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Getting HIV from Oral Sex

Illustration by Édouard-Henri Avril of fellatio scene

Illustration by Édouard-Henri Avril of fellatio scene

Getting HIV from Oral Sex

What you need to know:

  • It is possible but extremely rare. The risk is much lower than anal or vaginal sex.
  • Scientific Data on HIV transmission in Oral Sex is not strong.
  • The type of Oral Sex that carries the highest risk is Receptive Fellatio.
  • Ejaculation, Gum Disease, Poor Dental Hygiene, Ulcers in the mouth and the presence of blood can increase the risk.

Oral sex refers to contact of the mouth to the ano-genital region.

It includes:

  • Receptive Fellatio (using your mouth on your partner’s penis)
  • Insertive Fellatiio (inserting your penis into your partner’s mouth)
  • Anulingus (using your mouth on your partner’s anus)
  • Cunnilinugs (using your mouth on your partner’s vagina)

While every one of these oral sex acts have case reports suggesting that they are possible, the only one with enough evidence to estimate a risk is Receptive Fellatio.

Therefore, it is accepted by most experts that this is the highest risk of all sex acts.

What exactly is the risk of contracting HIV from Oral Sex?

Unfortunately, no one knows for sure.

Most experts would agree that risks are extremely low.

Factors that increase the risk of transmission are:

  • Mouth Ulcers
  • Gum Disease
  • Use of Crack-Cocaine
  • Presence of blood (e.g. during menses)
  • High HIV Viral Load
  • Ejaculation

There have been many studies done on the transmission of HIV in oral sex. The vast majority concluded that oral sex in itself is NOT a risk factor for HIV transmission.

Click here for HIV Testing FAQ

There were however a handful of studies that found oral sex to be significantly associated with HIV infection. These studies focus on MSM (men-who-have-sex-with-men), CSWs (commercial sex workers) and people from lower socio-economic groups with a higher incidence of poor oral hygiene and mouth sores.

What serves for more scary reading are the case reports. Bear in mind that case reports are not as scientifically or statistically significant or important as clinical studies.

That said, there have been many case reports on possible Oral transmission of HIV. More notable cases include:

  1. Female to female transmission of HIV via oral sex
  2. A man who was bitten by a HIV +ve patient while trying to help him during a seizure

Studies conducted in San Francisco and London in 2000 and 2001 amongst MSM indicated that 6% to 8% of HIV +ve cases were believed to be cause by oral sex. Note that this does NOT mean the risk of getting HIV from oral sex is 6% to 8%.

Positive OraquickSo what exactly is the risk of getting HIV from oral sex?

No one really knows. A systematic review done in 2008 concluded that there was insufficient data to precisely estimate the risk. In my opinion, there are so many variable factors that there is really no way to accurately estimate the risk anyway.

However, everyone would agree that the risk is less than penetrative sex which has been estimated to be anywhere between 1% and 0.01%. So what we can say at this point in time is that the risk of contracting HIV via oral sex is less than this.

The only type of oral sex where there was any kind of risk estimation at all was receptive fellatio (the partner using his mouth) amongst MSM. The magic number given to this per-act-risk is 0.04%. Even then, some experts believe that this risk was over estimated because it was calculated from very complex mathematical models.

What is in saliva that kills HIV?

In 2008, a Swedish research team discovered that HIV –ve people produced antibodies in their saliva that can ‘kill’ the HIV virus. This provided an explanation as to why HIV transmission via oral sex is so low.

Another study found that the concentration of saliva is so low (i.e. hypotonic) that it ‘kills’ the white blood cells that carry the HIV virus. There was an experiment done in the lab (not on live patients) to show that if the volume of semen is high enough, it makes the overall environment closer to the concentration of cells (i.e. isotonic) and therefore increases the chance of cell survival and as a result increases the risk of HIV infection. This may explain why ejaculation is thought to increase HIV risk in oral sex.

There was also a study that suggested that a chemical found in saliva called Mucin can also inactivate the HIV virus.

The Burden of Scientific Proof

The real problem is that there have not been any good quality studies on HIV and Oral Sex. Most are based on interviewing HIV +ve patients on their sexual practices. So there is a problem of ‘recall bias’ (i.e. they forgot or their lying).

Furthermore, most studies involve relatively few participants. Since the incidence of HIV from oral sex is so low in the first place, many studies did not even have a single case of HIV transmission so were unable to estimate the risk in anyway.

So far in the studies that have been done, the estimated risk of contracting HIV from oral sex is either zero or really close to zero. So close to zero that physicians like myself find it hard to counsel patients who are concerned about getting HIV from oral sex. On the one hand, we do not want to tell them with absolute certainty that they are not at risk, on the other hand, we do not want to unnecessarily play up the risk leading to unwarranted anxieties, tests and treatments.

Why is it so difficult to get good data on HIV Transmission in Oral Sex?

