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.
I have performed 69 with a tranny. Unfortunately she was a sex worker and the 69 was without condom on my side. The act lasted 3-5 minutes with breaks. No ejaculation, maybe some pre-cum. Not sure, was to much saliva in mi mouth. What is my risk, coz my anxiety is over the roof and I need to wait another 3 weeks to get tested.
Hi Sujit,
Please see this link to ways that HIV is not transmitted.
Oral sex (kissing, deep French kissing, sucking) with HIV infected …then any chance to get infected?
Hi Michael,
There’s a difference in risk when you are receiving oral sex from when you are giving oral sex.
If you receive oral sex, your partner’s mouth is on your genitals. If you are giving oral sex, it’s the other way round.
Hi, can you explain this two sentences? It sound a bit contradictory to me… The two sentences both from this website
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 you don’t know your partners HIV status, or if they are HIV positive with a detectable viral load, then giving a man oral sex should be considered a potential risk for transmission. If you have poor oral health this risk may be high.
So is it zero risk or not…
Hi John,
Please see here for all FAQs on HIV testing and HIV risk.
I gave oral to a guy who I didn’t know well. I only had precum in my mouth, no full ejaculation. After asking him recently he said he’s clean and was tested 3 months ago.
I’ve recently been ill with a cold that won’t go away which I thought was brought on by a lot of stress at once, but now 3 weeks after I have got oral thrush after my cold has finished a bit of fever (could be by my anxiety). Booked in to get tested in a weeks time and really anxious as you’d expect despite reading precum only provides a very tiny risk.
Hi Beth,
We don’t have resources to answer more questions about transmission and testing. But all frequently asked questions are answered here.
I gave a blow job to this guy idk I heard he has hiv if he ejaculated in my mouth am I infected he goes to treatment for it I believe. I’m very worried
Hi Thanks for the reply. I know it wasn’t a risk but I got the test done at 7 and half weeks mark and the result was negative. I hope that’s enough to move on in my life?
Thanks
Chak