If one of the partners is infected with HIV and neither of them has pre-cum, is blowjobs contagious?

Answer

It is known that infectious virus can be present in pre-cum and ejaculate in an HIV-infected person. Although the amount of infectious virus in semen decreases drastically with very low numbers of viruses in the blood, eg by anti-viral therapy, recent data indicate that even with optimal therapy, detectable infectious virus can sometimes still be found in semen. Furthermore, studies of the risk of HIV transmission associated with oral sex are complicated by the incomplete reporting of more risky acts (such as unprotected anal or vaginal penetration). However, we can repeat that with regard to fellatio (pipes):

1. There is a minimal but detectable risk to the receiving partner, especially in the event of ejaculation and in the presence of lesions/wounds in the mouth and/or pharynx. Ejaculation on skin is harmless.

2. The insertive partner runs a negligible risk (although a case has been described of a man who (in his own words) became infected with HIV only after fellatio by a prostitute. (Spitzer PG, Weiner NJ. Transmission of HIV infection from a woman to a man by oral sex. N Engl J Med 1989; 320(4):251).

3. The risk is reduced to zero through the correct use of a condom.

Recent data in Belgium point to a continued spread of HIV, especially among homosexuals. The infection should not be trivialized: the lifelong therapy is a heavy burden for the person (side effects, psychological burden) and society (cost), many late complications of the infection are not known whether they can be completely avoided by the treatment. Use a condom remains the message.