We can all appreciate that medicine is never black and white. And almost nothing is 100% certain. Medical knowledge is gained from scientific study and statistical analysis. Once something is termed ‘statistically significant’ we generally tend to accept it as truth or fact. However, it also means that a small but definite number or people will fall outside of this ‘statistically significant’ majority. Also, it is often very challenging if not downright impossible to conduct scientific studies of enough quality and depth to reach a conclusion. Take our topic for example; we want to find out if HIV can be transmitted via oral sex. The best thing we can do is round up a million HIV positive women from around the world, make them perform oral sex on a million HIV negative men and determine if any of the men caught HIV. Then do it all over again this time with a million HIV positive men and a million HIV negative women. Then do it all over again with men performing oral sex on men and again with women performing oral sex on women. Even if somehow we manage to conduct this impossible and ethically questionable experiment, and somehow the number of people who caught HIV was absolutely zero, one can always say ‘what if the one million and one person would have been the one to catch HIV?’ Conversely, if one person out of this million couples does contract HIV, then we would have to come to the conclusion that HIV can be transmitted by oral sex. Right? Wrong. We have to take into consideration the possibility that there was a confounding factor. For example maybe this person already had HIV but was in the window period and so happened to be diagnosed only after the experiment. Which then opens up a whole Pandora’s box of ‘what ifs’. What if there was an ulcer on the lips? Ulcer on the gums? Sore throat? Cut on the lip? Dry cracked lip? A sore on the penis? Warts on the vulva? False negative HIV tests? False positive HIV test? Etc etc. The list is endless. You can see now why it is virtually impossible to reach a definitive conclusion and make a statement as strong as ‘HIV cannot be transmitted by oral sex’. This then leads to all the great authorities on HIV, infectious disease and public health coming to the same conclusion. ‘There is a possibility HIV can be transmitted via oral sex but this is rare.’ This statement very nicely covers all possible legal loopholes. E.g. ‘you might get hit by an asteroid while walking in the park but this is rare.’ Mind you, although the experiment we talked about is impossible and morally reprehensible, scientists around the world have been trying very hard to gather data about the risk of HIV transmission via oral sex. They did this through complex questionnaires and very clever statistical analysis. But just like every experiment involving people, there are just too many confounders. E.g. people forget or miss out details of sexual activity, people rarely have oral sex alone, the HIV positive partner may already be on antiretroviral treatment which itself reduces transmission risk anyway etc etc So at the end of the day, these scientific studies are still not able to make the statement ‘HIV cannot be transmitted via oral sex’. Again they come to the same conclusion which is ‘There is a risk of HIV transmission via oral sex but this risk is low to miniscule’. This also means you are never going to come across a doctor who would advise you NOT to have a HIV test because your exposure was ‘only oral sex’. So if you are still worried about having caught HIV via oral sex please remember this one very important fact: YOUR RISK IS EXTREMELY LOW. And yes, this is regardless of the fact that you think you might have a small cut, small scratch, infected hair gland, mouth ulcer, bleeding gums etc etc But LOW risk does not mean NO risk. You still need to get yourself tested

In Conclusion

  • Getting HIV from Oral Sex is possible but extremely rare.
  • The type of oral sex with the highest risk if receptive fellatio.
  • Ejaculation, Gum Disease, Poor Dental Hygiene, Ulcers in the mouth and the presence of blood can increase the risk.
Depiction of fellatio on Attic red-figure kylix, c. 510 BC

Depiction of fellatio on Attic red-figure kylix, c. 510 BC

Also remember that aside from HIV, Oral Sex can transmit a variety of other STDs including:

What should you do now?

If you had a high risk exposure less than 72 hours ago, please see Our Doctors at Our Clinics for a discussion on PEP.

Click here for details on HIV PEP Treatment at Our Clinics

If not, get a HIV test just to be safe.

Click here for HIV Testing FAQ

You should also screen for other STDs that you can get fro Oral Sex.

Click here to see the full range of our HIV/STD Services

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Need more advice?

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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

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902 Comments

  1. stalin1812

    I was having vaginal sex with a woman who works there when the condom broke (condom was broke at the shaft of penis not in the uretheria). I believe it was only a couple of seconds ( 5 to 10 seconds), maximum, until I realized it and promptly ran to the bathroom and washed myself off with soap and water. I do not have any open sores, cuts, abbrasions, etc… on my penis.

    Do you have any idea what the chances of catching HIV from this woman are given the situation? And also she shows her medical report for hiv above six months. it was non reactive. pls answer me, i am so worried..

  2. TannedButCute

    Hi Doc,

    I had a sex with unknown guy last 25 April 2016 at Sauna. Though it is protected on the time I fucked him on the ass, I’m still scared that I can get HIV from it. I took Rapid test last 18 May 2016, 3 weeks after the intercourse and it showed negative. Does this test concludes everything or shall I still need to have another test after 4 weeks, and 6 weeks thereafter?

    Thanks..

    • drtan

      The HIV rapid test at 3 weeks is indicative but not conclusive. You should get it repeated.

  3. Dear Dr Tan, Place clarify, is hcv transmitted via fingering.

    Waiting for reply.

    Regards

  4. Hi Dr,
    Request your immediate reply on this question:
    On Jan 4th I had been a massage parlr, the girl massaged me and did handjob. I inserted my finger(no wounds) in her vagina. I’m sure i didn’t touch with same finger. I have read from your forum as there are no risk by fingering if the finger has no wounds. Now after 8 weeks, I’m feeling irritation in the throat. now for 4 weeks I’m facing it. for last 5 days I’m taking antibiotics. but it’s not working. Also some time getting night sweat also.
    now my fear is that is it any ARS? will the ARS start after 8 weeks and long for more than 4 weeks?

