[Question #772] Hiv from male to male oral sex

54 months ago
Dear Dr,I'm have been searching for a way to ask one of you'll a question and finally found it . I am a bisexual male and I recently gave oral sex to another male by su king his penis in my mouth and throat...it was deep and rough oral sex but he did not ejaculate in my mouth .he wore a cindom through out the act but I am worried if the condom was torn or had a hole in am not sure about that...he didnt ejaculate in my mouth...and I dnno his hiv status ..this was my only exposure till date ...I am very worried I may have got hiv ...request a response from u are the earliest...
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
54 months ago
Welcome to the forum. Thanks for searching us out; I'm glad you were successful.

This event carried absolutely no risk for HIV. Even without a condom, the best estimate for the risk of HIV transmission to the oral partner by fellatio (penis to mouth) is once for every 10,000 exposures, if the penile partner has HIV. That's equivalent to giving BJs to infected men once daily for 27 years befoe infection might be likely. And that's typically with ejactulation in the mouth. Given your wise use of a condom which did not obviously break, and since you don't know your partner had HIV anyway, your risk is far lower than even this figure. Condoms do not have small holes and rarely if ever leak without rupture; and such breakage generally is instantly obvious. And most men who have sex with other men are not HIV infected; and many others are on treatment with anti-HIV drugs that makes them non-infectious.

Based on this exposure, you don't need to worry, don't need to be tested for HIV, and can safely continue unprotected sex with your other sex partner(s), male or female. However, anyone who has high risk sex of any kind -- including safe sex with other men -- should be tested from time to time for common STDs, including HIV. So if you have not been tested recently, this might be a good time, while it is on your mind. But not because of this particular event.

My last advice is that in event of future sex with other men, you ALWAYS ask beforehand if he has HIV, and do not proceed with those who are positive (and not on treatment), don't know, or seem evasive about it. When asked directly, most people tell the truth about their HIV status.

I hope this has been helpful. Best wishes and stay safe--   HHH, MD

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54 months ago
Thanks a lot dr handsfield for your prompt response.I have been going crazy searching every forum. I have read some of your replies on medhelp but if I'm not wrong dr Edward had me times in a post in 2014 that oral sex  arrives low risk and there have been a few cases. I am really paranoid and have even stopped eating properly . I am in india and I guess people are the very responsible here when it comes to testing for hiv . I had found this man on a gay social app . Since he mouth fucked me and his penis reached my upper throat I am worried that the friction might have caused his precum to penetrate my mucous membrane in theouthouse and throat.  I also had a sire throat during the act and mouth pain fr an hour after the act . I remember you or dr Edward saying that oral sex poses low risk due to some cases reported...plz help ...thanking u in anticipation 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
54 months ago
This additional information does not change my opinion or advice. Even with vigorous or deep oral sex, and with friction, and with your sore throat at the time, there is no significant risk from this event.  It does not matter that "some cases have been reported"; the risk is probably about the same as being struck by a meteorite. However, because you have had such exposures with other men before this, you should be tested for HIV.


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54 months ago
This was my first exposure I haven't done such things ever with a male or female ...my only exposure befire this was kissing and body play with another male who I layer got to know ow had hiv ....I however tested negative after that event ..I had jaundice tested last week ...and I was stressed for that too ...and now again this exposure has stressed me out....there was no other exposure besides these ever in my entire life...I however remember dr Edward hook saying on medhelp that there have recently been cases where hiv passes on thru oral sex...and he also recommended people to test after oral sex....request u to please advice me on the same...since this incident happened in the man's bathroom whee I gave him oral sex it was dark and I think I saw the condom torn ..but the guy said that it was not the torn and that it was an air bubble....assuming the condom tore and his precum rubbed in my mouth and throat...do I need a test?
54 months ago
Wat if the friction caused some blood in my mouth or throat and his pre cum entered...that would be a risk right ??
54 months ago


Dear Dr handsfield..below is the reply given on the medhelp fir by Dr rdward hooks in 2014 .he says that oral sex has a risk...plz help me with this conflicting evidence...thanks once again 


Welcome to our Forum. I'll be pleased to comment.  Previously we stated that there is no risk at all for acquisition of HIV from performing oral sex on an HIV infected man however, in the past few years there have been several case reports in which performance of oral sex on an infected partner may have led to infection.  Thus it appears that VERY rarely oral sex can result in infection- we estimate this to occur less than in every 10,000 instances in which persons perform oral sex on infected partners (in contrast, there are still no instances in which receipt of oral sex from an infected partner appears to have led to infection).  It is very, very rare. 

In your case, you do not know that your partner has HIV (did you ask) and even if he did, your risk is tiny. Further, your PCR test, while not definitive is further evidence that you were not infected.   

You do not mention how long it has been since your exposure.  While the symptoms you report are among those that we see in persons with the ARS syndrome, they are non-specific and sound more like a cold than the ARS.  While PCR tests are not recommended for definitive diagnosis of HIV, testing with either a DUO (combination HIV p24 antigen/HIV antibody) test or the combination of a PCR test and a standard test for HIV antibodies at 4 weeks following exposure will provide a definite answer to whether or not you are infected. 

I hope these comments are helpful.  Your risk for HIV from the exposure you provide are tiny.  If you could find out the HIV status of your partner, or provide information as to how long it has been since your exposure I may be able to provide a little more information.  EWH 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
54 months ago
You entirely misunderstand Dr. Hook's statement above. Of course some such transmissions have occured, and I did not say otherwise. The point of his comments is the same as mine: such infections are too rare for you to worry about. This still does not change my opinions or advice.

You came here for expert reassurance. I have done my best, but you continue to argue about it. If you believe you were at risk, why did you even come on the forum to ask the question? This is not a debate and I will not discuss it further.

Each question on this forum includes up to two follow-up questions and replies, which are now complete. This thread will be closed. Do not post a new thread with any further questions about this exposure. Repetative anxiety driven questions are not permitted. Re-read my replies above, concentrate on them, then do your best to move on without worry.

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