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 Maxwell,
Sorry but we are not a service for people worried about their risk of HIV or about HIV testing. It is not that we don’t care – this is just not what we are set up for.
We understand the need for good information about HIV risks and HIV testing – so we developed two very detailed resources that you can see here.
I just wanna ask whether I’m at any risk. 3 months ago I received an unprotected oral sex with a guy I met in online. A week after that I did antibody test which came out negative and the counsellor told me to comeback again for another test again. So I went on the 3rd week to do my test and I did antibody/antigen test which also came out as negative. Again I went to do the test on the 4th week to do the same antibody/antigen test again and it came out negative as well and my counsellor told me that the test results is conclusive and I don’t have to come back for another test. Question, is my test result(4th week) conclusive or do I have to do my test again. Is there any chances the results will change after 3 months?
Hi Lahed,
Thanks for this question but sorry, I’m not sure I understand it.
However, receiving oral sex is generally low risk for HIV transmission. HIV is not present in saliva.
An HIV negative person with a sexually transmitted infection (STI) such herpes can be at increased risk of HIV. That’s because of increased numbers of immune cells at the site of infection. HIV targets these cells. Genital warts are an STI.
However, the risk depends on whether the guy rimming you is HIV positive and if viral load is high, and also if he has dental problems such as bleeding gums.
What does your doctor say about treating the anal warts? You can ask them about what risk there is for all STIs.
Hey!
10 days ago i met someone online. He rimmed and fingered me. I also did oral sex. But after he rimmed he said that there’s something in anal part. I checked it and there was something there. Like it was pustule! But how would it be there like in a hour? Anyway i checked a doctor and he said that it was wack! So that guy licked my wart. My question is what if he got hiv + would i get it too though licked my wart? Even There would be a sperm on it! So sorry for my bad english! Pls help me
Hi Grace,
This link on Simon’s answer says, receiving oral sex (having someone’s mouth on your genital organs) is likely to be zero or near zero risk. Saliva is not linked to HIV transmissions.
So this is low risk because the positive partner would have to have oral concerns like bleeding gums as well as a high viral load too.
Can a woman get infected with hiv when she notice she has a cut in her vaginally after been suck by a man
Hi Joy,
As Simon says above, 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.
If I have hiv and I give a man oral sex can he get it from me
Hi DoubleG,
Thanks. But receiving oral sex (having someone’s mouth on your genital organs) is likely to be zero or near zero risk. Saliva is not linked to HIV transmissions.
There’s more info about oral sex on this link.
Hello,
Im sorry for my poor english, but i want to say keep up the good work informing people about HIV transmission. Last week I had oral sex with a girl, I was the insertive partner (I got the blowjob), I dont know her HIV status. After alot of worries I started to look on the Internet and all I could find was: “There is no risk of catching HIV trough oral sex, the risk is theoritical”. I Tought to myself, ok I’m safe, nothing to worry about. Then I came across a a blog of a HIV+ person who got infected trough insertive oral sex, no bleeding gums or sores on the penis or whatsoever. He says he got infected trough saliva entering the peehole or the mucous membrane of the penis. Is that even possible if the viral load in saliva is high? And is there any reported/documented case of HIV transmission trough INSERTIVE oral sex like this? Anyways I went to a doctor after a few days, got tested, all negative to HIV and other STD’s, I have to go back in 4 weeks for another test. Hope im not infected!