HIV risk, unprotected oral sex,

[Worriedgirl7]

Hello all,

 I am a UK citizen. I am concerned about HIV because I am travelling to stay with some friends who live in Russia, which requires a HIV test for long stays.

First of all I want to say that I have not had unprotected vaginal or anal sex. Neither am I a drug user, nor did my mother have HIV which could have been passed on to me.  I know to always use a condom during vaginal and anal sex.  However, I once gave oral sex to my first boyfriend I had 2 years ago. I am pretty sure he was a virgin like me, we were both young teenagers, but of course you can NEVER trust what people say about their sexual history, I know. I am concerned about the HIV risk from this. Stupidly, at the time I thought it wasn't an HIV risk, only herpes, HPV, chlamydia and syphilis. So I inspected his penis before I did it, and saw no sores, so I continued.

Also, with this same boyfriend, I let him rub against my thighs, with absolutely NO penetration of the vagina or anus. He came all over the tops of my thighs, and I was scared a tiny bit of semen would have leaked onto my vagina or anus, so I ran off and washed off around that area. I also took the morning after pill.

So I remained a virgin with this boyfriend. With my second boyfriend, I felt mature enough to engage in  vaginal sex and lost my virginity to him. I have had both vaginal and then anal sex now with my present boyfriend but ALWAYS with a condom.  We are in an entirely monogamous relationship. We recently decided to 'come off' condoms, and I insisted we went together to get a full STI screening beforehand.  He came back negative for everything, (blood and urine).  I made sure I opened the envelope first, as I am quite paranoid!
I had a chlamydia and gonorrhea test and was negative, but didn't have  a blood test as the nurse couldn't get blood from my veins. ( Surprising, I know, but she was rather incompetent!)

Anyway, my boyfriend said that as he was negative for everything, and I had never had  vaginal or anal sex before him,  and was also negative for chlamydia and gon. that it was OK now to engage in unprotected sex.

However, I am scared about the risk from the previous oral and thigh rubbing incident- and don't want to harm him. I have to have a HIV test anyway for travelling abroad, should I be concerned?

Sorry for the rather long-winded note,

[RapidRod]

Oral sex is not a risk of HIV transmission.

[Worriedgirl7]

Thank you for your reply, Rod. However, looking at the NHS leaflet on HIV transmission, they say that oral sex poses a 'very low risk' but not NO risk. So perhaps there is a chance?

[RapidRod]

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.

Here are some responses from some Doctors on oral sex.

There is no debate (among experts) about the HIV risks associated with oral sex. The risk is so low that almost nobody who cares for HIV infected patients has ever had a patient believed to have been infected that way. Among experts, it's a semantic issue about using terms like "no risk" and "very low risk". There is no difference between my or Dr. Hook's use of "low risk" and other experts' "no risk".
DR. HANSFIELD

"And oral sex is basically safe sex -- completely safe with respect to HIV and although not zero risk for other STDs, the chance of infection is far lower than for unprotected vaginal or anal sex. Please educate yourself about the real risks. If you stick with oral sex and condom-protected vaginal or anal sex, you have no HIV worries and very little worry about other STDs. " DR HANSFIELD

"I am sure you can find lots of people who belive that HIV is transmitted by oral sex, but you will not find scientific data to support this unrealistic concern..." DR HOOK

"HIV is not spread by touching, masturbation, oral sex or condom protected sex."- DR. HOOK

in the public HIV Prevention forum of MedHelp, TEAK and the other moderators maintain that oral sex in all forms is a zero risk activity. Would you agree with this assessment?
I TOTALLY AGREE / DR GARCIA

"The observation on thousands and thousands of observations is that HIV is not spread by oral sex (of any sort)." DR HOOK

[Andy Velez]

From what you have reported I don't see any reason to expect anything other than a negative result when you test.

Just keep using condoms consistently for vaginal and anal intercourse and you will be well protected as far as the sexual transmission of HIV is concerned. Those are the only confirmed risks for the sexual transmission of HIV.