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Oral sex risk assessment with mouth ulcer/UK testing
Hi doctors,
1 - 5 weeks ago I performed fellatio on a man that was older than me. It was for 20 seconds at most, although I may have tasted pre-ejaculate. There was no ejaculation as I decided I did not like it after the 20 seconds. The only thing bothering me is that I had a small mouth ulcer on the bottom of my gums, just in front of my front teeth. I know all the stats and odds and have read so many posts regarding oral sex on this forum. You may also notice that I already have posted on the community forums, however I thought it would ease my mind to get information from a doctor.
2 - However, I that an ulcer was an 'open sore' and is a break in the mucosal lining, meaning HIV could easily pass through it? It was quite small and I'm pretty sure it's healing, but what if some had got inside? If a small cut in the anus or vagina can transmit HIV, why not the mouth? A website I read said that even microscopic cuts or breaks in the ulcer could let HIV through.
3 - Is it easy to get HIV through pre-ejaculate? Also, is it likely to be infected with HIV if it was pre-ejaculate in the mouth? I read notes from the round table conference that oral sex without ejaculation is extremely extremely low risk, is this true ?
4 - Have you ever seen any cases or treated anyone where fellatio was the route of HIVtransmission ? I know it is partly because I feel guilty, but I can't stop thinking that I put myself at risk. It's starting to ruin my life :(
5 - I know that if there was considerable risk, there wouldn't be all these questions and studies because there would be overwhelming evidence that you could be infected via oral sex.
Finally, I'm in the UK, what tests are available to me? If I go down to the local hospital, will they test me straight away? What tests should I ask for? At 6 weeks, how accurate would my result be? Sorry my post was a bit long, and thanks very much for reading.
1 - 5 weeks ago I performed fellatio on a man that was older than me. It was for 20 seconds at most, although I may have tasted pre-ejaculate. There was no ejaculation as I decided I did not like it after the 20 seconds. The only thing bothering me is that I had a small mouth ulcer on the bottom of my gums, just in front of my front teeth. I know all the stats and odds and have read so many posts regarding oral sex on this forum. You may also notice that I already have posted on the community forums, however I thought it would ease my mind to get information from a doctor.
2 - However, I that an ulcer was an 'open sore' and is a break in the mucosal lining, meaning HIV could easily pass through it? It was quite small and I'm pretty sure it's healing, but what if some had got inside? If a small cut in the anus or vagina can transmit HIV, why not the mouth? A website I read said that even microscopic cuts or breaks in the ulcer could let HIV through.
3 - Is it easy to get HIV through pre-ejaculate? Also, is it likely to be infected with HIV if it was pre-ejaculate in the mouth? I read notes from the round table conference that oral sex without ejaculation is extremely extremely low risk, is this true ?
4 - Have you ever seen any cases or treated anyone where fellatio was the route of HIVtransmission ? I know it is partly because I feel guilty, but I can't stop thinking that I put myself at risk. It's starting to ruin my life :(
5 - I know that if there was considerable risk, there wouldn't be all these questions and studies because there would be overwhelming evidence that you could be infected via oral sex.
Finally, I'm in the UK, what tests are available to me? If I go down to the local hospital, will they test me straight away? What tests should I ask for? At 6 weeks, how accurate would my result be? Sorry my post was a bit long, and thanks very much for reading.
MEDICAL PROFESSIONAL
An ulcer is not "technically an open cut". Mouth trauma including mouth ulcers are quickly covered by epithelial cells making an effort to "seal" the wound. the mouth is a hostile environment to all sorts of infections including HIV.
I don't believe the CDC has any evidence to support the idea that mouth ulcers increase the risk. It is an entirely reasonable assumption but as far as I am aware there is no evidence to support it.
I have answered this bit already also as below but you seem intent on acquiring HIV.
"Your mouth is very different to an anus or a vagina - its meant to have all sorts of objects such as food etc in it and is loaded with bacteria. In fact, generally speaking, mouths are pretty dirty areas - and the skin there is used to minor trauma from food etc and will heal very rapidly indeed. Also, saliva and the enzymes contained in it are fairly robust at infection repellant"
The fact is, this will not expose you to HIV. I'm afraid that however determined you are to have HIV from this event, luckily you will not.
