Insertive oral sex and hiv. HIV Transmission and Risks.



Insertive oral sex and hiv

Insertive oral sex and hiv

Despite recognising that transmission does occur, some feel that the underlying risk of HIV transmission via oral sex is so low as to be negligible. However, two recent studies as yet unpublished in peer review journals suggest that oral sex may be contributing to a higher proportion of new HIV infections than previously thought.

In the first study, of men who had recently seroconverted, eight 7. Of these eight, unprotected oral sex was the only risk factor in four, but four had also had protected anal sex. Six per cent believed themselves to have been infected because of oral sex alone. Further follow up of these and other patients in our unit, who believe themselves to have been infected by unprotected oral sex is ongoing and about half, where data are available, have had recurrent infections of the mouth, which could have increased their risk.

An interview study found that a similar proportion, seven of 75 9. However, the investigators felt that they must have had other risk factors as they denied ejaculation as part of their oral sex. One seroconversion was found but thought to have occurred outside the study period. It is therefore unlikely such a study would have had sufficient power to detect transmission, or to reject the hypothesis that transmission does occur presented by Dr Kimberly Page-Shafer et al, National HIV prevention conference, Atlanta, August These include receptive oral intercourse ROI with ejaculation, high viral load, and various factors which might breach the oral defence mechanisms.

Saliva is protective and has a number of antiviral components, such as thrombospondin and secretory leucocyte protease inhibitor SLPI , but these are likely to be overcome by the volume effects of seminal fluid. The relative rarity of cases of HIV infection attributed to oral transmission is likely to be influenced by the rarity with which oral exposure has occurred without other forms of penetrative sexual contact and the tendency of attributing HIV transmission to any higher risk exposure which can be identified.

In recent years, many participants in studies have indulged in protective anal and vaginal sex but oral sex has normally been unprotected. This might explain why a real but low risk of unprotected oral sex is now becoming more apparent. Another difficulty is the power of studies to identify such a small increase in risk. For example, in one important cohort study from four sites, the multivariate analysis showed that for the pooled data, the odds ratio for receptive oral intercourse and increased risk of HIV transmission was only 1.

Concern has also been raised that highlighting the risk of unprotected oral sex may incite higher risk sexual practices as alternatives. Conversely, it is important that individuals and the public understand that oral sex is not risk free and may lead to transmission of HIV as well as other STIs. The expert advisory group on AIDS, following the publication of the working party review on the evidence on the risk of HIV transmission and oral sex last year, recently released a statement on risk.

This reads as follows: This risk is less than from unprotected penetrative anal or vaginal sex. The risk of HIV and other sexually-transmitted infections can be reduced by using a condom for all forms of penetrative sex, including oral sex. If a condom is not used, avoidance of ejaculation into the mouth probably lessens but does not eliminate the risk of HIV transmission.

A more comprehensive discussion, in the form of questions and answers, is available on the Department of Health website: Are there figures to assist counselling of the risk of oral sex on an individual level? Is there ever any justification for using PEP following oral sex? There have been no per contact risks provided for unprotected receptive fellatio with a known HIV positive individual. However, Vittinghoff et al have come up with an estimate of 0.

Additional factors such as a known high viral load in the source, recent dental surgery, pharyngitis, trauma, oral ulceration, or bleeding gums would also increase the likely risk. In conclusion, unprotected oral sex carries a risk for the transmission of HIV.

Although using a condom will reduce the risk of transmission of HIV and other STIs, following penetrative oral sex, it has to be recognised that many will choose not to follow that advice. A wider discussion of risk assessment should take place so that individuals might make informed choices about their sexual behaviour.

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Is Oral Sex Safe Sex? A Gay Man Speaks Out



Insertive oral sex and hiv

Despite recognising that transmission does occur, some feel that the underlying risk of HIV transmission via oral sex is so low as to be negligible. However, two recent studies as yet unpublished in peer review journals suggest that oral sex may be contributing to a higher proportion of new HIV infections than previously thought.

