Inflammation And Oral Hiv/siv Susceptibility
Although infants are exposed to HIV-containing breast milk for many months, even in the absence of antiretroviral prophylaxis, only a relatively small number of infants born to HIV+ mothers will become infected . Indeed, if we assume a 40% MTCT infection rate, then each infant born to an HIV+ mother has a 16% chance of acquiring HIV during breastfeeding. This suggests that certain infants may be particularly susceptible to HIV. Understanding the factors that enhance oral HIV transmission will be critical for developing effective interventions to protect infants from postpartum transmission of HIV.
It is well documented that different types of mucosal inflammation at multiple sites impact sexual and vertical transmission of HIV . Oral mucosa inflammation is also a risk factor for oral HIV transmission. For example, infant oral candidiasis increases the risk of MTCT of HIV through breastfeeding . The risk of HIV acquisition associated with oral sex is increased in individuals that smoke crack cocaine, which is known to cause oral lesions , and oral sores are associated with HIV infection in crack cocaine users who performed ROI . In contrast, studies in HIV-uninfected, highly exposed individuals indicate that low levels of CD4+ T cell activation and quiescent CD4+ T-cell phenotypes are associated with reduced HIV susceptibility . These studies suggest that inflammation at the oral mucosa increases susceptibility to HIV.
Hiv Must Get Into The Bloodstream
It is not enough to be in contact with an infected fluid for HIV to be transmitted. Healthy, intact skin does not allow HIV to get into the body.
HIV can enter through an open cut or sore, or through contact with mucous membranes. Transmission risk is very high when HIV comes in contact with the more porous mucous membranes in the genitals, anus, and rectum, which are inefficient barriers to HIV. Although very rare, transmission is also possible through oral sex because body fluids can enter the bloodstream through cuts in the mouth.
HIV can be transmitted from an infected person to another through the following infectious fluids:
- Blood
- Vaginal secretions
- Rectal fluids
- HIV can also be transmitted through breast milk expressed through feeding, in limited circumstances, where there is exposure to large quantities.
Hiv From Oral Sex With No Condoms
Dear Alice,
What’s the latest word on oral sex without condoms? What is the risk of HIV infection for each partner, with and without contact with orgasmic ejaculation? Sure I know that this is supposedly low-risk behavior, but if that is so, why are so many gay men still becoming HIV positive? Are they all having unprotected anal sex? Many of my friends practice oral sex without condoms and I tell them they are crazy but I’ve no hard data to back up the risk since not a single case of HIV has been proven to be transmitted by oral sex.
Signed,Uneasy
Dear Uneasy,
First, it’s good to note that gay men aren’t the only population infected with HIV â many men, women, and non-binary people, regardless of their sexual orientation or the gender of their sexual partners, are living with HIV every day. Generally, the risk of HIV transmission during oral sex, even without using a condom or dental dam, is quite low, although there are some factors that may increase the likelihood of transmission . While transmission can occur due to having anal sex without a condom, it’s not the only reason that men who have sex with men have higher rates of HIV. There are complex factors that contribute to this such as not knowing their HIV status, substance use, social discrimination and cultural issues , and there being an already existing high prevalence of HIV among the MSM community. As for why your friends have oral sex without condoms, it could be for any number of reasons.
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What Is The Risk From Oral Sex
Results from the PARTNER study show that if someone with HIV is taking effective HIV medication and has an undetectable viral load, they cannot pass on HIV.
According to Public Health England, around 1-3% of sexual HIV transmissions in the UK are because of oral sex. Other studies found that the risk is very low but is not zero.
Unprotected anal and vaginal sex leads to far more HIV infections than oral sex.
The risks are higher if the person giving oral sex has:
- cuts, sores or abrasions in their mouth or gums
- a sore throat or infection in the mouth or throat.
Or if the person receiving oral sex is:
- HIV positive
Honesty Is The Best Policy
The best way to protect yourself or your partner during oral sex is to keep it 100. Be clear about your HIV status, and ask your partner to be clear about theirs.
If youre not sure about your status, get tested. In fact, its best for both you and your partner to get STI tests on the reg.
PSA on dental hygiene: Make it a priority. Taking care of your teeth and gums could prevent bleeding gums, mouth sores, or other issues that increase your risk of getting HIV during oral sex.
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Other Types Of Hiv Transmission
Though less common, the virus can be transmitted through oral sex, transfusions of infected blood, and organ transplants. In rare cases, HIV can be transmitted when infected blood touches a persons open wound or comes into contact with a persons eyes.
The transmission of the virus through oral sex is less common than through any other sexual behavior. However, there still remains a risk. An HIV infected person providing oral sex can transmit the virus when blood in their mouth enters their partners body via the following ways: the lining of the vagina, urethra, anus or in open wounds and cuts. Conversely, an HIV positive person receiving oral sex may pass bodily fluids containing the virus through the mouth of the non-infected partner performing oral sex. This risk is heightened if the non-infected individual performing oral sex has wounds in the throat and/or mouth, if the HIV infected individual ejaculates in his/her partners mouth or if the person receiving oral sex has a sexually transmitted disease . Refraining from sexual behavior is the most successful method in preventing HIV. However, should an individual opt to engage in oral sex, it is strongly recommended that condoms and/or latex barriers are used.
