I'm HIV+ and have been undetectable (<50 copies/ml) for about a year. I'm dating an HIV- guy who loves to rim me. I don't bleed or have hemorrhoids, but I'm still concerned that he might get it from me that way. I've been trying to convince him also to gargle with a mouthwash afterwards to reduce his risk. What is the latest info about the risk of getting HIV from rimming? Thanks so much for your time.

It is unlikely that your partner would be at risk for HIV infection through insertive/giving anilingus (rimming, oral-anal contact).

A person putting their mouth on an HIV positive person's anus/rectum poses a very low-risk for HIV infection. There is only one published case of transmission occurring oral-anal contact (possibly through contact with blood). HIV is difficult to isolate in feces, and any HIV present in feces is probably uninfectious or at harmless concentrations.

Transmission is only likely to occur if your partner's mouth comes into contact with blood in your rectum; your partner having sores in his mouth might increase the risk of transmission if he come into contact with blood in your rectum.

For these reasons, it is not advisable that your partner rim you after anal sex, or any other activity that might increase the odds of rectal bleeding. He can practically eliminate the negligible risk by using a barrier (dental dam, condom cut into a square, plastic wrap).

A person rimming another without a barrier is at greater risk for infection with hepatitis A virus, parasites, and bacteria. Getting a hepatitis A vaccine is a good idea if for sexually active people (especially for men who have sex with men) or in a region where hepatitis A is prevalent (B vaccines are important for additional reasons).

RMK