swallowing risks

[xifangren]

Hi everyone.

I think it's the first time i post here. Although i read and try to get info here from time to time. I'll try not to make this a masturbation post, but I need some feedback here.

So I'm a neg top, although I haven't been topping much lately for several reasons (including not being so happy about using condoms). Anyway, I enjoy facefucking and love to feed a guy who really wants it. However I also love sucking. Though I suck even less often than topping for another set of reasons. Whatever.

Lately I'm approaching guys to blow them. Still nothing has happened, and I also passed on some opportunities, but it is going to start happening and I'm pretty sure I will want to taste their cum in my mouth, although not necessary swallow. I'm pretty ok with that in risk terms, I guess.

Being in this situation, I met a greek-god guy online, nice cock, etc. So he likes my cock but reacts when i ask if he likes to get good head, and asks me if i like cum. I say i do, but ask about status and he says he's poz under treatment without viral load. I try to be sensitive about it cos it's the first time it happens to me and i'm not too informed. He tells me he wants an oral sub to please him. I say I like that and he asks if I swallow. I ask about risk and he says it's low risk and to check online (which i already had done).

Ok, that's it. Now, I'm thinking: I've read the news about the PARTNER study and stuff like that and seems that undetectable (I guess that's the same as no viral load, right?) guys won't transmit the virus. I also now that oral sex is also a low risk activity per se (few or none documented cases i think? like 1 in 2500? I'm not sure if that 2500 would all be poz though). So if at some point I'm gonna find myself sucking some guys who probably don't really know their status, it seems stupid to not suck an UD guy off (it might be safer), but I also feel pretty anxious and like i'm might be behaving self-destructively. The guy also asked again if i swallow. So i guess he's got some kind of fixation about it too (I understand). I don't know if i could convince him or stop him from feeding me... and anyway is there a significant difference in risk between swallowing or not? It all seems so relative.

On the other hand I recently learned about PreP and I'm considering it. For this (probably nor worth it because of minimal risk?), but also for topping. So I might do that before. I just don't want to regret it later or feel scared when he cums. Also I'm thinking, if we like it we might do it again and again and the risk overall would probably be higher. Also he might not actually be undetectable (knowingly or not). And I definitely want to stay neg. I'd accept without thinking if it were someone who I "know" or believe to be neg. And I don't want a poz fetish.

I know I'm overthinking it, but I can't help it. I think I know most of the facts, but I still feel unable to see things clearly. Any insight or tip or something?

Thanks!

tl;dr: an undetectable poz wants to use my mouth and feed me his load, i'm probably irrationally scared (or not), calm me down, thx!

[everopen1]

You are over thinking it. It just takes the first time and your be fine

[bearbandit]

In my opinion the figures for oral transmission are inflated by the guys who think it's somehow "less gay" to admit to sucking cock than it is to get fucked. So although they've been taking it up the ass they'll only admit to sucking. They seroconvert and claim that it can only have been through sucking. Enzymes in saliva knock HIV for six, and stomach acids destroy what little survives the saliva. To get HIV through sucking there'd have to be enough oral trauma (mouth ulcers, recent tooth extraction, accidental bite to the cheek, you get the picture) that you wouldn't really be up for sucking. Remember too that it takes a quantity of HIV to establish a "successful" infection: a single virus particle getting through all that isn't going to do anything apart from eventually get destroyed by stomach acid. Ever thrown up to the extent that you're throwing up bile? Remember how it made your mouth sting?

However, a herpes or syphilis lesion in the mouth or throat (or pretty much any other STI) will increase the chances of transmission, so it's important to keep up with regular STI checks (in the seventies the recommendation was every three months or at the first suspicion of symptoms if less than three months). The last time I heard of doctors finding out about a sexual practice that they couldn't believe was 1982. Apparently doctors at a London hospital had to be shown a fisting video before they'd admit it was possible and enjoyable...

[Guest cardoc49]

Hi and fine post - you are irrationally scared - do go ahead and enjoy swallowing, no risks at all

[xifangren]

Thanks for you replies. Do you guys know some statistics like "oral receptive sex is less dangerous than anal insertive sex with condom"? that one's always comforting...