Hiv Undetectable=untransmittable Or Treatment As Prevention
In recent years, an overwhelming body of clinical evidence has firmly established the HIV Undetectable=Untransmittable, or U=U, concept as scientifically sound. U=U means that people with HIV who achieve and maintain an undetectable viral loadthe amount of HIV in the bloodby taking antiretroviral therapy daily as prescribed cannot sexually transmit the virus to others. Thus, treatment for HIV is a powerful arrow in the quiver of HIV prevention tools. Read more about how a durably undetectable viral load prevents HIV transmission with NIAID’s fact sheet 10 Things to Know About HIV Suppression.
For nearly two decades, scientists have recognized that viral load is a key determinant of HIV transmission. Studies conducted before the availability of ART revealed that higher viral loads correlate with higher rates of both sexual and perinatal transmission of HIV. Following the advent of triple-drug ART in 1996, observational studies suggested that viral loads lowered by ART were associated with reduced risk of sexual and perinatal HIV transmission. In addition, epidemiological studies showed that as the number of people in a community who are virally suppressed rises, the number of new HIV transmissions falls.
To read more about the underlying science and the value of U=U, see NIAIDs blog post Science Validates Undetectable=Untransmittable HIV Prevention Message.
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So There Is Only A Low Risk For Contracting Hiv When Having Oral Sex What About Other Stis
While it is low risk for HIV there is the possibility of contracting other Sexually Transmissible Infections such as chlamydia, gonorrhoea and syphilis. These are all bacterial infections, so the good news is they are easily treated and cured.
Syphilis can be spread through oral, anal or vaginal sex. It can even be spread when there is no visible sore present. If youre having multiple sexual partners even if youre only having oral sex its a good idea to make sure you are getting a sexual health check every 3 months to ensure you dont have an STI.
The presence of an STI does increase the risk of HIV transmission. This is true whoever has the STI. If the negative person has an STI it increases their susceptibility to contracting HIV as it may cause breaks in the skin and allow entry of the virus as well as activate the bodys immune response in that area. Its these immune cells that HIV targets. If the HIV positive person has an STI, HIV transmission is more likely as the presence of an STI causes and increase in the amount of HIV in cum and pre-cum.
The best way to protect ourselves and the guys we fuck is to regularly use condoms and have regular sexual health tests, whether were HIV positive or negative, to make sure we dont also have other STIs.
Giving And Receiving Oral Sex
Though semen and pre-cum are not the only routes for contracting HIV, they are two avenues. Ejaculating during oral sex increases the risk. If you or your partner feels ready to ejaculate, you can remove your mouth to avoid exposure.
Barrier methods like latex or polyurethane condoms and dental dams can be used during every oral sex act. Change condoms or dental dams if you move from the vagina or penis to the anus, or vice versa.
Also use lubricants to prevent friction and tearing. Any holes in the barrier methods can increase exposure risk.
Abstain from oral sex if you have any cuts, abrasions, or sores in your mouth. Any opening in the skin is an avenue for possible viral exposure.
Be careful not to cut or tear your partners skin with your teeth during oral sex. This opening can expose you to blood.
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Estimating The Risk Per Exposure
A satisfactory answer to the question, How high is the risk of HIV transmission through oral sex? has been notoriously elusive. Collecting reliable data is challenging for several reasons:
- Very few people report oral sex as their sole risk.
- Self-reported data on sexual behaviour are hard to collect accurately, with participants failing to report condomless anal or vaginal sex they have had.
- If a person practises any other form of unprotected intercourse in addition to unprotected oral sex, any resulting HIV infection is usually attributed to the higher risk behaviour.
- Studies have frequently grouped all oral sex practices together, often not distinguishing receptive from insertive roles, whether ejaculation occurred in the mouth, etc.
Many reports of oral transmission are in the form of isolated and anecdotal reports, rather than from observational cohorts or other studies with more rigorous follow-up.
Most cohort studies following men who only practiced oral sex, or serodiscordant couples, have tended to show very low levels of risk, in many cases approaching zero. A few studies have given higher estimates which are difficult to reconcile with the others.
When Is The Risk Greater
These risk factors can increase the chances for transmission of HIV:
- Status: Risk varies based on whether the person with HIV is giving or receiving oral sex. If the person with HIV is receiving oral sex, the person giving it may have a higher risk. Mouths may have more openings in the skin or lesions. Saliva, on the other hand, is not a carrier of the virus.
- Viral load: The risk of contracting HIV is higher if the person with HIV has a high viral load. Higher viral loads increase infectivity.
- Ejaculation: During oral sex, ejaculation may increase risk for sharing the virus, but ejaculation alone isnt the only possible way of contracting HIV.