    Regards,
    Anup

  5. Hello dear doctor!
    i want to ask about risk of HIV from licking vagina (cunilingus).
    I had unprotected cunilingus few monthes ago with a girl who is HIV positive.
    i have licked her vagina for about few minutes. it was wet and fluids got in my mouth. i tried not to swallow them but still i think it happened little bit.
    we didn’t had any other type of sex besides this. only licking.
    i’ve learned about her hiv positive status few weeks ago.

    now anxiety is killing me…
    right now i don’t feel anything bad in my health. i had flu about a month ago but i think it was cause of cold weather only.

    please tell me, can i become infected this way?

    Thank you in advance, dear doctor!

  6. Hello doctor!
    I wanted to ask about HIV risk with unprotected cunnilingus.
    I had a PROTECTED vaginal sex and unprotected cunnilingus with a girl in Germany who’s HIV status is unknown for me, but i suspect that she can be HIV positive.
    I performed cunnilingus on her (licked her vagina for about 20-30 seconds two times during sex. i’m not sure but i think i swallowed the vaginal fluids a little bit. she was not on her periods and her vagina was clean and smell free. and as far as i remember i didn’t had any sores or wounds in my mouth.
    about a week after that i had a temperature and a fever at night. i took a shower and felt better. next day there was almost no symptoms of fever anymore (it was really cold in Germany where i was sleeping, so i don’t know is this just a normal common cold or hiv symptom). it has been already 4-5 month since that sexual contact. i started to feel really depressed and worried cause of that. and behind my right ear there is a small swollen growth appeared few weeks ago. but its getting smaller by time and i think it will disappear soon.

    So can you please tell me, do i have a risk of HIV infection? are these symptoms can be a symptoms of HIV?
    Or i am not in risk?

    the problem is that i cant get checked right now due some reasons.
    And right now i am so depressed and so scared that i can’t concentrate on anything. can’t work or sleep normally. this stress will kill me…
    Please tell me, do i have to worry? is my case with cunnilingus carries any risk of HIV?

    Please help me doc!
    Thank you very much in advance.
    Jack. C

    • Your worries are slightly misplaced. There is NO risk of HIV from cunnilingus.

      However, there is a very small risk of HIV even from protected sex. The fact is condoms are extremely good at reducing the risk of HIV but they are NOT 100% foolproof. There have been very rare cases of HIV infections even from protected sex.

      So because of this and not the cunnilingus, I have to say you are at risk of HIV but this risk is extremely small. Whether or not your symptoms are due to HIV is impossible to tell. Honestly asking these questions on forums is not going to help you at all. Regardless of your current situation, what you need is a HIV test to put your mind at ease. Please do this before the stress and anxiety because a bigger problem for you than HIV.

      • Jack. C

        Thank you doctor! i feel better now.
        you said that there is a risk with condom, but condoms were really strong (extra safe) and also didn’t broke or slide during sex. and i didn’t even ejaculated inside the condom. i was bit tired back then. and it was my first sex experience…
        pity thing that i can’t get tested right now and i will be able to do it only in few month minimum. =(
        and yeah do you think that my risk of protected sex is real?

        thank you very much in advance

        • The fact is we have lots of statistics comparing the rates of HIV infection between people who use condoms and people who do not use condoms. Although the rate of HIV infection in the condom-use group is always much lower, it is not ZERO. There are many theories why this happens. This does not matter now. What matters is we have to admit to the fact that statistically, there is a risk of HIV infection from protected sex. We just do not know why.

          I do not know how to answer is your risk if “real” or not. I would tell you to get a HIV test just like everyone on earth who is sexually active should get regular HIV testing.

  7. A sex worker has licked my anus for several minutes. I washed it afterwards and there was no sign of blood. After a week, I felt weakness and stuffy nose for a day. Is there a risk of HIV? Early symptoms can appear after seven days last just a day?
    Thanks.

  8. anxiousBJ

    dear dr tan,

    sorry i am not sure if my previous message posted, doctor i have insertive fellation ( BJ from a girl) i did use a condom, the blow job laster 3 to 4 minutes and after i carefully took of the condom and threw it away and washed my penis, i also did not see any signs of blood or sores in her mouth, i am very worried now about the risk of hiv and std associated with this stupid thing, please can you advise what my risks are ? pls respond, thanks for helping dr tan,

    • You are worried about getting HIV from protected insertive oral sex? That is the one thing I’m sure your will not get. The same however, cannot be said of the other STDs.

      • anxiousBJ

        hi drtan

        no my question is what risks of what kind of stds do i have if i received a protective blow job ?
        there was no skin to skin contact above the condom, if there are risks of getting std from having a blow job with a condom what stds am i at risk of ? sorry t rephrase question but i just want to understand what std risk i have not just hiv,

  9. anxiousBJ

    dear dr tan, i had a momement of weakness and peformed insertive fellatio for 3 to 4 minutes with a condom, the condom did not break at all and i carefully took it off after and washed my penis, i did not see any blood or any sign of open wounds at all, i am very worried about hiv and std risk associated with this interaction, please can you tell me the risk ito %tage that i have from this experience ? pls respond, i am very worried

  10. Hi, i have sexual encounter with prostitute in JB few weeks ago. Oral sex without condoms, but vaginal sex with condom. I am having strange discharge from penis and have burning sensation when urine. I think might have caught UTI STD. Is consultation/testing anonymous? Is the Male Urethritis test instant result or have to wait for few days?

