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Spit and cunnilingus = HIV?

Hi

I would like some verification on this topic if I may! As a student nurse I should be a bit more clued up on this topic but hope to be enlightened some more by you guys. Does the following scenario pose a risk for HIV infection:

10-15 minutes unprotected cunnilingus on sex worker of unknown HIV status
Sex worker spat in mouth
Protected vaginal intercourse with worker

1) Why is there such an ongoing debate regarding whether or not oral sex is a transmission for HIV?
2)Why is this speculative and not definitive?
3) Would you recommend testing in this scenario? If so/not, why?
4) Could you care to mention any ball park figures for risk of HIV infection in this scenario?
Would LOVE some expert advice, thanks.

M



3 Responses
936016 tn?1332765604
MEDICAL PROFESSIONAL
Hello Mickey

You asked:-

1) Why is there such an ongoing debate regarding whether or not oral sex is a transmission for HIV?

I don't think there is. Most of this discussion centres around oral sex and males. We know that there is a risk to anyone who sucks an HIV positive male with ejaculation into the sucker's mouth PROVIDED the HIV positive male has a reasonable amount of virus in their semen. Successful treatment of HIV involves suppressing viral activity to an undetectable level. This undetectable level will vary from lab to lab but is generally less than 50 copies of virus per ml of blood - and in the case of the laboratory we use at Freedomhealth it is less than 20 copies of virus per ml of blood. There is a slight difficulty with this in that other events such as other illness, other drugs, may influence a persons "viral load" even though they may diligently take their medicines.

We know there is no risk - zero risk - to the person being sucked.

In terms of performing cunninglingus we know that the number of cases reported worldwide over the last 30 years or so is very low indeed - so whilst it may happen, the prospect is vanishingly unlikely.

2)Why is this speculative and not definitive?

I don't believe it is speculative. The facts as we know them are given above. The confusion arises because we are not there with people recording what they do sexually, with whom and when. The reality is that people are at least "coy" when recollecting their sexual events and are often inaccurate either inadvertently or deliberately.

3) Would you recommend testing in this scenario? If so/not, why?

the spitting and the protected vaginal sex are of no consequence whatever you might think of them. The unprotected prolonged cunninlingus does suggest testing for STD's such as gonorrhoea etc but I would not necessarily advise HIV testing unless the patient was particularly worried.

4) Could you care to mention any ball park figures for risk of HIV infection in this scenario?

1 in 1 million for cunnilingus. The others = zero.

Would LOVE some expert advice, thanks.

best regards, Sean
Avatar universal
Thanks for your response Sean, this was helpful.

A sore throat has started (two and a half weeks after incident) I assume this does not change the answer you gave in any way?

M
Avatar universal
A related discussion, Help me!! was started.

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