In the first study, of men who had recently seroconverted, eight 7. Of these eight, unprotected oral sex was the only risk factor in four, but four had also had protected anal sex.

Six per cent believed themselves to have been infected because of oral sex alone. Further follow up of these and other patients in our unit, who believe themselves to have been infected by unprotected oral sex is ongoing and about half, where data are available, have had recurrent infections of the mouth, which could have increased their risk. An interview study found that a similar proportion, seven of 75 9.

However, the investigators felt that they must have had other risk factors as they denied ejaculation as part of their oral sex. One seroconversion was found but thought to have occurred outside the study period. It is therefore unlikely such a study would have had sufficient power to detect transmission, or to reject the hypothesis that transmission does occur presented by Dr Kimberly Page-Shafer et al, National HIV prevention conference, Atlanta, August These include receptive oral intercourse ROI with ejaculation, high viral load, and various factors which might breach the oral defence mechanisms.

Saliva is protective and has a number of antiviral components, such as thrombospondin and secretory leucocyte protease inhibitor SLPI , but these are likely to be overcome by the volume effects of seminal fluid. The relative rarity of cases of HIV infection attributed to oral transmission is likely to be influenced by the rarity with which oral exposure has occurred without other forms of penetrative sexual contact and the tendency of attributing HIV transmission to any higher risk exposure which can be identified.

In recent years, many participants in studies have indulged in protective anal and vaginal sex but oral sex has normally been unprotected. This might explain why a real but low risk of unprotected oral sex is now becoming more apparent. Another difficulty is the power of studies to identify such a small increase in risk. For example, in one important cohort study from four sites, the multivariate analysis showed that for the pooled data, the odds ratio for receptive oral intercourse and increased risk of HIV transmission was only 1.

Concern has also been raised that highlighting the risk of unprotected oral sex may incite higher risk sexual practices as alternatives. Conversely, it is important that individuals and the public understand that oral sex is not risk free and may lead to transmission of HIV as well as other STIs. The expert advisory group on AIDS, following the publication of the working party review on the evidence on the risk of HIV transmission and oral sex last year, recently released a statement on risk.

This reads as follows: This risk is less than from unprotected penetrative anal or vaginal sex. The risk of HIV and other sexually-transmitted infections can be reduced by using a condom for all forms of penetrative sex, including oral sex.

If a condom is not used, avoidance of ejaculation into the mouth probably lessens but does not eliminate the risk of HIV transmission. A more comprehensive discussion, in the form of questions and answers, is available on the Department of Health website: Are there figures to assist counselling of the risk of oral sex on an individual level?

Is there ever any justification for using PEP following oral sex? There have been no per contact risks provided for unprotected receptive fellatio with a known HIV positive individual.

However, Vittinghoff et al have come up with an estimate of 0. Additional factors such as a known high viral load in the source, recent dental surgery, pharyngitis, trauma, oral ulceration, or bleeding gums would also increase the likely risk.

In conclusion, unprotected oral sex carries a risk for the transmission of HIV. Although using a condom will reduce the risk of transmission of HIV and other STIs, following penetrative oral sex, it has to be recognised that many will choose not to follow that advice.

A wider discussion of risk assessment should take place so that individuals might make informed choices about their sexual behaviour.

Insertive oral sex and hiv

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5 Comments

  1. Greetings Edie, I'll do my best to answer your questions as you've asked them: Touch, hug or kiss a person who is HIV positive. Additional factors such as a known high viral load in the source, recent dental surgery, pharyngitis, trauma, oral ulceration, or bleeding gums would also increase the likely risk.

  2. Studies have repeatedly demonstrated that certain sexual practices are associated with a higher risk of HIV transmission than others.

  3. In recent years, many participants in studies have indulged in protective anal and vaginal sex but oral sex has normally been unprotected. Studies have demonstrated that male-to-female HIV transmission during vaginal intercourse is significantly more likely than female-to-male HIV transmission.

  4. These include receptive oral intercourse ROI with ejaculation, high viral load, and various factors which might breach the oral defence mechanisms.

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