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Americans really want to know their HIV risk during fellatio—even more so than during anal sex.
Sure, you can Google the subject, but the results may further confuse and scare you.
And if an HIV-negative person bottoms for an HIV-positive top who doesn’t use any protection but does ejaculate inside, the chances of HIV transmission are, on average, less than 2 percent. If the guy pulls out before ejaculation, then the odds are 1 out of 154. Is HIV really this hard to transmit, especially in light of the alarming statistics we are bombarded with?
Although the CDC estimates that nearly 1.1 million Americans are living with HIV and that the rate of new infections remains stable at about 50,000 per year, there has been a 12 percent increase between 20 among men who have sex with men (MSM)—including a 22 percent jump among young MSM ages 13 to 24.
Yet not even the Nate Silvers of the world would be wise to gauge HIV risk based on statistics. Numbers and probabilities can be miscalculated and misinterpreted.
Case in point: Having a 1 in 70 chance of transmitting HIV does not mean it takes 70 exposures to the virus in order to seroconvert.
For example, the average risk of contracting HIV through sharing a needle one time with an HIV-positive drug user is 0.67 percent, which can also be stated as 1 in 149 or, using the ratios the CDC prefers, 67 out of 10,000 exposures.
The risk from giving a blowjob to an HIV-positive man not on treatment is at most 1 in 2,500 (or 0.04 percent per act).A Centers for Disease Control and Prevention (CDC) fact sheet describes the probability of oral sex transmission as “low.” But what does that mean?The website puts it this way: “You can get HIV by performing oral sex on your male partner, although the risk is not as great as it is with unprotected anal or vaginal sex.” Regarding going down on a woman, the site explains: “HIV has been found in vaginal secretions, so there is a risk of contracting HIV from this activity.” Does this put your mind at ease? That’s why many of us seek out percentages and ratios when we talk about risk. But do they give us a better understanding of HIV risk and sexual health? Probabilities of HIV transmission per exposure to the virus are usually expressed in percentages or as odds (see chart at the end of this article).The risk of contracting HIV during vaginal penetration, for a woman in the United States, is 1 per 1,250 exposures (or 0.08 percent); for the man in that scenario, it’s 1 per 2,500 exposures (0.04 percent, which is the same as performing fellatio).As for anal sex, the most risky sex act in terms of HIV transmission, if an HIV-negative top—the insertive partner—and an HIV-positive bottom have unprotected sex, the chances of the top contracting the virus from a single encounter are 1 in 909 (or 0.11 percent) if he’s circumcised and 1 in 161 (or 0.62 percent) if he’s uncircumcised.A report by the Black AIDS Institute states that African-American same-gender-loving men have a 25 percent chance (which is one in four odds) of contracting HIV by the time they’re 25 years old—and a 60 percent chance by the time they’re 40.