[Question #13497] Cunnilingus more details

1 months ago

Hello doctor . Can you please elaborate more in the risks of giving cunnilingus and receiving fellatio . Primarily hiv . But other stis as well . I undertand cunnilingus is low risk or perhaps lower risk from previous reply . Are there any numbers on this . Could you please elaborate what are the chances of catching hiv from performing cunnilingus on a woman of unknown hiv status . are there any proven cases of catching hiv this way . Under what situations.

1 months ago

i understand receipt of fellatio is extremely rare . How about performing cunnilingus . Is it at the same level ?

1 months ago

Could you also please elaborate on frottage when standing up . Where female rubs penis against vaginal area

1 months ago

Its been 24 hours since . Should i consider PEP for peace of mind . Given i had a history of pancreatitis my doctor suggested it might be hard on my fatty liver and pancreas to take hiv pep for 28 days.

H. Hunter Handsfield, MD

1 months ago

Welcome back but I'm sorry you found it necessary. This will have to be your last question about oral sex, frontage, or any other sexual risks for HIV aside from intercourse (penile penetration). There isn't much to add to the prior replies from both me and Dr. Hook.

There has been no research on cunnilingus or frontage and HIV risk. What we know is that there are no known cases of HIV transmitted by such exposures. Must busy HIV/AIDS clinics probably have never had any patients whose only possible exposures were cunnlingus, frontage, massage, or genital contact without penetration (regardless of standing up or any other body position). That doesn't prove HIV cannot be transmitted, but if it does, it is extremely rare.

I don't recommend even being tested for HIV on account of such events, but of course you are free to be tested if you would like the additional reassurance of a negative test result. Certainly you should not take PEP and I would never advise it just for "peace of mind". And I doubt you could find a clinic or doctor willing to prescribe PEP in this situation, assuming you told the truth about your exposure(s) and reasons for worry about it. I know of no reason that past pancreatitis would raise the risk of more serious outcomes from HIV infection. But this obviously doesn't matter since you are not at risk for HIV anyway.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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1 months ago

sincere thank you doctor. I am working on myself to not get into anything risky . I take this very seriously. I am hoping this will be my last message on this forum and not indulge into any outside distractions and ensuring steps moving forward. I happen to be an anxious person about STIs and HIV in particular due to social stigma surrounding my personal life.

What concerns me is following.

1. my gums bleed during flossing . I don't floss regularly. But ever time I try to , they have some tiny bleeding. I don't bleed from brushing. But do get little bleeding from flossing. Should I be concerned about this gingivitis affecting this . I read some resources online stating oral hygiene does impact risk. (https://i-base.info/guides/testing/oral-sex) .

2. About my pancreatis, to clarify what my doctor said was if I take PEP , it would have a stress on my liver and some extent my pancreas. Given that I have fatty liver and had an episode of pancreatis 4 months ago , there would be a risk of a flare up . So the doctor told me to think about it warning me potentially ] there is a chance that a heavy medication like PEP for 28 days would be hard on my liver and pancreas given where my fitness was.

3. Can I forget about this exposure totally and move on

4. is it safe for me to say this is a near zero risk event.

5. Should I be concerned about any other STIs outside of HIV for this exposure .

H. Hunter Handsfield, MD

1 months ago

1. Bleeding gums are not a sign of HIV.

2. This makes no difference.

3. Yes.

4. No. It was not a "near zero risk event". It was truly zero.

5. No. There was no possibility of any STD.

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1 months ago

thankyou doctor . I would like to clarify . My first question was “not” if bleeding gums was a symptom of hiv. Rather if bleeding gums when flossing (gingivitis) changes your risk analysis for my exposure .

Thanks in advance

H. Hunter Handsfield, MD

1 months ago

Sorry I read that question too quickly. I really wouldn't worry at all about gum disease, bleeding, or flossing and HIV risk. This is one of those theoretical risks people thought about early in the HIV/AIDS pandemic 40 years ago but for which no data exist. Logically it cannot have much effect. Oral exposures are extremely common and so is gum disease, so billions of exposures have occurred in their presence -- and still there are no known cases in which gum disease was reported to be the main reason someone was infected. This can be disregarded.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful.

This has been your fourth quesition on the forum, including three in a few months, all reflecting more anxiety and worry about low risk exposures with little importance. The forum does not permit repeated anxiety driven questions by the same users. This will have to be your last one; new questions along the same may be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers; because experience shows that continued answers tends to simply prolong such anxieties rather than resolving them; and because such questions have little educational value for other users, one of the forum's main purposes. Thank you for your understanding.

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