Question

What are the risks from oral sex and how early can I test?

12 November 2008. Related: All topics, HIV transmission.

Dear i-Base,

May I take this opportunity to thank you for the service you provide online for no charge to the general public.

I am emailing in regards to my recent sexual experience and if you think I may be at risk. Since Feb this year I have had 13/14 occasions of unprotected oral sex with other men. None of which have ejaculated in my mouth although there has been one or two with a little pre-cum and I have stopped straight away. There has never been any anal sex or other activities apart from the odd bit of rimming. All of these happened when I was in Glasgow on business.

From what I have told you above would you think there is a major chance of HIV, and would I require a test, I have been tested for all other STDs and they were negative. Along with that could you advise me what the symptoms are of HIV and if the vast majority of people get these, as I hear around 90% of people get the flu/viral like symptoms that take over a week to clear up and it leaves you feeling quite ill with fever when seroconverting.

Again your help would be appreciated as I am in a geographical area where it is not that easy to get advice or certainly speak to a medical professional.

Answer

Answer: Simon Collins

Thanks for your questions and the nice feedback on the service.

Oral sex is generally a lower risk, but probably accounts for 5% of HIV infections. The two most important things that increase this risk are i) whether you have bleeding gums, etc and ii) the viral load of your partner.

If your partner has only recently been infected, perhaps not even knowing they are HIV-positive yet, their viral load is likely to be extremely high, and cum and pre-cum will be much more infectious.
As for testing, we advise everybody with an active sexual life to get tested regularly-say every 6 months.

Finally, the seroconversion symptoms should only be taken as indicators together with recent history of a risky exposure to HIV. It is fairly easy to confuse common cold with seroconversion, and there are many people who becomes worried and anxious when their risk of HIV is actually very low.

The percentage of people who get symptoms is not know exactly but is estimated as at least 75% – leaving therefore a reasonable number who have no symptoms at all.

Taking an HIV-test is the only reliable way to know if you are HIV-positive. For most modern tests (called 4th generation tests) you can test 3-4 weeks after any risk (compared to the 3 months that is still widely quoted) because they look for both antigens (parts of the virus) and anitbodies (an immune response).