    Thanks.

  11. taffyboo

    Hello, i received unprotected oral sex from a lady (casual, not sex worker) whose HIV status is unknown, after which proceeded to finger her. What are my risks of hiv? Should i be worried?

  12. Licking and fingering

    Hi Dr,

    I was with one promiscuos girl and she only kissed and licked my testicles (never my pennis) while i was masturbating myself , and I fingered her like 30 seconds (inside of her vagina). Thats all. Is that no risk? Should i do the test?

    She never touched my pennis.

    Thank you

  13. sir 3 weeks ago i had protected sex with a prostitute. i licked her vagina 1 time maybe 2 sec.can i get hiv.

  14. HI Doctor,

    I received an unprotected oral sex from one sex worker one year back and I have not gone for any test. I still have anxiety about STD and HIV disease. Whenever I have fever or flu I started thinking about HIV. Please help me doctor weather am I safe or not.

    Thanks!!!!

    • You seem to have answered your own question already. Go get tested. That is the only way to know if you have been infected or not.

  15. I received a unprotected oral sex from a worker. It was a brief less than 10 secs, should I test for HIV and STD?

    • I can tell you that in my opinion the risk of getting HIV from oral sex is negligible. I can also tell you that oral sex puts you at risk of many STDs like Chlamydia, Gonorrhea, Herpes etc. I cannot tell you if you should test or what test to do. This is medical advice that you have to get from your doctor.

  16. Dear Doctor,
    on monthe back I was messing aroung with message lady, i just performed oral sex .. I just suck and licked her breasts and nipple for (3 or 4 minutes ) no other contact
    there was no visible ulcer or wound in my mouse
    is there any risk to get hiv , please reply me because I am very worried and thank for ur help

    • If that is all you did, I think you are not at risk of HIV.

  17. Hi Dr Tan, I had a blowjob from a massage lady about 5 weeks ago, instead of a condom she used a saran wrap. What are my chances of contracting HIV? I came in the saran wrap and it was not broken or anything. I’ve had swollen lymphnode under my right jaw for the past 4 weeks and about 2 days ago I developed a slight sore throat. What do u think I should do?

  18. I am also tested herpes Igm(done by elisa mode) test after 25 days that incident.if its conclusive?

  19. 1). I was licked outer lips of vagina(labium majora)at only one time maximum 2 sec and there is some fluid present that place and also i gave open mouth kiss to her lot of times. After 1 week i have small burning (like patches) on my cheek, thigh,leg and arms. If it symptoms of hiv.I m so scared pls tell me…

    2). The fourth generation elisa (ag/ab) test will be accurate or not after 25 days?

    3). Can hiv (TRI-DOt method) test will be accurate after 48days?

    4). Can herpes spread through by licking labium majora of vagina at only one time maximum 2 seconds? If it possible? Pls ans me…

    • 1. That does not sound like HIV symptom.
      2. It is a good indicator but not conclusive. It is only conclusive after 28 days.
      3. No. It is only conclusive after 12 weeks.
      4. Yes it is possible since there is skin to skin contact.

  20. Hi Dr.,
    I have fingered a sex worker about 5 days ago, insirted my finger a few times and my fingers where in touch with her vaginal fluid. Is there any HIV risk. I had no open wounds or similar on my hand. There was no other form of sex, just petting. Do I have to be concerned?
    Thank you,
    Marco

    • If that truly was your ONLY exposure, then I can safely say you are not at risk of HIV.

  21. anxiety2015

    dear dr,
    it was my first time visiting a sex worker,i did fingering on her and then she gave me a blowjob,i’m wearing condom but it felt loose but still holding in it place.Did i get HIV from her saliva if it slips through the condom?

  22. I was licked outer lips of vagina(labium majora)at only one time maximum 2 sec and there is some fluid present that place and also i gave open mouth kiss to her lot of times. After 1 week i have small burning (like rashes)on my cheek, thigh,leg and arms. If it symptoms of hiv. I m so scared pls tell me…

  23. Hi doc,

    I was involved in a risky activity some 2 weeks plus ago.. was my first time …regretted immediately after a day. I had unprotected blowjob with massage lady hot water and cold ard 1-2 minute and sex with condom provided with no ejaculation for 2 minutes with her on top..

    I took rapid test kid 4 days later and was negative… and same day 4th day took PEP of Lopinavir/Ritonavir and lamividine and zidovudine and continues

    what are my risk.. I am really worried

    • Dr Justin Sim

      The chance of getting HIV from oral sex is almost zero. Since you are already on PEP I would recommend finishing the course and then getting tested after.

      • anxiety

        I am even worried thinking what kind of condoms that maybe defective or etc..despite the sex was short and no thrusting at all from me due to scare…

        My first time I do not even know what kind of condoms and d quality.. used their condom..

        you mention to get tested after finish PEP that would be 30 days after risk..?

  24. Dear doctor,

    I am extremely worried about getting HIV from receiving oral sex from a sex worker (about 10 min). We only knew about her mouth had blood/bleeding (unknown reason) after the act. I am having phimosis and does it increase my risk?

    Thank you.

  25. Dear Dr. Tan,

    I hope this finds you well.

