Standard oral question

[ltc1858]

Hello, guys. I'm sorry to be yet another person asking this question, so I will be straight to the point

So a couple of weeks ago, I, male, performed oral sex on this guy and I did not know his status. What happened was that besides the whole act, he also ejaculated in my mouth and I swallowed it. I believe I shouldn't have done any of these acts, since I remembered a few hours after it that I had a mouth ulcer due to biting my cheeks, but it wasn't bleeding or hurting at the time. I also remembered that sometimes when I brush my teeth my gums bleed a bit, but again, it wasnt bleeding at the time and it had been a while since I brushed my teeth. And I do not know if it's of any relevance or not, but I did not immediately swallowed, it stayed in my mouth for a few seconds.

I am so sorry if this description was a bit graphical in nature, but I am thinking of all of these things these days thinking that I might have been infected.

So in short: he ejaculated in my mouth and I swallowed it (but not immediately) and I had a mouth ulcer (it wasn't hurting at the time) due to biting my cheeks and I also have bleeding gums sometimes after brushing my teeth (again, it wasnt hurting nor bleeding at the time).

Could you help?

[Jim Allen]

The mouth generally lacks a route for HIV to infect; nothing you mentioned changes that, and saliva also neutralises HIV by damaging the receptors needed to infect human cells. It's such a minute HIV risk that it doesn't warrant testing outside the standard yearly screening.

So in short:

Move on with your life.

I did not know his status

Well, you never can be sure unless you tested him after keeping him locked up 24/7 for several months... I trust you don't do this to other people you have sex with so in fact you never truly know their status.

Here's what you need to know to reduce your HIV risks:
Use condoms for anal or vaginal intercourse correctly and consistently, with no exceptions. Consider talking to your healthcare provider about PrEP as an additional layer of protection against HIV

Keep in mind that some sexual practices described as safe in terms of acquiring HIV still pose a risk for other easier-acquired STIs. So please do get tested at least yearly for STIs, including but not limited to HIV, and more frequently if condomless intercourse occurs.

Also, note that it is possible to have an STI and show no signs or symptoms; testing is the only way to know.

Kind regards

Jim

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[ltc1858]

Hello, Jim. Thanks a lot for taking the time to answer my question. While I'm not saying that you are not telling me the truth, would you mind giving me the names of the studies (or pointing me to then) that support the fact that this kind of exposure posures little to no risk? I do test yearly and, as you mentioned, I am not going out there to test myself due to THIS situation, but you would be doing me a huge favor by just letting me read those scientific papers.

Just so you know, I hope I am not offending you in any way nor calling you a liar, ok?

[Jim Allen]

That saliva neutralizes HIV... I think you are mistaking me for some sort of fecking librarian about things established decades ago

Here are a few references to get you started, but don't return. I would suggest you actually start with learning about the life-cycle of HIV and then move on to the below.

Oral and Saliva/the mouth.

Still valid today and includes the single longest and biggest on oral sex. Start here and work your way forward. Stick to unbiased studies and avoid anecdotal surveys/studies.

J Campo1, MA Perea1, J del Romero2, J Cano1, V Hernando2, A Bascones1
Oral Diseases (2006) 12, 219–228

In total, almost 19,000 instances of unprotected oral sex were estimated to have occurred involving the 135 couples over the ten years of the study,
but not a single case of HIV transmission was detected. The study authors conclude that:

“this seems to point to a very low probability of HIV transmission related to this practice.”
Reference

Romero J et al. Evaluating the risk of HIV transmission through unprotected orogential sex. AIDS 16:9:1269-97, 2002.

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.

http://www.aegis.com/conferences/12wac/21143.html

Saliva neutralizes HIV-1 infection by displacing envelope gp120 from the virion.

Int Conf AIDS 1998 Jun 28-Jul 3; 12:267 (abstract no. 21143)

Malamud D, Nagashunmugan T, Friedman HM, Davis CA, Abrams WR
Dept. Biochemistry Univ. Penn Dental Med., Phila 19104-6003, USA.

BACKGROUND: Incubation of HIV-1 with human saliva decreases infectivity. This inhibition is specific for HIV-1, with no effect on adenovirus, HIV-2 or SIV and appears to work at the level of the virus rather than the host cell. We have now identified an active protein fraction and provide evidence that the mechanism of action involves stripping of gp120 from the virus.

CONCLUSION: The specific inhibition of HIV-1 infectivity by human submandibular saliva is associated with removal of gp120 from the virus. The active fraction contains several proteins, including two high molecular weight glycoproteins.

http://www.aegis.com/conferences/4croi/412.html

Mechanisms of anti-HIV-1 activity of human submandibular saliva.
Conf Retroviruses Opportunistic Infect 1997 Jan 22-26; 4th:140 (abstract no. 412)
Nagashunmugam T, Malamud D, Davis C, Friedman HM; University of Pennsylvania, Philadelphia, PA.

http://www.aegis.com/conferences/12wac/60770.html

Neutralizing effect of secretory IgA to HIV in parotid saliva of HIV-infected patients.

Int Conf AIDS 1998 Jun 28-Jul 3; 12:1142 (abstract no. 60770)

Moja P, Desgranges C, Pozzetto B, Lucht F, Genin C
Gimap University of St.-Etienene, France.

BACKGROUND: The aim of this study was to test S-IgA purified from secretions of HIV seropositive patients in a neutralization assay to determine whether specific S-I&A can protect from HIV infection.

CONCLUSION: These data demonstrate that secretory IgA, which is the predominant isotype in secretions, can inhibit HIVMN infection of MT4 cells. HIV neutralization has been carried out with CD4+ T cell line adapted virus strain as a standardized model system, but the use of mucosal autologous primary isolates in neutralization test would be useful to estimate the actual protective effect of these antibodies in each patient.

[ltc1858]

Jim, thank you very much and I hope you have a wonderful life!