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 Chak,
As Simon says, 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.
But it’s good that you’re going for a test if you think you might have been at risk.
Hi simon
I have had an episode of receiving oral sex from a sexworker in Thailand 7 weeks back. I have taken Pep in 52 hours for 28 days precisely. I have been reading a lot and have so much different information on insertive fellatio about hiv risk and making me crazy. I can see you have update your original answer from 2010 back in 2018 addressing risk as zero based on no cases which you have come across in your career. Can you please confirm if the risk is really zero or just rhetorical? I am due to go for testing next week but really scared.
Thanks
Chak
Hi Rajn,
Unfortunately we don’t have resources to answer more questions about transmission and testing. But please see this link https://i-base.info/qa/11844.
And this guide to oral sex.
Hi im 24 years old young boy last 3 month ago i had sex with foreigner girl in sex time i also use condom but before the sex i freely oral sex with her like french kiss my mouth in her vagina ,,her mouth in my penis $ my finger in her vagina so what the risk in my mouth there is no cut but that time im suffering from tonsils and flu and i also use medicine
Hi Sanjay,
The answers to your question are included in this Q&A. All questions about testing and risk are answered in this guide http://i-base.info/guides/testing.
Hi there. I’ve a question. I am a HIV negative but I have some oral concerns like my bottom lip sometimes bleeds because of cold wether and when I took skin off from my bottom lip it bleeds little bit. And I’ve made the dental issue an year back and very rarely it bleeds sometimes. Recently I’ve kissed a HIV positive person like deep French kiss and without condom I gave the blowjob. After that I asked my partner that if she has dental issues or any cuts in mouth she said nope and she been taking the treatment for HIV and she is on medication now and she said her HIV condition is perfectly fine and her doctor said she can kiss someone and have sex with condom. Now I am scared of I’ve that oral concerns which I mentioned above and I have the blow job to that HIV positive person without condom, so how much of risk I’ve now? I am scared now and scared to go for the hiv test. Please Help me
Hi Steve,
i-Base doesn’t have resources to answer questions about testing and risk. We are a treatment information source for people who are HIV positive and family and friends.
Q&As about risk and testing are already answered here.
Hello,
The other night I was at a bachelor party. I got a private lap dance from one of the dancers. When I got in the room she took my pants off and rubbed her vagina on my penis with no penetration. then she rubbed her vagina on my face and lips. Is there a possibility of getting a std or hiv?
Hi Rhonda,
There are different factors that are listed above that can affect this. So no, it doesn’t mean you will 100% catch HIV if he has it.
i have dental problem and yet i give oral sex to a dude. does this mean i will surely catch hiv if he has it.