HIV and Oral Sex

Many people mistakenly regard oral sex as a no-risk or safe sexual practice. Case in point: A national survey of 15- to 17-year-olds, conducted by The Kaiser Family Foundation, found that 26% of sexually active teens believed that they could not become infected with HIV by having unprotected oral sex. Another 15% did not know if a person could become infected with HIV via oral sex. Sadly, they’re very wrong.

So what is the reality of the risk of HIV when it comes to giving and receiving oral sex? And what are some of the issues lovers need to think about when considering whether or not to use a barrier method to protect themselves?

It used to be that oral sex was considered a low risk activity for acquiring the human immunodeficiency virus (HIV), the virus that causes AIDS. And while the risk of contracting HIV from oral sex is believed to be much lower than that of vaginal or anal intercourse, public health officials and researchers are changing their tune on the level of risk involved. According to the Centers for Disease Control (CDC), numerous studies show that HIV and other STDs can be spread via oral sex. It is hard to assess the level of risk involved, however, since people tend to engage in all sorts of sex acts, making it difficult for researchers to determine the exact sexual exchange during which HIV is transmitted.

That said, the partner receiving oral pleasuring is regarded as having very little chance of contracting HIV since this lover is mainly being exposed to saliva. Saliva’s concentrations of HIV are so small that it warrants little attention as a transmission threat. For the partner giving pleasure during fellatio (oral sex on a male), though, HIV could be transmitted to this individual through any fluids, including pre-cum, that come in contact with the mouth, or by contact with a lesion or open cut on the penis.

For the partner providing pleasuring during cunnilingus (oral sex on a female), while the chance of HIV transmission is lower than that involved in fellatio, there is still a risk of transmission. The risk of spreading HIV increases during a female’s period since menstrual blood can carry enough HIV to cause infection. While anti-retroviral drugs are helping HIV-positive individuals to live longer, healthier lives, there is no cure for HIV infection.

Getting Aural about HIV & Oral Sex

For lovers thinking about losing the protection, the best thing to do is to first assess your HIV status by getting an HIV test. In any case, for couples grappling with whether to forego using a dental dam or condom, despite the risk of HIV transmission, the risks need to be weighed against the benefits. Lovers need to discuss the pros and cons of not using protection, honestly expressing how they feel. Are the psychological and physical pleasures worth the risk of acquiring, and coping with, what is still a terminal infection? For some, their decision may come down to what the research on risk of transmission says.

In cases where one partner is HIV-positive and the other is negative, research (like a 1994 study published in The New England Journal of Medicine) has found that among 121 couples that did not consistently use condoms, about 10% of the HIV-negative partners became infected. Compare this to the 124 couples that did use condoms consistently and saw none of the HIV-negative partners become infected. Other studies have found similar results, stressing that consistent and correct condom use is vital to lowering the risk of HIV transmission. Until there’s a vaccine, anything unprotected is high risk.

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