Imgameu41, What do you mean it just takes the first time?? The first poz load? After this I'm not sure whether I should ask the status of guys i just intend to blow. I mean, if the risk is so minimal in any circumstance, knowing their status might just make me anxious...

Yes, bearbandit, I need to do a check up soon. Also before I decide to go on PreP or not (I think I should...). I tend to have sores in the mouth (biting tongue or cheeks), even if not open and not all the time. Otherwise I think my oral health is ok. So that's also to take into consideration.

go ahead and enjoy swallowing, no risks at all

wow, that is a bold statement i really want to believe. :/

[NYCBearpig]

As far as I know it's only a problem if you have some sort of gum disease where your gums bleed or are otherwise compromised, or if you just had some major dental work.

[Poz1956]

I've debated whether to repeat this here, or just link to where I posted it on another site. It is a dissection of the risk posed by oral sex down to a ridiculously minute detail. I put about 40 hours of research into it reading most the medical literature available online. Since you are over thinking, I might as well give you a big blob of text to over think about.

By the way, in the study that produced the 1 in 2500 number you quoted, no actual transmissions occurred. Just like in the Partner study the statistical "fudge factor" called a confidence interval created that theoretical risk number. They are 95% sure that their results did not come about by random chance. They know that the real number lies somewhere between the theoretical number, and zero. If they studied more subjects for a longer time, the confidence interval would go up, and the theoretical risk be stretched out further.

---

One of the most common questions I get is "How safe is oral sex?" Since it gets asked so often, I thought I'd post the answer here.

Firstly I should mention that I'm not any kind of medical professional. I'm just another Pozzie. I'm very well read up on the topic, but in the end, just I am just an ordinary Poz guy. But this answer has about 40 hours or research behind it. I reviewed countless websites and all available medial data.

Let me preface the whole conversation with a couple of points. I know everyone is terrified of HIV, but in reality it is NOT that easy to catch in the first place. The body is pretty good at fighting off all sorts of infections. It honestly takes exposure to a MASSIVE dose of HIV to cause transmission. It has to be enough to overwhelm the body's own defences, and take root in many CD4 cells. They are the type of white blood cell that the virus reproduces inside, killing them in the process. It takes very specific circumstances for HIV to gain a foothold. Remember that not even a bottom receiving full bareback fuck, from a high viral load Pozzie, results in transmission every time.

There really is no consensus amongst medical professionals on the risk of oral sex. They usually take the most conservative approach to advice, with the least risk of being sued. There have been so few cases where oral sex was the only risk, that researches have not felt it worthy or even possible of serious study. Let's face it, most people do more than just suck cock, so it's difficult to asses if their risk was from BJ's or that little something something else.

Over all oral sex has always been considered very low risk. Most experts agree that a "blow job" is not an efficient route of HIV transmission. There is a "theoretical risk" of HIV transmission. "Theoretical risk" means that passing an infection from one person to another is considered possible, even though there haven't been any (or only a few) documented cases. And there really have only been a hand full of documented cases of oral transmission in the 28 years we've been able to test for HIV. Even those few are suspect. It's impossible to know if people are always reporting their sexual behaviour accurately. (Study volunteers often have a difficult time admitting the truth about potentially embarrassing activities to healthcare professionals.)

I am going to divide this out into a few different topics to give you something more realistic, on which to form your own opinion, and make your own choices.

The mouth has a lot of defences to getting any kind of infections. It doesn't have the delicate mucous membranes like an ass, urethra (pee tube), or vagina. Think of all the potentially bad stuff that goes into peoples mouths all the time. Have you ever done the "10 second rule" on food you drop? Especially think of a toddler who sucks on everything, and put anything that will fit, into their mouth. They are not constantly getting infections by that, right? How about the guys who rim? (Rimming certainly does have higher risk of other infections, but considering the number of guys who rim, there just isn't an extremely high number of people with mouth infections because of it. Rimming is extremely low risk for HIV.)

Saliva is a part of the body's natural defences against infection. It is pretty acidic, and contains enzymes, and antibodies which kill most bugs. Additionally, the saliva has a tendency to disrupt any cells and viruses which may be floating around in it. And lets face it, what ever was in the mouth, doesn't stay there long. It gets swallowed and put into the extremely caustic environment of the stomach. Additionally, remember that the HIV virus is actually quite fragile.

