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Jun 10, 2007

Dr., You answered a question on 5 June:

HIV can be absorbed directly across intact mucous membranes. Damage and bleeding are not necessary!

The tongue does have a mucous membrane.

How is it, then, that people say HIV transmission through oral sex is nil if trauma to the mouth/tongue is not necessary to contract HIV???

Thanks, D

Response from Dr. Frascino

Hello D,

There are a great number of factors that come into play for HIV transmission to occur. That the tongue has a mucous membrane and that HIV can be directly absorbed across intact mucous membranes are facts. The actual risk of HIV transmission occurring involves many other factors. I do not believe nor have I ever stated that the risk of HIV transmission from oral sex is completely nonexistent. The theoretical risk clearly exists and there have been case reports suggesting transmission has indeed occurred via this route. How often it occurs and how likely it is are the real questions. An analogy might be getting struck by a bolt of lightening. Clearly the theoretical risk is real and there have indeed been documented cases, but obviously the overall frequency of this occurring is so low that most folks don't think twice about walking outside in a rainstorm carrying an umbrella. One of the major factors in HIV transmission via oral sex may be the fact that saliva contains certain chemicals that inhibit HIV, thereby additionally reducing the risk of transmission.

Hope that helps explain this often confusing conundrum!

Stay well.

Dr. Bob

Coffe with Kurt from Palo Alto
2nd time writing. Post PEP. Please Help - Deperate

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