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Is cunnilingus safe regarding HIV? Do not have bleeding gums. Good oral hygiene. Negative rapid ELISA test

DOCTOR OF THE MONTH - Jul 2012
Jul 2012
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Dermatologist
Practicing since : 1993
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Is cunnilingus safe regarding HIV ? I am a male who occasionally does cunnilingus on casual sex workers. Most times I just use tip of tongue and spit out saliva immediately and wash my mouth once the act is over. I do keep good oral hygiene and do not have bleeding gums although I have two caps on my back teeth.. On all occasions the woman’s vagina never had any trace of blood. What about unprotected fellatio from woman , if no wounds are there on my penis? I had protected sex on 25/7/2012 on a casual sex worker but condom broke during intercourse. It was hardly 30 seconds or so , I immediately pulled and washed off with water.I tested negative on 17/8/2012 on EZ – Rapid elisa home test. Is this a good indication of my HIV status?
Posted Sat, 15 Sep 2012 in HIV and AIDS
 
 
Answered by Dr. Praveen Rodrigues 2 hours later
Hello there XXXXXXX
I read all your queries with interest & will try to answer them as you have asked them...
1. No unprotected sexual act is 'safe' as regards aquiring the HIV virus..it all depends on the mucous membranes & fluids in question. In your case, the risk is definitely higher as you are dealing with commercial sex workers. The virus may spread through 'micro-trauma' as well without overt evidence of any 'visual cuts' but yes the risk is significantly lower.
2. Fellatio & cunnilingus both run the same risk effectively for either party (not just your penis) & again, it does make a difference if the sex is traumatic or if there is any break in the mucous membranes in question
3.EZ-Elisa while a good test may or may not be entirely accurate in the first few weeks & is not a good indicator of your HIV status
Now, to put things in a nut-shell, going by all you have said & described, itis highly 'unlikely' for you to be HIV positive. However, i recommend doing a PCR test in a hospital/clinic set up &/or a Western blot to confirm the status & put your mind at ease. Also, henceforth, please practice protected sex as 'prevention is better than cure' is an adage never more truer than in a HIV infection scenario.
For the moment, please do what i have suggested & am sure it will all work out.
Cheers & Good Luck with the tests!
Dr Praveen Rodrigues MD Dermatologist, Venereologist & Cosmetologist
XXXXXXX Hospital, Bangalore
Above answer was peer-reviewed by
 
Follow-up: Is cunnilingus safe regarding HIV? Do not have bleeding gums. Good oral hygiene. Negative rapid ELISA test 2 hours later
Dear Dr. XXXXXXX

Thanks for the informative answer. I understand in full your explanative answer but need a little elaboration on below points:

1. condom breakage - what are the chances of hiv contraction during such short span?has any documented case of transmission occured via this way?

2. has there been confirmed documented cases of hiv transmission in cunnilingus/fellatio? many tell it is only theoretical. some say no risk. others say it is very negligible. can you sooth my mind of these confusions

can you tell me does truvada protect a person from hiv even if he has unprotected sex ? how can you practice safe oral sex?
 
 
Answered by Dr. Praveen Rodrigues 9 hours later
Hi there. I am not a big fan of percentages. While dealing with an issue like HIV that involves your life, it may just take one exposure. Having said that, No to the best of my knowedge, am not aware of a documented case of transmission this way largely because fluids like saliva & tears & feces are not contagious unless contaminated with blood. So as i said, you seem to be safe given your history. However, for the record, receptive oral intercourse chances are 0-0.04%; Insertive oral intercourse chances are 0-0.005% (assuming no condom use). This answers your second question.
Truvada is a combination of 2 drugs tenofovir + emtricitabine. Yes it does have a protective potential in HIV infections. In a particular study, healthy XXXXXXX and bisexual men who took Truvada daily lowered their risk of becoming infected by up to 42%. In another study involving heterosexual couples in which one partner was HIV-positive, the uninfected partner had a 75% lower risk of contracting HIV if they took Truvada.
In the end, there is no sure safe method for practicing any form of sex except using a condom/protection & adhering to one partner. Perhaps prudent to avoid high risk individuals such as prostitutes. Cheers & Godspeed!
Above answer was peer-reviewed by
 
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