Can HIV be Transmitted Through Oral Sex (fellatio and cunnilingus)?

Oral Sex

    Safe sex is one of the beneficial topics that help human gain pleasure and preventing sexual transmitting disease (STD). Luckily nowadays we can talk openly about sex matters by asking a doctor face to face or online without any feeling of embarrassment as compared to decades ago. Most people will think oral sex is totally safe from STD such as HIV compared to vaginal or anal sex but is it really safe?

    Researchers and doctors are unsure of how many people suffering HIV due to practice of oral sex. Numerous observations and data show very low risk of acquiring HIV from oral sex but that does not mean it is zero. Definitely a relief to know it is safer than vaginal and anal sex but again, the risk is still there.

    So why oral sex is safer? As the name itself suggests, oral involves mouth and gastrointestinal tract such as throat and stomach. Once in contact with HIV strain existing in semen, pre-ejaculatory fluid or vaginal fluid, multiple parts along the oral tract immune system will be initiated. Saliva in the mouth is able to eliminate the HIV virus rapidly by initiating immune response. Tonsil which plays a role in the immune system, is able to produce HIV target cells. Even if the HIV virus is able to travel down to the stomach, acid in the stomach will eliminate the virus before it is able to cause infection.

    Even so, in the condition of inflammation and infection of the mouth and gums or lesions such as cuts, sores and abrasion, the likelihood of getting infected by HIV is high. This will lead to a compromised immune system and giving chances for the virus to replicate in the body.

    Interestingly in cases of insertive fellatio which means a person with HIV positive giving oral sex (blow job) to a HIV-negative person, it is almost impossible for the HIV-negative person getting infected. There is no documented case of person acquiring HIV receiving cunnilingus (oral sex performed on a woman) from a HIV living person. However, in cases of receptive fellatio which means a HIV-negative person performing oral sex on HIV living person, HIV is likely to be transmitted.

          Although having a HIV living person as sex partner seems incredibly scary, it is not an excuse for a halt stop from receiving pleasure. Oral sex is considered much safer aside from vaginal or anal sex for this group. This is especially true when a HIV-positive person adheres to ART (antiretroviral therapy) and maintains very low viral load or undetectable viral load. Numerous reports of sexual activity between the undetectable viral load person and HIV-negative person shown no evidence of HIV transmission.

    As the old saying goes “prevention is better than cure”, taking safe measures in reducing the likelihood of acquiring HIV is the best way. The classic humble latex of condom and dental dam (square condom) should be your best friend especially knowing the partner is HIV-positive. Carefully check yourself for oral lesion such as cuts or inflammation and avoid brushing your teeth literally before hopping on oral sex as this could cause minor abrasion or trauma. Routine medical check up should be a must especially if a person is sexually active and always involves in risky sex such as having sex with multiple partner or having another sexually transmitted infection (STI) such as syphilis, herpes, chlamydia, gonorrhoea and bacterial vaginosis. For an extra added protection and peace of mind, you may want to consider taking pre-exposure prophylaxis (PrEP).

References:

https://sti.bmj.com/content/77/5/307

https://www.aidsmap.com/about-hiv/oral-sex

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821196/

Author: Sarah Richad