Question
What is the risk of HIV transmission through oral sex?
5 February 2018. Related: All topics, HIV transmission, South Africa.
First of all my thanks to everyone at i-Base!
I have a question regarding transmission. I am HIV positive and have a low viral load (under 250) and am not yet on medication. I always use condoms for anal intercourse but my questions relate to oral sex.
From what I’ve read, the risk increases:
• if the insertive partner has a high viral load.
• if the receptive partner has infections in the mouth or cuts, gum disease, has had recent dental work etc
• if the receptive partner takes semen in the mouth
Also, if the HIV positive receptive partner has blood in the mouth – could they possibly infect a negative partner
I can only find terms such as ‘low risk, very low’ but this all seems subjective. Low compared to the risk of unprotected intercourse doesn’t really mean much. Does that mean that with an undetectable/low/mid/high viral load that condoms should always be used or that if you avoid the higher risk scenarios unprotected oral sex is considered safe? I guess it all relates to the level of risk someone is willing to accept so I was hoping you might have some data e.g. percentage risk per act etc.
I read that there was a Spanish study reporting no seroconversions from 19,000 exposures over 10 years in serodiscordant couples and other reports saying that up to 5% of infections could be attributed to oral sex. Are there any recent studies to clarify the level of risk and also which reports would you regard as the most accurate?
I’ve recently met a great guy and it’s come to the point that I want to disclose my status. I’m hoping this might allow us both to put the level of risk into perspective.
Many thanks in advance and best wishes
Answer
Thank you for your question.
HIV is not easily transmitted by oral sex – and it probably needs ALL the factors you listed. For example, the positive partner would have to have a very high viral load AND the negative partner would have to have oral concerns like bleeding gums or recent dental work.
There are no cases of people catching HIV from receiving oral sex (from a person who has blood in their mouth). This is zero risk.
Your viral load is currently very low, which make any risk incredibly low. If your viral load was undetectable on treatment, the risk would be zero for all types of sex.
In 2018, HIV treatment is routinely recommended for anyone who is HIV positive. This, together with the evidence that undetectable viral load prevents transmission has dramatically changed more discussions about HIV risk. A review of this evidence is at this link:
https://i-base.info/htb/32308
This booklet has more information about sexual transmission, including a section on oral sex:
https://i-base.info/guides/testing
For any further information please contact us via the website, e-mail or through the treatment information phoneline (Mon-Wed 12-4pm).
Best wishes for the future with your new partner.
Note: This answer was updated in February 2018 from a question first posted online in April 2010.
Hi Manny1986,
As it says above on this Q&A, there are no cases of people catching HIV from receiving oral sex.
I recently had oral sex with a female….. should I still be worried about getting HIV??
Hi Louisa,
People who are positive can have sex whenever they want, you don’t need to have a low viral load to have sex. You do however need to have an undetectable viral load if you wish to have sex without using a condom. Please see Q’s 9 and 14 here for more info: http://i-base.info/qa/what-are-the-most-asked-questions
Yes there is a medication that a negative person can take if they wish to reduce the risk of contracting HIV, its called PrEP. See here: http://i-base.info/guides/prep
I just want to ask
Must a person viral load be low b4 one can have sex
I thought they are drugs for the negative people against it
Please i want to know how it works
Hi, All questions on risk and transmission are answered here. Receiving oral sex is very low risk.
Dear sir,
I am man 48 years old, have oral sex when a women suck my penis very quickly (3 ~ 4 times) then I stopped her.
Is the risk of getting his infection high?
For question on HIV risk please see this FAQ page:
http://i-base.info/qa/factsheets/hiv-transmission-and-testing
And this booklet:
http://i-base.info/guides/testing
i had oral with someone. like i have taken his gum in my mouth and i didnot taken inside puts outside only after i really worried about that means may be he having any virus or not.my question is if positive to him to spread to me any chance is there or not ? please advise early, thank you
If the rapid test came back negative after 4 weeks then it is likely you are negative. You will know for sure when your p24 test comes back. Some rapid tests are more accurate than others at 4 weeks depending on whether they look for the virus itself (antigens) or the immune response (antibodies). Good luck!
I gave a man oral sex 4 weeks ago and did a rapid test and a p24. The rapid test came back negative and I don’t have the results for the p24. Can I trust the results of the rapid test? I have been having panic attacts everyday and have had a little bit of swollen glands. Please help me