HIV Transmission and Oral Sex

HIV infection is most commonly passed by sexual transmission. The most common ways it is passed is through vaginal or rectal intercourse. There is a common but false perception that oral sex is safer than other types of sexual activity when it comes to HIV transmission. HIV is passed through oral sex as well other sexual activities.

Risk of Transmission of HIV Through Oral Sex

Each type of sexual activity has a different level of risk:

Male-male insertive anal sex. Risk significant (1 in 500-1000 chance)
Male-male/female receptive anal sex. Risk highest (1 in 200-500 chance)
Male-female insertive vaginal sex. Risk significant (1 in 500 chance)
Female-male receptive vaginal sex. Risk significant (1 in 500-1000 chance)
Male insertive oral sex. Risk unclear/worse if uncircumcised.
Male to female/male receptive oral sex. Risk significant (1 in 1,000 or slightly more)

So it is possible to acquire HIV infection through oral sex.

Preventing HIV Transmission

With so many well documented cases of HIV transmission through oral sex, it is important to take precautions.

Barrier methods: The current recommendations call for the use of dental dams or other barrier methods, to prevent the passage of bodily fluids into the partner’s mucosal membranes. HIV can be isolated for oral secretions in low levels, but it is not unusual to have small amounts of blood and ulcerations from periodontal disease or the simple act of flossing and teeth brushing.

How safe is protected sex: It is safer than unprotected sex. The use of barrier methods decreases the chances of HIV transmission but not to zero. For example occasional rupture of the condoms may allow the transmission of HIV and other STDS.

What about kissing: No cases of transmission of HIV through kissing have been documented, and it is considered a safe practice, but no contact between bodily fluids and mucosa is 100% safe.

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