HIV Infection and Oral Sex One of the primary ways of acquiring HIV is through unprotected sexual
intercourse (no condom), thus permitting partners to exchange blood, semen, or
vaginal secretions. However, there are different degrees of risk for different
types of intercourse, with oral sex by far the least risky.
It’s not that oral sex doesn’t have any risk at all; it does. A small number
of infections definitely can be documented as acquired through performing oral
sex on a man (fellatio). Documenting transmission through oral sex on a woman
(cunnilingus) is more difficult, but the possibility must always be
acknowledged.
It is always the person performing the oral act (the “do-er”) who is at risk.
After all, the only body fluid that the person being performed upon (the
“do-ee”) is having contact with is saliva, and saliva is not a vector for
transmission with HIV.
The bottom line of oral sex is this: Don’t take a man’s ejaculate into the
mouth (don’t let him cum in your mouth). By taking that one precaution, the
bulk of the risk will be reduced. It’s not that there won’t be any risk at all,
but at least a relatively low level of risk will have been reduced even
further.
Research is still inconclusive about pre-ejaculatory fluids (pre-cum). HIV can
sometimes be found in pre-ejaculate, but not typically at levels capable of
achieving infection. Semen is of greater concern.
Of course, to be completely safe in oral sex, a condom always should be used
for fellatio and a dental dam for cunnilingus. There are even flavored condoms
available for that purpose.
Sandy Bartlett
ASA Community Education
This article appears in March 21 • 1997 and March 21 • 1997 (Cover).