Question
What is the risk of HIV transmission through oral sex?
5 February 2018. Related: All topics, HIV transmission, Southern 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.
Dear Mario thank you for your question.
The risk of catching HIV from oral sex is very low.
Please take a look at the HIV transmission and testing information we have available:
https://i-base.info/guides/testing
Hello.
Hello. On 14 June I had oral sex with 2 different women (unprotected). After 3 weeks I had mouth candidiasis.
After 31 days of receiving oral sex I did a fourth generation test and it was negative.
I still have to worry?
Hello Jimmy and thank you for the question.
From what you write you have done everything right.
Often testing and using PEP are the right steps.
I would suggest reading more on HIV transmission from websites that are accurate and evidence based, like this one.
https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Also, have you considered using PrEP?
https://i-base.info/uk-guide-to-prep-february-2024/
Hi. Thanks for all the great advice and info. I received a blowjob (I was the insertive partner) and there was a lot of blood during this session. I could not see any cuts. I started PEP within 8 hours. I test regularly for all stds although I always wear condom (except in oral sex) and I’m top. Am I exaggerating? Should I continue with PEP? I read the risks etc but there’s so much contracting information? From this kind of oral sex can you catch hiv? Were there any cases? What should I do? Thanks
Hello James and thank you for the question.
From what you describe your risk is very low.
Please see below the links with information about HIV Transmission https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Have you thought about using PrEP?
Here is a link with more information you might useful https://i-base.info/guides/prep
I Gave a blowjob to someone and a little bit of precum got inside my mouth. We put on a condom for penetration but I also have cavities & my gums bleed slightly when I brush… am I at risk for HIV ? I’m freaking out..
I also missed the 72 hr checkpoint for pep
I am also in the state of Atlanta
Hi Daniel, please see this link for info about HIV risk:
https://i-base.info/qa/11844
The bookler (link2) includes a section on oral sex.
HIV is not an easy virus to catch and your risk is very low. This isn’t something to sworry about but when you next get a chance a routine sexual health screen sounds a good idea. This is more for other STIs though than for HIV.
Hi team.
I gave the oral sex to a women but her genital was very dry and thought no fluids. But, after that I checked my mouth condition,found some of tooth gum were inflammatory but no bleeding and I did that job only short periods of time. Please answer me can this virus infect to me? Now I am now away working at sea and got too much anxiety and cannot sleep well.
Hi Tenson
I am sorry but this service is not about HIV testing or risk.
Please see the info on PEP here:
https://i-base.info/qa/factsheets/pep-faq
More info on why this is not a significant risk for HIV is at the lins here:
https://i-base.info/qa/11844
thanks
I give oral sex to sex worker women.less than one minute.after five minutes i split it.and wash my mouth.i have bleeding gum.i don’t know the hiv status of that women.i take PEP within 72 hours.now I on 24 th day.what is possibility of getting hiv