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HIV and AIDS

What Are The Factors That Enable HIV To Be Transmitted During Oral Sex?

10/09/2000

Question:

I have a question regarding the transmission of HIV from female to male during oral sex. Without using a dental dam, what are the risks, whether if its high or low, that HIV can be passed on from female to male? Should I be really worried about transmission? Does the environment of the oral cavity decrease transmission? Also, without any abscesses or cuts in the mouth, can HIV diffuse through the mucosal lining of the mouth and gums?

Answer:

The risk of transmission of HIV infection from females to males appears to be equal of the risk of transmission from males to females by sexual contact. In two recent studies from Africa, there was no difference in the rates. Presumably, most of those couples were having vaginal intercourse. There are really no good studies on exclusively oral sex in heterosexual couples. There is one study published from Seattle documenting cases of HIV transmission with largely oral genital contact between men. It is clear that HIV transmission can occur both ways with oral genital contact. The rate is far less clear. If there is bleeding of the gums the risk is clearly higher. However, no one knows the true rate. Whether it is safe to avoid using a dental dam, saran wrap or a condom is not known with oral genital contact. There are some factors that inactivate HIV in the saliva. Whether this prevents transmission with oral genital contact is not known. So, your questions are good and cannot be completely answered at this time. In the absence of information, it is probably best to be safe and continue to use protection with oral genital contact.

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Response by:

Carl   Fichtenbaum, MD Carl Fichtenbaum, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati