Oral sex used to safe now slight possibility?

[Shogun4775]

Ok I've followed this site for years and have always loved and respected the work. But I read a post about oral sex and Dr. H states that there is a possible risk from oral. Your stance used to be a firm no risk policy. What happened? Which brings me to my situation at hand. I received and performed oral sex on a stripper. She claimed to be HIV negative but dealt with mainly AA men as i am one myself. A few days later I realized I had a bruise in my gum from a tooth bite and wasn't sure how fresh it was during oral sex. Two weeks later I get sick with chills and small fever aches and swollen lymph glands in throat. Now i did party hard in vegas right before getting sick and was run down from the lack of sleep and partying. But should I have been tested. Also I'm married with kids and thought I was fine due to response of no risk you would give in the past and now i worry i could have posed great danger to my family.

[Edward W Hook, MD]

Welcome back to our Forum.  Oral sex is still safe sex in terms of HIV risk.  Not sure which Dr. H you mean but our collective stance remains as it has been when Dr. Handsfield replied to you in 2007 and when I replied last year.  There is no meaningful risk of HIV from receiving oral sex.  there are several questionable case reports which do not make the case in a meaningful way.  

Please realize that there may be some day to day variation in our responses using words such as virtually zero, zero, and extraordinarily low.  It suggests I should clarify an important point.  As a generalization for both you and other readers, you must realize that we VERY frequently get questions asking if different types of exposures or prevention measures are 100% effective.  The answer to that is that this is scientifically impossible.  For a variety of complex mathematical reasons far too complex to go into here, all one can do with well conducted scientific studies is estimate probabilities.  By definition, any estimate, cannot be 100% certain.  On the other hand, when Dr. Handsfield or I say that something is very close to no risk or of minimal risk, or use any other term to indicate a very small risk, that means "close to zero" in a world where zero cannot be attained.  

As we have each also said before, the most conservative figure cited for risk of HIV from receipt of oral sex is that IF a partner is infected the risk of transmission is 1 in 10,000 and both of us feel that this estimate is far too high.  If it were 1 in 10,000 however and there was a 1% chance that your partner had HIV (again, a conservative but not unreasonable estimate for a stripper) then your risk of HIV would bee, AT HIGHEST, 1 in million.  Is that high?, I do not think so.  


My guess is tha the symptoms you describe were coincidence (at least in relationship to the sexual part of your vegas activities) and is not suggestive of HIV.  If testing will give you peace of mind, then I encourage you to do so but I certainly see nothing in your description that makes me concerned that you may have gotten HIV through the activities described above.  EWH

[Shogun4775]

Thank you for the response. Your message is reassuring and I appreciate. This has become such a psychological thing for me that I need to get tested but I don feel reassured with your feelings of being HIV free.