    I’ve read below whereby you state that there is no risk of contracting HIV from performing cunnilingus.

    However, I unwisely performed cunnilingus about a day and a half after a minor dental extraction. Had to get an extra tooth right at the back of my mouth pulled out. At the time I performed the cunnilingus, I believe the extraction site was still seeping some blood. I did it for about half a minute, tops, primarily around the region of the clitoris with my tongue.

    Unsure about my partner’s sexual health status, although she did say she had a test done about a month back which came back negative.

    Would you still say I’m am at low/negligible risk as a result of this episode?

    Many, many thanks.

  26. Regretfullme

    Hey Dr tan, hope you have been well ? DR. Tan, you responded to my questions below about insertive felatio, one thing i forgot to mention is that i have has HSV 2 for many years now , but i had no open lesions at time of the event, will this increase risk of HIV ? if so what %atge risk does this carry ? u said 0.04 % onlya applies to gay men fromo insertive felatio, would having herpes with no open lesions increase this risk ? and if so to what ?

    i did hiv pcr at 10 days, and i tested for gonoreah and chlymodia and syphillis, std wasngative, but waiting for results of the hiv pcr, if hiv pcr is negative and std negative at 10 days would you say its safe to have sex with my female partner because since i am back from travels after mistake i have been avoiding sex because i dont want to put her at risk, please advise if you think its safe for me to have sex with her now ?

    your soonest response will be aprichiated.

  27. Dear Doctor.

    when is the best time after exposure to test for hiv for combo test?

    I have put myself at risk recently (happen on 15/july), we never done anal sex. but we did oral sex only. he ejaculate into my mouth while i had an canker sore ( he never tell me when he is about to cum). when i do fellatio on him suddently i sense a heaty liquid, that is obviously sperm and i quickly withdraw/ move away my mouth and have a quick rinse with water.

    please tell me doctor… when is the best time to get test for hiv.

    • Dr Justin Sim

      Best time for a combo test is 28 days or more.

  28. Dr Doctor,

    I recently engaged in oral sex with a male who turned out to be HIV+ but is taking anti-virals and says he his “undetectable”.

    It was mostly Insertive Fellatiio for me, but there were occasional brief Receptive Fellatio on my part. There was no ejaculate from him, but there was for me.

    Would this be a high risk exposure? Which test would you recommend and when?

  29. regretfullme

    dear doctor tan, also pls advise when is soonest i can test for std from exposure explain above

  30. Good day dr,

    7 weeks ago I do some oral sex on a woman. She seems pretty clean and disease free but my concern is the transmission of hiv. I dont have any fever or symptom that related to hiv.

    I had done rapid hiv test, the result came out negative for hiv. Do i need another test or just move on with my life? Im so anxious right now. 7 weeks test using rapid test is reliable result or not?

    Thank you in advance

    • You did oral sex on a woman. In other words you performed cunnilingus? There is no risk of HIV infection from cunnilingus.

      • yes, i performed cunnilingus on her. Only cunnilingus. My rapid test for hiv at 7 weeks post exposure came out negative. So, this result is conclusive?

  31. regretfullme

    dear dr tan

    3 days ago i was drinking alcohol and was not thinking when i gave a prostitute cunnilingus only licked her clitorus maybe 4 times and she preformed insertive fellatio on my penis for maybe 4 strokes, then when i sucked her nipple i felt little bit liquid in my mouth and stopped, i a very worried and please can you tell me in %tage what are the risk of hiv from this way ? i know for all oral inlcuding receptive fellatio you give 0.04 % but what about cunnilingus and insertive fellatio like in my situation ? is this still 0.04 % ? i know its hard to say but if you can add a number to it in terms of %tage figure what would it be ? pls respond i am very worried, also is it common way to spread std via oral or is it not common way ? thanks for taking time to read my concern, thanks very much dr tan

    • The 0.04% only applies to gay men. Your risk of getting HIV from the scenario is a big fat zero. You can however get all sorts of STDs from oral sex inluding Gonorrhea, Chlamydia, NSU, HPV, Herpes etc etc

      • regretfullme

        thanks for the response doc, im asuming i also dont have to worry about the nipple fluid in my mouth ? thanks for always responding to people and assisting with relieve in anxiety and i apprichiate that you are not scared to comment on a zero risk answer, most doctors i read are insecure about taking a view on this and it proves that you are specialized in your field and know your field well, thanks a mill, u are a superstar !

        • Having nipple fluid in your mouth is very different from breast feeding. There is no risk.

  32. Hi Dr,

    I received unprotective oral sex from a commecial sex worker, and performed oral sex on her for about 2min.

    It was only after everything was over that I realised I had an ulcer on the inside of my lower lip prior to this.

    I am quite concerned as to the risks of getting HIV and STDs now. is it significantly high?

    • The risk of HIV and STD is low from oral sex. If you are worried, please see a doctor and get yourself tested. You are welcomed to visit any of our clinics.

  33. what are the chances of getting hiv from blowjob? I just got blowjob from my gf and im not sure if she has hiv but shes a virgin.

    • Dr Justin Sim

      Firstly getting HIV from oral sex is almost zero. Secondly what are the chances your GF has HIV if she is a virgin? If her mother didn’t have HIV while she was pregnant and she is not a hardcore intravenous drug user then where would it have come from? People don’t just ‘get’ HIV from nowhere.

