Question

Is oral sex a risk when I’m undetectable?

27 March 2013. Related: All topics, HIV transmission.

Dear Advisors,

Thank you for your website, you have been a great help to me in accepting my condition.

I was diagnosed with HIV infection in August, 2012. My condition then was very poor although I hardly felt that. My VL was over 1 200 000 and my CD4 was 110.

I immediately started HAART treatment (COMBIVIR + KALETRA) so in three months my VL was 27 (almost undetectable?) and my CD4 was 230.

After six months my viral load rose a bit to 56 (I was travelling a lot before blood test through a lot of timezones and my doctor said it was because of that – it affected when I took my medications) and my CD4 was 550.

Now I have had an undetectable VL for nearly 9 months, CD4 is stable at between 550-590. I changed medication to Kaletra + KIVEXA. And soon I will start another PI to reduce the drug burden on my system.

I could very fast come over with the news that I am HIV+ as my sister and best friend stood beside me and reading your website. The problem that I have had to face ever since my diagnosis was the question of finding a partner. As a gay person it is extremely difficult to find the one, the proper partner (and my mistrust is also a concern as I was infected by my boyfriend who had kept cheating on me without me knowing what he had been doing).

Now, this has changed. I have been in a relationship since January. It is a great feeling and a great relief. I love my partner and he loves me. A real dream has come true. I have never been in love with someone before.

However, I am extremely afraid of infecting my partner. I take the passive part during sexual intercourse, and we always use condoms through out the intercourse and I never let him give me oral sex. However, it happened like five times that he gave me oral sex (only for half a minute, so it was an “incomplete action”) before sexual intercourse.

I searched through your Q&As, but what I found was that being undetectable on ARVs lowers the risk of transmission.

Answer

Answer: Rebecca McDowall

Hi,

Thanks for your email. I’m sorry but I think the end of the message was cut off- please let me know if there was anything additional to what is below that you would like to discuss.

I’m very happy to hear how well you are going on treatment- it looks like you have had a very strong response in a relatively short period. Just a quick comment on viral loads- anything under 50 is considered undetectable so you had already achieved this at the 3 month stage!

I am also very happy to hear that you have found a partner that you love and are happy with. It’s normal to be worried about transmitting HIV and it sounds like you have been very careful to protect your partner. The actual risk of transmission, however, is very very low because you are undetectable on treatment.

The risk of oral sex is generally very low, and when your viral load is undetectable it is close to zero. You can read more about risk levels with oral sex and risk levels associated with viral load in our testing and transmission guide. Please let me know if you have any questions after reading these.