HIV transmission via oral sex

Last reviewed 01/2018

• there is evidence that human immunodeficiency virus (HIV) can be transmitted via oral sex (the risk is much lower than in anal or vaginal sex) (1)

• HIV transmission has occurred through  
• oral contact with the penis – fellatio
• oral contact with the vagina - cunnilingus
• oral – anal contact – anilingus (1)

• the evidence suggests that there is a significant seroconversion risk associated with receptive fellatio - it is theoretically plausible that receptive fellatio with ejaculation into the mouth from an HIV infected partner would involve exposure to the greatest amount of HIV

• there have been reports of transmission via insertive as well as receptive fellatio. There have also been two reports of transmission via cunnilingus

• the possibility of HIV transmission through oral sex may be increased if a person has
• oral ulcers, bleeding gums
• genital sores
• other STD’s (1)

• HIV has been isolated from an infected woman's menstrual blood. There is limited evidence that vaginal intercourse during a woman's menses increases the risk of female to male transmission of HIV - it is plausible that cunnilingus during a menses could pose a greater risk than at other times

• the relative rarity of HIV transmission via oral sex is likely to be because there are relatively few cases where oral exposure can be identified as the only risk factor and the tendency to ascribe HIV transmission to any high risk exposure that can be identified

Reference:

• (1) Centers for Disease Control and Prevention (CDC) 2009. Oral Sex and HIV Risk