  34. worried

    Hi Dr,

    I receive a protected blow job for a short time followed by a unprotected hand job and I ejectulated on the commercial sex worker’s hand. Last year I was diagnosed with herpes 2. The day after I started having a sore throat and the back of my tongue turned yellow, can I ask am i at risk of HIV or any other STDs?

    • Risk of contracting HIV or STD from a protected oral sex and unprotected hand job is extremely low. However, if you are concerned, you can get yourself tested just for reassurance.

  35. bryannn

    hello doc, just wanna ask. i was tested reactive in my first screening test and now i am waiting for my confirmatory result. I dont have sexual intercourse but only oral id just did and usually making oral sex i am the insertive. I dont give oral sex but i received oral sex from them (someone gave blowjob). Now, my question is.. how come that my first screening test was reactive? and what are the possible causes being reactive in first screening test for hiv?

    • Dr Justin Sim

      This is difficult to say. Oral sex carries almost no risk for HIV transmission so you would be a world first if you caught it that way. Maybe the test is a false positive? Maybe you did get the infection elsewhere, which is why you are reactive? Either way you should wait for the results of the confirmatory test then see advice again depending on that result.

      • bryannn

        doc, actually i have fungi..i have this skin problem for how many years but now it does not really itchy anymore..i never take antibiotic but only ointment . do you think doc its because of my fungi and thats why my screening test was reactive?

        • Dr Justin Sim

          Unfortunately a fungal infection will not cause a reactive HIV result. It just doesn’t cross react that way. Your options here are to wait for the confirmatory test or get a second screening test done in case the first one was invalid or was a false positive.

          • bryannn

            doc, any idea what is the main reaseon or cause why my screening test was reactive? i dont have any sexual intercourse and i never take drugs.. what is the possible cause? i am so much worried doc. What is the cause of false positive in rapid test.. is it rapid test trusted?

          • Dr Justin Sim

            I cannot tell you the reason why it is positive without knowing exactly how the tests were run and how the doctor actually did your test. You really should go back and speak to them about this once the confirmatory result comes back.

  36. mike green

    Hi Doctor I am a male I recieved unprotected oral sex from a women about 2 weeks later ive been having a cold congestion , head ache,phlegm and feeling weak and dizzy also its hard to breathe am I at risk of hiv and are these symptoms if Hiv or any other STD please reply

    • Risk of HIV transmission by oral sex is low. If you are worried about HIV and STD, you should get yourself tested. You are welcomed to visit any of our clinics.

  37. Arturo Diaz

    Hi doctor,

    Thank you for all this info. and care our fears.

    My english is not perfect, but here i go. I´m a man, 38 years old.

    I have 2 situation of risk in the past. 1st. APR11. I do receptive fellatio with another man (he dont eyaculate, only precum), and he tried penetrated me, but finally, i rejected. He don´t penetrated but put his penis in my annus. All happened for over 5 mins and we don´t use condom. 2nd. Risk APR 24 (after 2 weeks). I do receptive cunnilingus with a prostitute and have sex with condom. Here, my fear is about oral sex.

    38 days after the 1st risk and 27 of 2nd risk, i do a HIV combo test. The lab in Mexico is called “El Chopo”, and offers the test as: HIV Test electroquimioluminiscencia 4th generation and supoustly detect the Antigen or Ac HIV, 2 weeks after de exposition!

    Fortunately, my results is not reactive and negative in syphilis. But i´m still affraid and scared, can i take this result conclusive? Is possible get a “false negative” with 6 an 4 weeks of window, respective?

    Thank you doctor,

    • Dr Justin Sim

      If you did combo tests at the times you state then you should be okay and clear from HIV. The more important exposure was your first one, with the man. Chances of false negatives are low if the tests are used correctly and during the right window period.

      • Arturo Diaz

        Thanks for your reply, doctor! But I only done one HIV combo test, not twice, 4 weeks after the possible exposure with the prostitute, and 6 weeks with the man… Do you recommend another test?

        The VDRL test was included in the HIV combo. Is this ok for another diseases?

        Thank you again!

        • Arturo Diaz

          I mean, its enough performing only one test HIV Anti HIV 1-2, Antigen p24 by ECLIA from 4 and 6 weeks after possible exposure?

          • Arturo Diaz

            What happened if the test of anti VIH 1-2, by ECLIA, 4th generation, dont include The p24 antigen? Still is a good test to 4 weeks Window? Sorry, i have this fear because are many inconsistent info with The lab in mexico. One guy say that test include The p24 and the result paper dont say anything about. Thank you

  38. Worried guy

    Hi Dr. Tan,

    I performed an oral sex, suddenly he cum to my mouth and i accidentally swallow the sperm, this was happened 1 month ago, but i didnt find any symptoms on me, we talked also regarding if he is safe or not and he said he is tested, but i still want to make sure. Is there any possibilities to get HIV if u accidentally swallow a sperm to your throat?

    • Risk of HIV transmission via oral sex (regardless of whether you swallowed the semen or not) is low. The exact number or percentage is unknown.
      If you are worried, get yourself tested now since it has already been 1 month.

