HIV Risk Without Ejaculation During Sex

How HIV May Spread Through Pre-Seminal Fluid

Stack of multi-colored condoms
Stack of multi-colored condoms. Getty Images/Rafe Swan/Cultura

Determining your risk of getting HIV from different sexual behaviors can be confusing. One common myth is that a person cannot get HIV if their partner does not ejaculate.

A good rule of thumb is that there is an HIV transmission risk with all unprotected sexual contact.

Let's explore this myth in more detail and discuss what you can do to best protect yourself during any sexual contact.

Getting HIV Through Pre-Seminal Fluid

According to the Centers for Disease Control and Prevention, or CDC, HIV can be present in a male's pre-seminal fluid, also known as pre-ejaculatory fluid, or "pre-cum"

Pre-seminal fluid is released from a male's urethra — the opening in a male's penis — during sexual arousal, before ejaculation. A male can release up to 4mL of this pre-seminal fluid, which is a little less than one teaspoon.

Where is HIV Present: In the Sperm or the Seminal Fluid?

There are only a handful of studies that have examined the presence of sperm in pre-seminal fluid, and they are small and show mixed results — meaning some show sperm in pre-seminal fluid and others do not.

For instance, in one 2010 study in Human Fertility, of 27 men who ejaculated, 11 produced pre-seminal fluid samples that contained sperm, and 10 of these 11 men had motile sperm in their samples.

Still, while semen is a dominant carrier of HIV — there is still debate as to whether the sperm within semen can be infected with HIV or whether it just carries the HIV particles, like a transporter. One older 1991 study in the Journal of Infectious Diseases found that the seminal fluid men carried HIV, but not the actual sperm cells.

Regardless, the take home message here is that pre-seminal fluid, which is fluid release prior to ejaculation, may spread HIV.

So there is a risk of getting HIV, even if your partner does not ejaculate.

Getting HIV Through Sores on the Penis

Also, you can still get HIV if your partner has open sores or cuts on their penis or urethra.

So, even if he pulls out and does not ejaculate, transmission can occur.

Remember too, HIV can be absorbed through the tissue lining the vagina or cervix, regardless if there is any tissue injury.

What Can You Do?

If you are concerned that you may have been infected with HIV, please see a doctor for an HIV test. Practice safe sex practices and be informed of your risk — take charge of your health.

More on Safe Sex and HIV Transmission

Sources

Centers for Disease Control and Prevention. (2015). HIV/AIDS: HIV Transmission. Retrieved October 1st 2015.

Killick SR, Leary C, Trussell J, & Guthrie KA. Sperm content of pre-ejaculatory fluid. Hum Fertil (Camb). 2011 Mar; 14(1):48-52.

Mermin JH, Holodniy M, Katzenstein DA & Merigan TC.Detection of human immunodeficiency virus DNA and RNA in semen by the polymerase chain reaction. J Infect Dis. 1991 Oct;164(4):769-72.

Tortortec AL & Dejucq-Rainsford. HIV infection of the male genital tract – consequences for sexual transmission and reproduction. Int J Androl. 2010 Feb; 33(1): e98-e108.

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