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HIV and AIDS

Can HIV Be Spread Through Saliva During Oral Sex?

10/05/2005

Question:

Dear doctor, I know HIV can be spread during oral sex between men if semen is discharged into the mouth, and if one, or both men have open sores, or bleeding issues in and around the mouth. I would like to know what are the chances HIV can be spread during oral sex between two men if no sexual fluids are discharged during the sex act. That is, can HIV be spread through saliva during oral sex? Thank you for your response.

Answer:

You correctly pointed that, among the bodily fluids, semen has been the most efficient vehicle for HIV transmission. Technically, blood is more infectious than semen because it has higher titers of viral particles, but human mucosae and tissues are not exposed to substantial amounts of blood in normal circumstances. The type of contact you are suggesting, in which there is contact between mouth mucosa with genital mucosa carries some risk, albeit not as severe as your first example. There is a small but definite amount of viral particles in saliva and genital secretions even if no obvious open sores are visible. Also, the sexual act itself can produce small abrasions and mucosal trauma in either partner that may act as portal for HIV transmission. In the circumstances you describe, it is advisable to use condoms.

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Response by:

Francisco   Gomez, MD Francisco Gomez, MD
Assistant Professor
College of Medicine
University of Cincinnati