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Hiv receptive oral sex

Participants: Susan P. Buchbinder, MD; Frederick M. Hecht, MD; Jeffrey D. Our goal today is to address three specific questions that have remained controversial throughout the AIDS epidemic.
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Can You Get HIV from Oral Sex?

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Risk of HIV Infection Through Receptive Oral Sex

This is a transcript from a panel discussion of medical experts on HIV transmission risks associated with receptive oral sex, specific factors that may affect these risks, and advice for health care providers and public health officials on counseling people who have or are thinking of having oral sex. The panelists agree that although receptive fellatio oral sex given by a person that is seronegative to a person that is seropositive without ejaculation is an extremely low risk behavior with no undisputed case reports, the biological possibility of transmission remains. Studies regarding receptive fellatio with ejaculation show that transmission is definitely possible, with some reports of occurrence on record. However, in context, this is still considered a low-risk behavior, and there is strong possibility that these studies are flawed on account of inaccurate self-reporting of sexual behaviors. Studies on transmission through oral sex with ejaculation seem to point to a conversion rate of one in 2,, or somewhere between one and 5 percent of all transmissions of HIV. This estimate is not concrete, and the ratio is relevant only to the extent that all variables are controlled. From a public health perspective, as rates of HIV transmission continue to rise in disenfranchised and marginalized communities, promotion of oral sex over other sexual behaviors could theoretically result in lower transmission rates.
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What Is the Risk of HIV from Oral Sex?

As the risk of transmission through oral sex is estimated to be much lower than for vaginal and anal intercourse in the absence of antiretroviral therapy, it is implausible that the risk of transmission through oral sex is not affected in the same way as other sexual transmission risks when effective treatment suppresses viral load. When HIV is not fully supressed, the risk of HIV transmission through the mouth is certainly smaller than through vaginal or anal intercourse. If undamaged, the tissues of the mouth and throat are thought to be less susceptible to infection than genital or anal tissues, and an enzyme in saliva also acts to inhibit HIV. Very few cases of transmission through oral sex have been reported amongst gay men despite the continued practice of oral sex often with ejaculation into the mouth by large numbers of men over many years. There are no reliable reports of HIV being transmitted from the mouth to the genitals.
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Access your health information from any device with MyHealth. You can message your clinic, view lab results, schedule an appointment, and pay your bill. What do the latest studies tell us about this risk? And how should we interpret and communicate the results?
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