Unprotected Oral Sex

There is general awareness of the risk of transmission of the Human Immunodeficiency Virus (HIV) through unprotected penetrative sex (both vaginal and anal). However, most are not so sure when it comes to unprotected oral sex.

The Risks

Oral sex is generally regarded as a low-risk sexual activity in terms of HIV transmission. However, risks do exist.

At the 4th International Oral AIDS Conference held in South Africa in 2000, the risk of transmission through oral sex was placed at about 0.04 per cent per contact. Other studies have come up with slightly higher figures.

The problem with defining the exact risk factor for oral sex lies with the difficulty in singling out incidences of HIV transmission through strictly oral means. After all, very few people engage exclusively in oral sex but not other sexual activities.

Why Are There Risks?

In a HIV+ person, the virus can be found in these body fluids: semen, pre-seminal fluid (pre-cum), vaginal fluid, breast milk and blood (including menstrual blood and blood in fecal matter.)

During unprotected oral sex, the giver comes into contact with the other person's pre-cum and semen (for fellatio) or vaginal fluid (for cunnilingus). If there are cuts, ulcers, sores or bleeding gums in the giver’s mouth or throat, and the other person is HIV+, the virus in those body fluids can enter the giver’s system through those open wounds.

In the reverse situation (i.e. the giver is HIV+), the risk is much lower. However, transmission can still happen if the giver is bleeding in the mouth or gums, and his/her blood enters the receiver’s system through one of the following means:

• Lining of the urethra (opening at the tip of the penis);
• Lining of the vagina or cervix;
• Lining of the anus; or
• Small cuts or open sores on the genitals.

The risks of transmission increase if the receiver already has a pre-existing sexually-transmitted infection (STI).

Ways to Minimize Risks

1. To remove the risk completely, one can choose to avoid oral sex.
2. Another option is to reduce the number of sexual partners with whom one has oral sex. Preferably, one should be monogamous (i.e. one sexual partner).
3. For those who choose to practice oral sex, use protection and barriers. When giving oral sex to a male, a condom should be used. For females, use a piece of dental dam (a rectangular piece of medical-grade latex), or at the very least, a piece of plastic food wrap.
4. Regardless of the receiver’s sex, similar barriers should be used when there is oral contact with the anus (anilingus or rimming).
5. If protection was not used and the receiver is male, have him ejaculate outside the giver’s mouth.
6. The giver should avoid brushing his/her teeth or flossing at least two hours before performing oral sex. This is to minimize the likelihood of having cuts or open wounds in the oral cavity.
7. The giver should also avoid using any oral wash/rinse for the same duration because these contain active ingredients that irritate the cells lining the mouth, making them more susceptible to viral transmission.
8. After performing oral sex, the giver should rinse his/her mouth with oral wash to get rid of any germs and bacteria.

By adopting the various precautions stated above, not only will one be able to minimize the risk of HIV transmission, one will also avoid contacting other STIs through oral sex.

Oral Sex

Oral Sex & HIV

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