Question
What's the risk from oral sex if I've had recent dental work?
16 September 2011. Related: All topics, HIV testing.
I have had unprotected oral sex with a guy 1 week ago. When i reached home, I saw there are abrasion on my penis.
Symptoms of fever and bodyache came on the 6 days after. I do have sore throat as well. I have also just extracted my lower wisdom tooth 3 weeks ago and it is swelling at the same time. Test has not been taken as it is only 1 week after the oral sex.
May I know what are the chances of infected by HIV?
Answer
Hi
Oral sex is generally a much lower risk than penetrative sex without a condom.
However, approximately 5% of infections in gay men (or men who have sex with men) are thought to be from oral sex. This risk is from cum or pre-cum getting into the mouth (ie for the man who is doing the sucking).
This usually need to involve a cut, ulcer or sore in the mouth, poor gum health (bleeding gums), or other direct route into the blood. It also probably requires the HIV-positive person being sucked to have a high viral load. In someone who is recently infected, viral load is extremely high. Generally low-risk activities like oral sex then become a much higher risk because they are more infectious.
Receiving oral sex (getting you cock sucked) is not a route for HIV transmission.
If you only had your cock sucked, then your risk of HIV would be highly unlikely, even if your partner was HIV-positive. This is because saliva generally inactivates HIV.
If you also sucked your partner’s cock, then the previous unhealed dental work would increase the risk from oral sex.
Having an HIV test will be the only way to know whether you are now HIV-positive. HIV is a difficult virus to catch. At the moment, your symptoms might be unrelated, but it sounds like this might be good to test.
If you contact a testing centre, you may be able to access earlier testing, depending on an individual assessment of both your risk and your symptoms.
Information about testing is at this link.
UK clinics are listed on the BASHH website.
Hi Kay,
Please see Q1 here:
http://i-base.info/qa/what-are-the-most-asked-questions
Hello,
I had unprotected oral sex with a male I’m female. I had dental work done a few days before the oral sex. 5 days after oral sex I had sore throat it was red with pus pockets. I went to the dr she said I had strep but did not test me for strep. After two rounds of antibiotics I felt much better pus pockets and redness in throat were gone but I tested positive for oral thrush and am on my 2nd day of Nystatin to clear it up. What are my chances that I was infected with HIV? He did not cum in my mouth but pre cum might have happened.
Thanks for your help!
Concerned
Hi
I think I have answered you by email as this sounds like a similar question that came directly to the Q&A service.
It sounds like your family member has been unlucky with their responses to treatment. It would probably better to try and find a treatment that is not associated with this type of side effect than waiting until the CD4 count continues to drop. This will depend on which drugs are available in your country.
There are usually advantages from most people from starting at 350 rather than 200.
Hi
Most guidelines (including BHIVA in the UK and EACS in Europe) recommend starting treatment when CD4 counts are about 350. This is because several studies have show a benefits from not waiting until 200. This is also related to the ability to use newer drugs.
So the recommendation for starting treatment may be dependent on which country you are in, and you didn’t say.
Most Western countries where guidelines are 350 (or sometimes 500) have a wide range of options for starting treatment. It sound like previously the rash may have been related to a type of drug called an NNRTI (either efavirenz or nevirapine). If you are able to use a protease inhibitor, then these reactions are much less likely.
In countries where access to protease inhibitors is more restrictive, there would still be a reason to try these while the CD4 count is still as high as it is now.
Starting at 350 rather than 200 will make it easier to maintain higher CD4 counts for the rest of his life.
Hi , a family member is HIV positive , have been for the last 4 years , his cd4 count has been in the 500 range , since his last check which was 4 months ago it has dropped to 350 from 480 , he has used 3 different ARV previously about 4 years ago and was always admitted to with hospital with side effects such as rashes , extreme fever , body swelling , he was advised to discontinue using the ARV.
Should he start at a 200 level , as the doctor has advised that he can visit him in January 2012 , and than start treatment , what are your views