That's it from me. We're going round and round in circles a bit with this. I wont be coming back to this question.
very best wishes, Sean
Thanks for you response I appreciate it. Sorry if I seemed abrupt/rude
But I just want to know why an ulcer isn't an efficient route of transfer?
It's technically an open cut, so a route into the bloodstream? No one can seem to give me a proper answer as to why ulcers aren't a problem. CDC says it increases the risk.
It's technically an open cut, so a route into the bloodstream? No one can seem to give me a proper answer as to why ulcers aren't a problem. CDC says it increases the risk.
MEDICAL PROFESSIONAL
You said:-
"What are the odds of me contracting HIV?
I did pay for this question... "
And I have answered it in my original response:-
"It is unlikely to acquire HIV through pre-ejaculate in the mouth - even if it was present in the person you were sucking. I do not believe this represents a signifcant risk to you at all."
I can't give you a number - they don't exist.
"What are the odds of me contracting HIV?
I did pay for this question... "
And I have answered it in my original response:-
"It is unlikely to acquire HIV through pre-ejaculate in the mouth - even if it was present in the person you were sucking. I do not believe this represents a signifcant risk to you at all."
I can't give you a number - they don't exist.
Doctor Cummings?
What are the odds of me contracting HIV?
I did pay for this question...
What are the odds of me contracting HIV?
I did pay for this question...
Doctor?
Hi Dr Sean
Thanks very much for your reply I really appreciate it. What do you think are the odds of me getting HIV this way?
Even though I'm a perfectly rational person, I keep thinking I could be that tiny statistic that will contract HIV from oral sex. Do you admit that I could be that 1 in 10,000 to catch this disease from this? That's what's killing me... I could just be unlucky.
The Spanish survey is comforting, but I wonder how many couples actually ejaculated in each others mouth... is this normal behaviour for a long-term couple? I don't know... I know that there was no ejaculate present but the fact I had an ulcer is just making the situation so much worse. I can't see any scientific explanation that an ulcer doesn't let HIV through... apart from the whole saliva thing, and this doesn't seem to be pushed by that many people.
Cheers again.
Thanks very much for your reply I really appreciate it. What do you think are the odds of me getting HIV this way?
Even though I'm a perfectly rational person, I keep thinking I could be that tiny statistic that will contract HIV from oral sex. Do you admit that I could be that 1 in 10,000 to catch this disease from this? That's what's killing me... I could just be unlucky.
The Spanish survey is comforting, but I wonder how many couples actually ejaculated in each others mouth... is this normal behaviour for a long-term couple? I don't know... I know that there was no ejaculate present but the fact I had an ulcer is just making the situation so much worse. I can't see any scientific explanation that an ulcer doesn't let HIV through... apart from the whole saliva thing, and this doesn't seem to be pushed by that many people.
Cheers again.
MEDICAL PROFESSIONAL
Hello
Lots of questions! My strong feeling would be that you are absolutely fine and you are not likely to be infected with HIV by what seems like a rather innocent event.
I've repeated your questions beneath and will work my way through them.
1 - 5 weeks ago I performed fellatio on a man that was older than me. It was for 20 seconds at most, although I may have tasted pre-ejaculate. There was no ejaculation as I decided I did not like it after the 20 seconds. The only thing bothering me is that I had a small mouth ulcer on the bottom of my gums, just in front of my front teeth. I know all the stats and odds and have read so many posts regarding oral sex on this forum. You may also notice that I already have posted on the community forums, however I thought it would ease my mind to get information from a doctor.
No - I don't read the other Forums
2 - However, I that an ulcer was an 'open sore' and is a break in the mucosal lining, meaning HIV could easily pass through it? It was quite small and I'm pretty sure it's healing, but what if some had got inside? If a small cut in the anus or vagina can transmit HIV, why not the mouth? A website I read said that even microscopic cuts or breaks in the ulcer could let HIV through.
Your mouth is very different to an anus or a vagina - its meant to have all sorts of objects such as food etc in it and is loaded with bacteria. In fact, generally speaking, mouths are pretty dirty areas - and the skin there is used to minor trauma from food etc and will heal very rapidly indeed. Also, saliva and the enzymes contained in it are fairly robust at infection repellant.
3 - Is it easy to get HIV through pre-ejaculate? Also, is it likely to be infected with HIV if it was pre-ejaculate in the mouth? I read notes from the round table conference that oral sex without ejaculation is extremely extremely low risk, is this true ?
