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Safer oral sex

A Filipino who likes oral sex asks about the risk of getting infected with HIV (and STIs) from the act, particularly since he dislikes condom use when giving head. Dr. Jose Narciso Melchor Sescon provides some information about this.

Dr. Jose Narciso Melchor Sescon – president of the AIDS Society of the Philippines and current Chief of Clinics of Sta. Ana Hospital – answers all your HIV-related inquiries. For all your questions, email or

Dear Doc,

I like giving blow jobs (fellatio), but I cannot imagine doing so with a condom on. But I’m also scared of the risk of getting infected with HIV from this. What do I do?

Mr. Blow-by-blow

Oral sex involves giving or receiving oral stimulation (i.e. sucking or licking) to the penis (fellatio), the vagina (cunnilingus), or the anus (anilingus). HIV can be transmitted during any of these activities, but the risk is MUCH LESS than that from anal (rectal) or vaginal sex.

Receiving fellatio, giving or receiving cunnilingus, and giving or receiving anilingus STILL carry HIV transmission risk and this depends on the circumstances at that point in time, such as the successful entry of the virus. The infectivity rate or the “high” viral concentration at the time of oral sex is another thing or factor to consider; as well as the presence of mucosal breaks such as gum inflammation (gingivitis), dental caries, and the likes.

Note that the highest oral sex risk is for an individual performing fellatio on an HIV-infected man, with ejaculation in the mouth. If the person receiving oral sex has HIV, his/her body fluids have the virus. Blood from the mouth may enter the body of the one receiving oral sex through the urethra (opening at the tip of penis), vagina, cervix, anus, or through cuts and sores. Although oral sex poses less of a risk for HIV and some STI’s than vaginal or anal sex, the risk still exists. Ted Greene, writer and co-owner of shared with us that there are options when it comes to using condoms for oral sex. While they can make the experience less pleasant, oral condoms exist and can come in different flavors to cover up that horrible latex taste.

When we talk about other sexually transmitted disease/infection (STD/STI), such as human pappilloma virus (HPV), gonorrhea and Chlamydia, oral sex poses HIGH risk of transmission. Not to mention Hepatitis B! So the use of condoms offers some protection here. There are ways to protect oneself from HIV risk, including the correct and consistent condom use.

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At the end of the day, it is a decision one has to make – i.e. taking risk or keeping it safe. Making oral sex safe and pleasurable at the same time is what matters most!


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