- Cuts or sores: Openings in the mouth, vagina, anus, or on the penis are possible routes for HIV. These may be cuts or lesions from another infection or condition. For example, HIV-related infections like candidiasis can cause sores that compromise the integrity of the tissue in the mouth. Any break in the skin puts a person at risk for transmitting or contracting the virus.
- Menstruation: HIV-bearing cells do shed from the cervix during menstruation. Coming into contact with menstrual blood with the mouth may increase contraction risk.
- Urethritis: This condition causes inflammation and irritation in the urethra. It may increase the chances of HIV contraction, too. People with HIV are likely to shed the virus when they have this condition.
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How To Protect Yourself
Since there is still a chance that you could get infected with HIV through oral sex, you should always take precautions. Here is what you can do to lower your risk:
Do not let a male partner ejaculate in your mouth. You can do this if you remove your mouth from their penis before they ejaculate, or if you use a condom.
Use a condom or dental dam. A dental dam is a thin square piece of latex or silicone that you place over the vagina or anal area during oral sex. You can also cut a latex condom lengthwise and use it the same way.
Both of these barriers also lower the risk of infection from other STDs such as gonorrhea of the throat or hepatitis. Use a new one every time you have oral sex. Check the expiration date on the package, and make sure there are no tears or defects.
Don’t use oil-based products like baby oil, lotion, petroleum jelly, or cooking oil on condoms or dental dams because that can cause them to break. If you need lubrication, use a water-based or silicone-based product instead. Always use a condom or dental dam during your period since the virus can be present in menstrual blood.
Don’t brush your teeth just before oral sex. If you do, your mouth or gums may bleed, which raises chances of infection.
Skip oral sex during risky times. This includes a time when you have sores around your mouth, genitals, or anus , gum damage, a throat infection, or after dental work.
Is There Risk Of Hiv Transmission When Having A Tattoo Body Piercing Or Getting A Hair Cut Or Shave
There is a risk of HIV transmission if instruments contaminated with blood are not sterilized between clients. However, people who carry out body piercing or tattooing should follow procedures called ‘universal precautions’, which are designed to prevent the transmission of blood borne infections such as HIV and Hepatitis B.
When having a hair cut there is no risk of infection unless the skin is cut and infected blood gets into the wound. Traditional ‘cut-throat’ razors used by barbers now have disposable blades, which should only be used once, thus eliminating the risk from blood-borne infections such as Hepatitis and HIV.
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How Do You Get Aids
You need to have been infected with HIV before you can have AIDS. AIDS is a condition, as its name implies, which develops when the immune system is severely damaged by HIV. HIV is commonly transmitted by sexual behaviors with an infected partner, the sharing of needles with a person with HIV or through mother to child transmission. HIV can be spread by sexual activities that include vaginal sex, anal sex, and oral sex. HIV is spread by bodily fluids which include semen, preseminal fluid, vaginal fluid, blood and breast milk. The virus that causes AIDS is spread by breast milk during nursing or can be passed from mother to baby through birthing.
Can Hiv Be Transmitted Through Oral Sex
Yes, but the risk is relatively low.
HIV is transmitted through seminal and vaginal fluids, including menstrual fluids. The virus can enter the body through the bloodstream or by passing through delicate mucous membranes, such as inside the vagina, rectum or urethra.
If a person gives fellatio and has bleeding gums, a cut, or an ulcer inside their mouth, HIV could enter their bloodstream through infected fluid. This could also happen if infected fluid from a woman gets into the mouth of her partner during oral sex.
Using a condom during sex, including oral and anal sex, is the best way to prevent sexually transmitted infections , including HIV. Avoid using an oil-based lubricant, such as Vaseline or baby oil, because they can weaken the condom and increase the risk of it splitting.
You can use a dental dam to cover the anus or female genitals during oral sex. A dental dam is a latex or polyurethane square, measuring about 15cm by 15cm. It acts as a barrier to help stop STIs passing from one person to another.
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Oral Sex And Hiv Acquisition
Oral sex is not likely to transmit HIV under most circumstances. Many large studies have shown that a person living with HIV who takes HIV drugs and has an undetectable viral load cannot transmit the virus to their sexual partners. This includes any kind of sex, including oral sex and sex without using condoms or barriers. This reality is known in the HIV community as Undetectable Equals Untransmittable, or U=U.
When a person living with HIV is not on treatment, oral sex is still a low-risk activity for HIV. If a person is not taking HIV drugs and/or has a detectable viral load, that low chance of transmission is greater if one of the partners has bleeding gums, mouth ulcers, gum disease, genital sores, and other sexually transmitted infections or diseases .
A number of studies have tried to figure out the exact level of HIV transmission risk that oral sex poses, but this is not easy to do. When HIV is transmitted, it is difficult to tell if oral sex or another activity that poses more risk was responsible.
The chances of HIV being passed from one person to another depend on the type of contact. HIV is most easily spread or transmitted through unprotected anal sex, unprotected vaginal sex, and sharing injection drug equipment that has not been cleaned. Unprotected sex means sex in which no condoms, other barriers, or HIV treatment-as-prevention methods are used.
For HIV transmission to be possible: