From the Guidelines
It is possible to contract HIV through oral sex if you have bleeding gums, though this risk is considered low compared to other forms of sexual contact. HIV transmission requires direct contact between infectious bodily fluids (like blood or semen) and mucous membranes or damaged tissue, which can occur when bleeding gums provide an entry point for the virus 1. To reduce this risk, consider using dental dams or condoms during oral sex, postpone oral sex if you have bleeding gums, mouth sores, or recent dental work, and maintain good oral hygiene. Regular HIV testing is recommended if you're sexually active with multiple partners or with someone whose HIV status is unknown. Pre-exposure prophylaxis (PrEP) medications like Truvada or Descovy may be appropriate for those at ongoing risk. The risk is lower than for receptive anal or vaginal sex because saliva contains antiviral proteins that can inhibit HIV, but bleeding gums compromise this natural protection by creating potential pathways for viral transmission.
Some key factors to consider when assessing the risk of HIV transmission through oral sex with bleeding gums include:
- The presence of bleeding gums or other oral lesions, which can increase the risk of transmission 1
- The viral load of the HIV-positive partner, which can impact the likelihood of transmission 1
- The use of protective measures, such as dental dams or condoms, which can reduce the risk of transmission
- The frequency and nature of oral sex, which can impact the overall risk of transmission
It's also important to note that while the risk of HIV transmission through oral sex is lower than for other forms of sexual contact, it is not zero, and individuals should take steps to protect themselves and their partners. This includes practicing safe sex, getting regular HIV testing, and considering PrEP if they are at ongoing risk 1.
In terms of post-exposure prophylaxis (PEP), it may be recommended for individuals who have had a high-risk exposure to HIV, including oral sex with a partner who has a high viral load or who has not been taking antiretroviral therapy consistently 1. PEP should be started as soon as possible after the exposure, ideally within 72 hours, and should be taken for a period of 28 days.
Overall, while the risk of HIV transmission through oral sex with bleeding gums is low, it is not negligible, and individuals should take steps to protect themselves and their partners. By practicing safe sex, getting regular HIV testing, and considering PrEP or PEP if necessary, individuals can reduce their risk of HIV transmission and maintain their overall health and well-being.
From the Research
HIV Transmission through Oral Sex
- The risk of HIV transmission through oral sex is considered to be lower than through penile-vaginal or penile-anal intercourse 2.
- However, oral exposure to HIV-infected semen, blood, and breast milk can lead to infection 3.
- The presence of bleeding gums or oral trauma may increase the risk of HIV transmission through oral sex, as it can provide a portal of entry for the virus 2.
Factors Influencing HIV Transmission through Oral Sex
- The level of infectious HIV present at the oral mucosal site influences the potential for HIV infection through the oral mucosa 3.
- Salivary anti-HIV properties and local and systemic immunologic responses also play a role in determining the risk of HIV transmission through oral sex 3.
- The use of antiretroviral therapy and pre-exposure prophylaxis (PrEP) can reduce the risk of HIV transmission 4, 5, 6.
Pre- and Post-Exposure Prophylaxis
- Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are effective in preventing HIV transmission 4, 5, 6.
- However, the uptake of PEP has been limited due to insufficient awareness among persons at highest risk for acquiring HIV 6.
- Educational HIV prevention methods must focus on the potential risks associated with orogenital sexual behaviors, including oral sex 3.