Risk Assessment of HIV Transmission--Oral Transmission

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A. Kissing 

Potential for Transmission

There is no potential for transmission in pressing dry lips together. In wet kissing, there is only risk of transmission if blood is present in the saliva.  Saliva alone does not contain enough HIV virus to infect someone. 

Assessment of Risk of HIV Transmission

Dry kissing:  No risk (no exchange of blood)

Wet kissing:  Negligible risk (possible exchange of blood)

B. Oral Sex: Fellatio (Giving)

Potential for Transmission

In fellatio, there is potential for transmission to the person giving oral sex (receptive partner)  because pre-ejaculatory fluid (pre-cum) or semen can get into the mouth. The risk of transmission to the receptive partner is increased if there is a disruption in the oral mucous caused by bleeding gums, cuts, sores, lesions, ulcers or burns. In such instances, the receptive partner can reduce the risk by using a protective barrier, such as an unlubricated condom. Swallowing ejaculate (cum) does not increase the risk of transmission in a healthy mouth.

The risk of transmission can be reduced by avoiding ejaculation of semen in the mouth and can be reduced further by using a condom. The receptive partner should wait at least 30 minutes after brushing or flossing teeth before engaging in fellatio, since brushing and flossing teeth may cause temporary bleeding of the gums.

In the absence of some disruption to the oral cavity, the risk involved in either receptive or insertive fellatio can be regarded as quite remote.

Assessment of Risk of HIV Transmission

Insertive Fellatio (Receiving)

With Condom: Negligible risk

With no condom: Negligible risk

Receptive Fellatio (Giving)

With condom: Negligible risk

With no condom: Low risk (risk is increased if there are bleeding gums, cuts, sores, lesions, ulcers or burns in the mouth)