Firstly let's talk about oral health. Cuts, sores or abrasions in the mouth or gums, or infections in the mouth or throat that are inflamed do create a potential route of transmission. If you or your partner has these kinds of problems, oral sex should be avoided, or performed with protection.

Next let's take he case of a Neg guy receiving a blow job from a Poz guy. The chance is so close to zero that you can call it zero. It would take a perfect storm of misadventures to cause transmission. HIV is almost never found in saliva (even then it's usually just RNA particles, not a full virus.) A Poz guy has HIV specific antibodies in saliva too. That's how the mouth swab tests work. And remember antibodies fight the virus. About the only way it could be passed on is if the guy getting sucked had some kind of wounds on his dick (I certainly wouldn't consider putting my lips on a cock like that regardless of my status.) The Sucker would also have to have some kind of oral health issues as I mentioned above that caused bleeding. And if fellatio specialist did have wounds, or bleeding gums in his mouth, he really shouldn't be sucking anything anyway (or at least putting a condom on that cowboy). You would need both problems to occur at the same time for there to be the potential for transmission. And the Poz sucker would probably need to have an extremely high viral load as well. There has never been a single documented case of HIV transmission to the person being "sucked" during unprotected oral sex, either among MSM (Men who have Sex with Men) or heterosexuals.

The next scenario is a Neg sucker blowing a Poz guy.

Obviously those same oral health issues apply here as well. Don't suck a dick if you've got bleeding gums, open sores, an inflamed throat infection, or been eating Captain Crunch :-P (I know that stuff always tears the shit out of my mouth.) Obviously that last one is a joke, but before you step up to that glory hole, poke your tongue around, and think about the state of your mouth.

Take a moment, and admire that beautiful dick you're about to suck. Run your hands over it. Complement him on it. But what you're really doing is checking it for wounds, or abnormalities that would make you think, "I should give this one a pass."

Another point is how will you take the load? Cum in your mouth, take a facial or a chest shot? There is very little HIV in pre-cum, so up to orgasm, risk is Extremely low. Certainly there is more HIV in a full load of jiz.

But that "More" is relative. A guy under treatment, with an undetectable viral load, has so low of a dose that most HIV specialists think he has a very little risk of transmission, even if he does all the other Un-Safe stuff. Undetectable means below the threshold the test can measure - a viral load of less than 40. (Depending on where you live, and the test used, undetectable can vary. The most common test in North America has a lower limit of 40.) How far below 40 is an undetectable guy? A french study used the most sensitive assay available to re-test Undetectable Poz guys. That test measured down to less than one viral copy per ML of blood. 34% had a completely undetectable viral load. 44% had a viral load between 1 and 20. 21% had a viral load between 20 and 50 (Fifty was the lower threshold of the test commonly used in France at that time - ie 50 was their definition of undetectable.) Groups like UN-AIDS and the World Health Organization feel that transmission is unlikely with a viral load under 1,500. (Transmission through any method, other than direct blood to blood contact, like sharing needles).

Compare the risk of a guy under treatment who is undetectable, to someone who is Poz and doesn't know it. A newly infected guy (sometime in the last few weeks), who can't even test Poz yet, will have a viral load of over one million. Sometimes more than ten million. A few weeks later, after the immune system kicks in, and the body starts to fight HIV (ie after he is producing the anti-bodies and can then test Poz), the viral load will generally settle out between 30,000 and 120,000. A few will go lower than that, and some higher. Over the course of the pandemic, millions of guys with those extremely high viral loads must have had their dick's sucked.

Then there's the question of Spit, or Swallow? One school of thought says swallow. The most likely place or oral health issues is around the gums. Cum shots usually happen behind the teeth. If you swallow the cum stays behind the gums, but if you spit, you will spread the splooge all around your mouth.

Even with the highest viral loads, it is still considered very low risk of catching HIV through giving a BJ. There have been a number of studies that have closely followed MSM and heterosexual couples, in which one partner was HIV positive and the other partner was HIV negative. In all of the studies, couples that used condoms consistently and correctly during every experience of vaginal or anal sex, DID NOT use condoms during oral sex. There were ZERO cases where HIV spread from the HIV positive partner to the HIV negative partner. I should be obvious from the Partner study, that since they didn't use condoms for anal or vaginal sex, there is no chance they would have used them for oral sex. Recall that none of the Neg partners caught HIV from their Poz spouse in the Partner study. While no data was released on this, I think it is reasonable to assume that there were at least an equivalent number of blow jobs to bareback fucks. So I think we can say no transmissions occurred in at least 44,600 blow jobs as well.