      • Worried guy

        Thank You Dr. Sii Sik Liong, just went today at Robertson Walk, and its negative, I just want to make sure 🙂

  39. Dear Doctor,
    I performed unprotected cunnilingus (3-4min) and had one unprotected fellatio (10min) two weeks ago with a prostitute. I had unprotected fellatio again with another prostitute the day after. I did not have vaginal/anal intercourse (neither protected, nor unprotected)

    Is there a risk of HIV and if yes, when can I have my first test (28 days)? What about chlamydia and gonorrhoea and syphillis? Is there a risk and if yes, when can I do the first test?

    Thanks a lot for your reply. I am very worried.

    • Dr Justin Sim

      The risk for HIV with oral sex is incredibly low but it still may be wise to get conclusive testing at 28 days after exposure. STDs like gonorrhea and chlamydia on the other hand are much more likely to be passed on through oral sex. For this you can test you can do it as early as 3 days after exposure.

      • Dear Doctor,

        Thanks for your reply. So is a Male Urethritis (urine) test 100% conclusive after three days for all the STI described in the table above?

  40. Dear Doctor,
    I was recently diagnosed with throat gonohorrea and have been on tratment. I performed oral sex only with no ejaculation. There was no other penetrative sex. What could be the risk of hiv? It has been 16 days from the encounter and when can I get tested ? I always use condoms for oral but that time only unprotected oral and was infected. 🙁

    • Dr Justin Sim

      The risk is low especially without ejaculation and as long as there were no open wounds or cuts in your mouth. The best time to get tested would be 28 days after exposure using a combo test.

  41. Hi doctor,

    I got engaged with one escortes lady in deep kissing for more than 30 minutes, she bit my lips in a very aggressive way, and I started bleeding.. But no sex happened..

    What are the risks of HIV

    AM REALLY worried

    Thank you

    • You cannot get HIV from kissing.

      • Alley003

        Dear doctor, i had cunnilingus with a HIV+ girl about a month or two ago.
        i’ve learned about her HIV+ status only few days ago. thankfully i didn’t had any other type of sex with her.
        however i’ve performed cunnilingus on her for about few mins thats all.

        please tell me, do i have HIV risk?
        because its possible that i may have swallowed fluids by mistake few times.
        please help me dear doctor =((
        we didn’t had anything else with her. because i couldn’t find my condom. we only did cunnilingus.

        i’m really worried right now =(

        • As far as I am concerned, there is no risk of HIV from cunnilingus.

  42. Worries

    Hi Dr Tan,

    I want ask u question, 16 Feb 2015 i went to massage and with my stupid mistake she was give me unprotected oral sex, which is happen around 1 minute.

    On 26-27 feb 2015 i got fever, i went to clinics and Dr told me only got mild fever where the reading is 37.6 from under the tongue.

    Again 3 march 2015 till 5 march 2015 i feel mild fever (but when people touch my body they say i am not really that fever or hot). I feel itch some part of my body, i start feel so little tired, Headache, little pain on finger joint,little pain on my muscle, also little sore throat. ( FYI this time i also start worries to much because after i got fever on 26-27 feb, i start reading and search from internet, worries about HIV and STD etc. making me very nervous and unfocused).

    Because i start feel uncomfortable with my lymph i went to see the Dr on 6 march and Dr told me i got little swollen lymph. He just give some medicine and i been honest with him about what happen and ask him is it what i got is symptom of HIV or something. He say no.

    Went to see Dr again on 10 march and Dr told me, i don’t have swollen lymph anymore.

    Before that,i was go to check my blood at bp healthcare on 2 march 2015 which is 2 weeks after expose HIV non reactive with antibody/antigen (CMIA). Also VDRL non reactive. i also show Dr this result when i see him on 6 march.

    Again i been reading that HIV have window period so i go to check again my blood on 9 march 2015 with HIV antigen/antibody (CMIA) the result is non reactive.

    During my fever i also sweating during sleep little bit just for 2 night (between 3-6 march).

    And until today i still fell something weird in my body, some times itch, some time little pain on the muscle and finger joint, also i still feel little sore throat.
    Yesterday, i was running in the gym for 30 minute finish at 1.20 pm. went to bed at 2.30 pm i awake around 7 pm i notice i was sweating a lot. (sleep day time because work at night)

    My question is,

    1. Do u thing this is HIV symptom?
    2. Or STD symptom?
    3. I been check for HIV after 2 and 3 weeks expose with CMIA, do u thing this result is conclusive? if not how many % u thing this result could change?

    Please advise me about this matter, appreciate with your time and prompt reply.

    Thank You.

    • Dr Justin Sim

      1) HIV symptoms are usually described as flu-like and can occur at anytime between 2-4 weeks after exposure. Your symptoms sound like they are down to a mixture of a cold virus as well as anxiety. I do not think your symptoms are HIV related.
      2) STDs do not usually appear with the symptoms you describe. However, it is important to note that 40% of patients who get STDs do not have any symptoms – so it would be advisable to get tested to be safe.
      3) Your tests would give a very good indicator as to your status but to be absolutely conclusive you would need a repeat combo test after 28 days from exposure.

