

[wildhorse]

Hello,
tonight I think I had an accidental and very brief contact between the head of my penis and sperm.

Another guy and me were standing and self-masturbating, while a third friend was on his knees waiting to receive our ejaculation on his face.

The other guy came first, and I kept masturbating my penis for about a further minute, and just before coming, the head of my penis touched the face of the third friend who previously received the sperm of the other guy, on the same side.

It was an instantaneous and very quick contact, I am not even sure that my penis came in touch with the other guy's sperm, and even if I guess that 60 seconds were passed after his ejaculation. Nevertheless what has happened keeps me worried. Ann, Andy, do you believe this kind of indirect and instantaneous contact can be a risk of HIV contamination ?

Usually the only unprotected type of sex that I practice is receptive fellatio without ejaculation, which your forum do not consider a risky practice. When I practice penetrative sex (anal) I always use strong condoms and water based lubrificant.

Thank you for the support you keep on providing, best regards.

[RapidRod]

HIV is unable to reproduce outside its living host (unlike many bacteria or fungi, which may do so under suitable conditions), except under laboratory conditions; therefore, it does not spread or maintain infectiousness outside its host.

[wildhorse]

Thank you RapidRod.

What do you mean by "outside its host" ?

If we consider the sperm as the host, then the virus was not outside its host.

If we consider as host the body of the potentially infected person or my body, then the virus has remained for about 60 seconds outside its host (i.e. in the open air on the skin of a third person).

I want to specify that my penis just lightly brushed for an instant the skin of the third person (the surface where the potentially infected sperm could have remained for about 60 seconds) :

How long does it take an infected fluid (as sperm) to lose its infectious properties when exposed to the open air ?


best regards 

[Matty the Damned]

Thank you RapidRod.

What do you mean by "outside its host" ?

If we consider the sperm as the host, then the virus was not outside its host.

If we consider as host the body of the potentially infected person or my body, then the virus has remained for about 60 seconds outside its host (i.e. in the open air on the skin of a third person).

I want to specify that my penis just lightly brushed for an instant the skin of the third person (the surface where the potentially infected sperm could have remained for about 60 seconds) :

How long does it take an infected fluid (as sperm) to lose its infectious properties when exposed to the open air ?


best regards

Humans are the host for HIV.

Your circle jerk experience is not a risk situation. Whether the virus remained viable in the semen is irrelevant here as the circumstances required for transmission to occur simply did not exist.

HIV is transmitted in very particular ways. Those ways are:

Unprotected vaginal and anal sex;
Sharing contaminated injecting equipment such as needles and syringes;
In some cases from HIV positive mother to her unborn or nursing infant.

Your cock lightly brushing the skin of another person isn't a risk situation.

You do not need to be tested for HIV as a result of this encounter.

Please take the time to read our Welcome Thread. It contains the posting guidelines for Am I Infected? as well as links to our lessons on HIV transmission.

You should pay careful attention to the posting guidelines. You will not be permitted to ask endlessly about non risk situations. Failing to follow the guidelines will result in your account being suspended or even permanently banned.

MtD

[wildhorse]

Matty I am grateful for the high quality support and contents that you as well as the other forum senior members or administrators provide to the public.

This forum is, in my opinion, THE SOURCE of reliable information and exchange of information as far as HIV is concerned. Most of times I just read the forum posts (almost daily) without interfering by sending my own (unuseful) posts.

However my mind can be fragile as that of many other humans, and under certain temporary circumstances it may happen that I fall into the mistake to ask about "non risk events". I'll do my best not to do it again.

[wildhorse]

...Sexually speaking, hiv is transmitted through unprotected anal or vaginal intercourse and very, very rarely through giving a blowjob. And that's it.
Use condoms for intercourse and you will avoid hiv infection. It really is that simple.
...
Ann

I am sorry to come back on the same topic, but it seems that Ann has slightly changed her position as far as the risk of actively practicing fellatio :

Now it seems that there is statistical evidence of the contagious event through giving a blowjob, and the usual statement "use condoms for vaginal and anal intercourse and you will avoid hiv infection" has been changed with a more general "use condoms for intercourse and you will avoid hiv infection".

Ann am I right or it is just a matter of my subjective and "fragile" perception ?

[Andy Velez]

Sexually the only 100% safe is you with your own hand. So theoretically giving oral could be a risk. But it's one of the most common of sexual activities and we would have known long before today if it was a for real risk.

Longterm studies of both gay and straight sero-discordant couples, involved lots of mutual unprotected oral and only protected vaginal and anal intercourse. There results were that not a single sero-negative partner became infected.

You can simply for your own peace of mind get tested to collect the inevitable negative result. But it's only for your peace of mind because I don't see you as having had a real risk. And receiving oral sex is absolutely not a risk. Period.