It is unlikely to acquire HIV through pre-ejaculate in the mouth - even if it was present in the person you were sucking. I do not believe this represents a signifcant risk to you at all.
4 - Have you ever seen any cases or treated anyone where fellatio was the route of HIVtransmission ? I know it is partly because I feel guilty, but I can't stop thinking that I put myself at risk. It's starting to ruin my life :(
The answer to this is no - there are though reports of people who have sucked and had ejaulate in their mouths who have then gone on to be identified as HIV positive. Again, I do not believe that a 20 second suck will put you at risk of HIV in the circumstance you describe.
5 - I know that if there was considerable risk, there wouldn't be all these questions and studies because there would be overwhelming evidence that you could be infected via oral sex.
Finally, I'm in the UK, what tests are available to me? If I go down to the local hospital, will they test me straight away? What tests should I ask for? At 6 weeks, how accurate would my result be? Sorry my post was a bit long, and thanks very much for reading.
It rather depends on where you live - the postcode lottery of the NHS I'm afraid. Most units will test you and most in the UK are using 4th generation HIV DUO's as instructed by the Dept of Health. Even if you had a 3rd generation antibody only test at 6 weeks this would be greater than 99% accurate whatever the circumstances - but as I keep repeating, in your case the prospect of you having been infected is fantastically remote and a test at 6 weeks will be certain.
very best regards, Sean
Lots of questions! My strong feeling would be that you are absolutely fine and you are not likely to be infected with HIV by what seems like a rather innocent event.
I've repeated your questions beneath and will work my way through them.
1 - 5 weeks ago I performed fellatio on a man that was older than me. It was for 20 seconds at most, although I may have tasted pre-ejaculate. There was no ejaculation as I decided I did not like it after the 20 seconds. The only thing bothering me is that I had a small mouth ulcer on the bottom of my gums, just in front of my front teeth. I know all the stats and odds and have read so many posts regarding oral sex on this forum. You may also notice that I already have posted on the community forums, however I thought it would ease my mind to get information from a doctor.
No - I don't read the other Forums
2 - However, I that an ulcer was an 'open sore' and is a break in the mucosal lining, meaning HIV could easily pass through it? It was quite small and I'm pretty sure it's healing, but what if some had got inside? If a small cut in the anus or vagina can transmit HIV, why not the mouth? A website I read said that even microscopic cuts or breaks in the ulcer could let HIV through.
Your mouth is very different to an anus or a vagina - its meant to have all sorts of objects such as food etc in it and is loaded with bacteria. In fact, generally speaking, mouths are pretty dirty areas - and the skin there is used to minor trauma from food etc and will heal very rapidly indeed. Also, saliva and the enzymes contained in it are fairly robust at infection repellant.
3 - Is it easy to get HIV through pre-ejaculate? Also, is it likely to be infected with HIV if it was pre-ejaculate in the mouth? I read notes from the round table conference that oral sex without ejaculation is extremely extremely low risk, is this true ?
It is unlikely to acquire HIV through pre-ejaculate in the mouth - even if it was present in the person you were sucking. I do not believe this represents a signifcant risk to you at all.
4 - Have you ever seen any cases or treated anyone where fellatio was the route of HIVtransmission ? I know it is partly because I feel guilty, but I can't stop thinking that I put myself at risk. It's starting to ruin my life :(
The answer to this is no - there are though reports of people who have sucked and had ejaulate in their mouths who have then gone on to be identified as HIV positive. Again, I do not believe that a 20 second suck will put you at risk of HIV in the circumstance you describe.
5 - I know that if there was considerable risk, there wouldn't be all these questions and studies because there would be overwhelming evidence that you could be infected via oral sex.
Finally, I'm in the UK, what tests are available to me? If I go down to the local hospital, will they test me straight away? What tests should I ask for? At 6 weeks, how accurate would my result be? Sorry my post was a bit long, and thanks very much for reading.
It rather depends on where you live - the postcode lottery of the NHS I'm afraid. Most units will test you and most in the UK are using 4th generation HIV DUO's as instructed by the Dept of Health. Even if you had a 3rd generation antibody only test at 6 weeks this would be greater than 99% accurate whatever the circumstances - but as I keep repeating, in your case the prospect of you having been infected is fantastically remote and a test at 6 weeks will be certain.
very best regards, Sean
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