I obviously could never say there is absolutely no risk, but it is extremely low. (Nothing we do is zero risk - you could slip in the shower, or get hit by a car crossing the street.) As I said before, researches consider it a theoretical risk.

"Here's a good way to think about theoretical risk: In theory, it is possible that while walking down the street, a meteor will fall on your head and kill you instantly. This is because meteors do occasionally fall to earth. People live their lives above ground, so there is a theoretical risk of being hit be a meteor. In fact, there have been reports of a few people being hit by meteors. But because the risk is so small, given that few meteors fall to earth and the large number of inhabitants of this planet, the risk is purely theoretical. The same principle holds true with oral sex – millions of people all over the world are believed to engage in unprotected oral sex and there have only been a handful of documented cases of HIV transmission. In turn, fellatio, and other types of oral sex, remains a theoretical risk for HIV infection." (quoted from "How is HIV Transmitted?" @ AIDSMeds.com)

Put your fear aside, and just think about it logically for a moment. How many gay guys suck dick every day! It HIV were easily transmitted by oral sex, wouldn’t every gay man in every big city be Poz by now?

The truth is, there is far greater risk of getting some other STI from oral sex, than there is of catching HIV through giving or receiving a BJ.

And if the whole idea still totally freak you, take a facial, or chest shot. Or suck with a nice mint favoured condom (personally what I've found it the best flavour for BJ's).

Hopefully that puts your mind at rest around the topic of Blow Jobs.

Just as an aside on other STIs, Hepatitis B is 50 to 100 times more transmissible than HIV (but nobody seems to ask about it). It is completely preventable by a vaccination. If you haven't done so already, may I suggest you get that done now.

[xifangren]

Thanks for all the info. One problem I see with these numbers is that usually it is not clear how the ejaculation went on (outside, face, mouth, throat...), and I've found pretty difficult to find a guy who wants it in the mouth (not that I was really looking though), so maybe most of those blowjobs didn't entail cum in the mouth. I don't know if that's specified somewhere else... I suppose most of the guys in this forum swallows or makes swallow or will do it soon. But I think most guys out there don't (at least in most places where i've lived).

Anyway, I think checking periodically for STIs and mantaining good oral health should be enough. I know if I'm sucking a guy a like I'm gonna have him cum in my mouth, and since in most cases I won't really know his status I might probably end up with some poz guy, probably without treatment. So it seems stupid to not take this one, especially if he really is undetectable. Anyway, he didnt reply my last message, maybe he's fed up with me giving him this shit and just wants the blow and not so much drama.

Also I will never suck a cock with a condom!! mint or chocolate!! no way!!!!

[rawfuckr]

and I've found pretty difficult to find a guy who wants it in the mouth (not that I was really looking though), so maybe most of those blowjobs didn't entail cum in the mouth. I don't know if that's specified somewhere else...

Most of the guys that blow me want that load in their mouth. I consider my hookups a pretty good representation of the general population, specially does who don't do anal and just oral.

I know many many poz guys, and not a single one claims they got HIV from oral. I have a few that say they got it from a broken condom and I sort of believe it. Oral has to be very very safe (for HIV) no matter what you do. On that note, I think people should be a lot more concerned about other STDs in the mouth that you will likely get at some point if you are sucking dick. Gonhorrea, chlamydia are super easy to catch, so it's best if folks get STD tested with an oral swab in their mouth. It's important to get the oral swab because these infections are site specific. Another one you are almost guaranteed to catch if you suck a dick or two is HPV and this one can cause throat and oral cancer. It's quite rare, but gay men have a much higher risk for it because all of the dick sucking. There is also a vaccine for HPV, gardasil, but it's effectiveness is questionable if you've been playing around for a few years.

Edited April 20, 2014 by rawfuckr

[xifangren]

Thanks for the info, rawfuckr. You're right, it seems other STIs should be more of a conern. I have all my vaccines and do checkups periodically, so i'm not gonna worry about it.