Oral sex

Oral sex is generally a low risk activity. It is likely to be zero in most circumstances. This depends on these factors:

• Whether you are receiving or giving oral sex?
  Receiving oral sex is zero. This is when someone’s mouth is on your genitals or anus. Saliva is not a risk, even if it contains traces of blood.
• Whether you are giving oral sex to a man or a woman?
  Giving oral sex to a woman is likely to be zero or close to zero risk. Cervical/vaginal fluid, even if infectious, is more difficult to get in your mouth compared to semen.
• Whether cum or pre-cum or gets in the mouth?
  If there is no cum or no pre-cum then the risk is zero. But it can sometimes be difficult to know this.
• Oral hygiene of the person giving the oral sex?
  The mouth is generally very resistant to infection. But cuts or sores, or bleeding gums, can be a way to catch HIV. If you are giving a man a blow job and your gum health is not good, this could bea way to catch HIV.
  Most cases reporting oral sex as a risk for HIV report mouth problems. Gum problems are common (perhaps in 10-50% of adults). If your gums bleed when you brush your teeth or floss this is a route for HIV.
• Whether you are on PrEP.

In practice, condoms are rarely used for oral sex. This partly because condoms make oral sex so much less pleasurable for both partners. They are also more intrusive for oral compared to vaginal or anal sex. The risk from oral sex is also so much lower.

Giving a man oral sex is only a risk if their viral load is high. But you also need to have poor oral health – and be unlucky.

Less than 5% of HIV infections in gay men may be due to oral sex. These cases are likely to be explained by BOTH mouth/gum problems in the negative partner AND high viral load in the positive partner.

If viral load is undetectable, there is no risk of HIV.

PrEP also protects against HIV.

Last updated: 1 January 2023.