      • Worries

        Hi Dr,

        I just did again the test last week after 14 weeks, the result :

        1. Syphilis Serology (Modified VDRL ) – Non reactive
        2. HbsAg – Non reactive
        3. HIV Ag/Ab screening (CMIA) – Non reactive
        4. Herpes Simplex Type l IgG – 2.27
        5. Herpes Simplex Type lI IgG – 1.21
        6. Chlamydia – 0.28

        My question is :

        1. Can i take the result for the VDRL, HbsAg , Chlamydia and HIV conclusive?
        2. Look like i am positive for the herpes, so far i don’t have outbreak at my private part. But notice i quiet often got ulcer and sometimes fell like cut pain at my tonsil. Please Dr advise me about this matter.

        Appreciate with your time and prompt reply.

        Thank You.

  43. Hi Dr Tan.
    i received unprotected oral sex (insertive) from another men and also have an open mouth kiss with him on the 6 Jan. My question is
    1. Do i have the risk of getting hiv and how many percent.
    2. If i want to do the combo test this week, is the result conclusive.

    • Sorry Dr. its happen on the 6 Feb 2015

    • 1. No risk of HIV. 2. The combo test is conclusive at 28 days post exposure.

  44. Hi dr tan

    I have a protected oral sex with a guy on new year eve..im both the giver n receiver. after 14 days i went for hiv testing using the 4th gen at AFA n it shows negative.its it conclusive cause i feel uneasy now after 6 weeks since suddenly rashes appear on my body n i hv a slight fever… not as what u describe.. n i lost weights.

    • The Combo test at 14 days is definitely not conclusive. This really should have and would have been communicated to you by AFA when you got your test done.

  45. Hi Doctor Tan,

    Doctor Tan i am J from Malsysian. i had 4 time unprotected oral sex with CSW. from 17 Nov 14, 24 Nov 14, 30 Nov 14, 6 Dec 14(last exposure). And i had done 4 time 4th generation test at 7 Dec 14, 13 Dec 14, 9 Jan 15 and latest test at 8 Feb 15.
    my question is:

    1. Is my test is conclusive to proof my HIV status?
    2. During 31 Jan 15, my mouth got Bliss on my Tongue (at week 8 after last expose), is that ARS symptoms?
    3. Should i forget it and move on?
    (sorry for my poor english)

    thks Doctor

    • 1. Yes. 2. Since you do not have HIV, then logically it cannot be a HIV symptom. 3. Absolutely. Please forget about it.

      • Hi Dr Tan,

        Thank for your reply. i still got few question.

        1. I feel my throat in comfort and my skin is sensitive.
        2. Should i consider the sero-negative issue? as i read through the article that you post on the website. so can the 4th gen test can really overcome the sero-negative?

        Thank you Doctor and Happy Chinese New Years.

        • question 2 admen *throat no comfort and my skin feel hot and got pops.

      • Dr tan.

        I just want to say thank for concern and giving me encourage. Just update you that i have done another 4th gen test and it is non-reactive (86day). So i hope you and Dr Kumar can continue help more people in future. God bless you.

        Thks.

        • I am glad you are well. To quote the great Leonard Nimoy – Live Long and Prosper

  46. Dr Tan, what is the risk of catching HIV from protected oral sex if saliva of person who is performing oral sex has contact with common, benign, skin growths around base of penis or genital area? Are cherry hemangiomas, moles etc considered ‘broken’ areas of skin or do they offer same protection against hiv as skin without any growths? Many thanks for your help!

  47. Hi Dr Tan,
    Received blowjob from a Thai masseuse (Insertive Fellatiio) and ejeculated into her mouth. What’s the risk of HIV and/or STD? When’s the best period to go for a test and what test should I be doing?

    • Literally no risk of HIV. STDs however, you are at risk of all of them. A good time to screen is at 1 month post exposure assuming you do not have any symptoms. If you do develop symptoms, please see us earlier.

  48. Dear doctor and experts,

    I have couple of unprotected oral sex during earlier this month (2-4 jan)
    During the oral sex , no semen was contacted in my mouth as i was being quite cautious about it.however I am not sure about precum as it is very difficult to tell. I do have swollen gum from time to time and a hole in my teeth. I am also unsure about their hiv status

    Yesterday I started to have this rashes appear my chest and this morning it was 90% gone. i don’t have flu like symptoms or diaherra.

    I am so worried about chances of getting HIV , I came across a study saying that oral sex has a risk of 0.4-1% of getting HIV , in my case , without the semen contact in my mouth, do you think it will be lower ?

    To add on if it matters , I went out the whole afternoon doing extreme cycling , the rashes appear in the evening when I get back from cycling.

    Wanted to hear your advice on this and chances of getting HIV , should I go for test soon ?

    • I can’t say your risk is 0% but I can say your risk is extremely low. You should not pay too much attention to symptoms. Wait till you are 28 days post exposure then go get a combo test. Should you wish to get a HIV Combo test at our clinic our charges are $150 for the test $20 for consultation and 7% GST added to the total.

      • Hi doctor tan ,

        I am not a local Singaporean hence testing in sg won’t be ideal but I learn that your clinic has annoymous testing service as well?

        If you were to put a number of percentage to my case, is it still less then 1 % ?

        To your experience , have you ever encounter any case where HIV transmitted through oral sex ?

        My rashes are mostly clear but still itchy, I am just very worried at this moment

        Thanks doc

        • HIV testing at our clinic at Robertson Walk is 100% anonymous for Singaporeans, PRs and foreigners. As we say here “regardless of race, language or religion”. Yes less than 1%. No I have not.

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