Question
Risks from oral sex with undetectable viral load?
6 July 2016. Related: All topics, CD4 and viral load, HIV transmission.
I have HIV and I’m on treatment for almost a year, my blood tests show an undetectable blood viral load.
I’ve met a guy a month ago, and we hit it off straightaway, we started having sex in which I was the passive part, the anal sex was always protected, but oral, in either way, was not, but we never ejaculate in each other’s mouth. And we were involved in very deep kissing, with loads of saliva swap, but I’m still anxious if my partner might have caught the virus from me.
What’s the risk for him?
Answer
Hi – thanks for your question.
Ths short answer is that this risk is zero when viral load is undetectable.
One of the important bits of information that you included, is that you have been on treatment with an undetectable for the last year or so. This may be reducing any risk as much as the different type of sex you have.
HIV is not infectious in saliva, which makes kissing safe, even deep kissing.
By using a condom when you have anal sex, you are cutting out the highest risk factor.
Most cases of HIV transmission from oral sex are probably explained by two factors. The HIV-positive partner having extremely high viral load (often in the millions during the first weeks of infection), or often over 10,000 copies/mL when not on treatment.The second factor is oral hygiene and/or dental problems in the HIV-negative partner.
Otherwise, oral sex is very low risk, if your partners mouth is in good shape, especially as your viral load is so low. It is important that your partner doesn’t have bleeding gums or ulcers, or brushes his teeth just before. It is probably still better not to come in your partners mouth but if you did it is very unlikely to make much difference to the risk of HIV.
A group of Swiss experts recently estimated the risk from one exposure from an HIV-positive man to an HIV-negative woman – for example from a broken condom – to be perhaps 1 in 100,000 – so long as the man had undetectable viral load for the last six months, was taking his HIV meds on time, and had no sexual infections.
I see the most useful interpretation of this, to be to continue to use condoms, but not to worry too much if one breaks occasionally. For oral sex, which is already a much lower risk than not using a condom for anal sex, I think this is getting pretty close to zero.
More recently, other studies, including the PARTNER study, have reported that wehn viral load is undetectable, the risk from sex is likely to be zero. This is for any type of sex, even when condoms are nt used.
If the risk is zero for fucking without a condom, it is definitely zero for oral sex.
Note: This answer was updated in July 2016 from a question first posted in May 2008. The update was to include results from the PARTNER study that report zero HIV transmissions when an HIV positive partner has an undetectable viral load.
Hi Matthew,
When someone has an undetectable viral load, the risk of transmission is close to zero. Please see here for more info:
http://i-base.info/qa-on-the-partner-study/
Info about testing can be found here at Q1:
http://i-base.info/qa/what-are-the-most-asked-questions
Hi there. I had protected sex almost 2 weeks ago with a female who only just told me that she is hiv positive but has undetectable levels as per her report she obtained the day before we had sex. She is sorry for not telling me but i am stressing and currently a complete mess.
In light of these details is there a good chance i did not get hiv? Also will a rapid test or rna provide some clarity only 2 weeks after interaction? Any help will be greatly appreciated.
Hi Sunny,
No. You can’t contract HIV like this.
Can saliva that’s mixed with blood cause HIV? My partner is undetectable.
Hi Salley,
Its very common that a persons viral load will drop that quick. This is because ARVs are excellent at controlling HIV. This is something that you should be happy about. For more info please see here:
http://i-base.info/qa/4669
What your nurse has told you however is wrong. ARVs don’t cure HIV, they control it.
Hey .. I am salley 35 old male.
I begun treatment after 5 weeks of getting infection (2weeks after beginning of symptoms which was only normal fever 3 days ) after one month of treatment viral load dropped from 160000 to only 75 copies per ml .. the nurse said that I may be get cure in future if I continue treatment ..what is interpretation about this quick drop in load.. ??
Thanks
Hi Donna,
Please read the above post.
I recently had protected sex with a male hiv positive. The viral load is undetected and there was oral involved on both and. Oral lasted a while and I’m concerned if the virus was transmitted.being that he isn’t circumsiced makes me even more concerned. When should I get tested?
Hi Ed,
Please see quesiton one here:
http://i-base.info/qa/what-are-the-most-asked-questions
I recently had unprotected oral sex with another man. We only had oral briefly and no ejaculation from either one of us. It was only after that I saw that he was poz and undetectable. Needless to say I am concerned about my exposure. I don’t believe I have any mouth abrasions and it had been an hour or so since I brushed my teeth. Can someone help ease my fears? What are the percentages that I contracted the virus from him? Thanks!