Oral Sex and HIV: What’s the Risk?

All around the world, the most common way of HIV transmission is sexual. More specifically, unprotected sex, this is to say, sex in which no barrier is used (such as the male or female condom). 

However, not all sexual practices implicate the same level of risk to transmit the virus. It all depends on the fluids and tissues involved in each activity. 

Risky sexual practices

Anal penetration, for example, is the riskiest practice, followed by vaginal penetration. In both cases, we have to consider that semen from a man with HIV may contain a high virus load (as long the man is not under treatment). Besides, the mucous membrane of the anus is a fragile tissue that can easily be damaged, while the vaginal mucous membrane is a tissue capable of “absorbing”, or rather, letting pathogens through, including HIV. 

But even today, nearly 40 years after the appearance of HIV, many questions still persist on the risk of HIV transmission during oral sex. What has been discovered so far is that, in most cases, the risk is low to none, and in any case, it’s a much lower risk than the other two mentioned practices. 

To understand the risk, it’s important to know that the fluids that can contain HIV are vaginal fluids, semen (and pre-ejaculatory fluid) and blood. Saliva cannot transmit HIV. For an infection to occur, one of the fluids that do contain HIV must find a way to enter the organism of the person that does not have HIV, this is, through wounds or sores in the mouth. 

Up until now, it has been difficult to study the transmission of HIV through oral sex, since this practice is carried out together with other higher risk practices (penetration). However, it has been established that oral sex is riskier if one of the people involved: has an untreated sexually transmitted infection, bleeding of the gums or sores in their mouth; receives semen inside the mouth; practices oral sex on a woman who’s menstruating, or has genital wounds. 


Among the precautions that may be taken to minimize any risk in this practice are:

  • Not to practice oral sex if there are any oral lesions (i.e. lesions from herpes)
  • Look for genital lesions in the other person (cuts, wounds or scratches)
  • Not to brush your teeth or use dental floss before performing oral sex, since this could generate wounds or bleeding
  • Not to swallow any pre-ejaculatory fluid, semen, vaginal fluids or menstrual blood
  • Use a condom to perform oral sex on a man
  • Use a latex barrier (or a cut up condom to extend it) to perform oral sex on a woman
  • Take care of oral health. The probability of acquiring HIV with oral sex increases if there are any affections that cause oral wounds or bleeding.

Oral sex has a low risk of transmitting HIV; however, it is not risk free. Taking basic precautions will reduce the risk even more and will eliminate one more worry within a safer sex life. 

At AHF you can get a free HIV test, receive information and free condoms. Make your appointment, today.