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Kissing and infection with HIV
Feb 11, 1997

I would appreciate your explanation about the certainty and confidence of statements one frequently reads that "AIDS has never been transmitted by kissing". In the absence of an animal model, how could the frequency of transmission by saliva be quantitated, since sexual activity involves potential tranmission by other fluids and there can be no distinction as to which fluid was involved in transmission of HIV? Exceptions where partners claim only to have kissed or given oral sex are unreliable as anecdotal evidence. However, saliva, which contains traces of blood and buccal cells, does contain, albeit at a much lower level than semen or blood, HIV. Does anyone know, given the lack of an animal model, the minimum level of HIV necessary for infection? Given these uncertainties, the statement that AIDS has never been spread by kissing misleads to confusion. It has not been shown to be spread by saliva because ,absent an animal model, transmission by this route cannot be distinguished from other routes. Given the low titre of virus in saliva one would expect it to be rare.( Recently, there was a report of transmission from child to child through a bite.)

Response from Mr. Sowadsky

Hi. Thank you for your question.

This issue has been addressed over and over. Simply put, there is no evidence worldwide, that HIV has been transmitted by saliva alone. We do not need an animal model to study HIV transmission, since we have thousands of HIV infected people where we can track their source of infection. If saliva did pose a significant risk of infection with HIV, there would be many cases of HIV linked to kissing, sneezing, coughing, and receiving oral sex. However, over 15 years of evidence goes against saliva being a risk of infection. Theoretically, saliva can transmit HIV since the virus is found in saliva (but in extremely small concentrations). But we have to look at things realistically, not theoretically. If saliva did pose a risk of infection, we would see many more cases of HIV, since many people are exposed to the saliva of other people, much more than they are exposed to blood, semen, and vaginal secretions. There is no confusion on this issue. The risks of infection thro ugh saliva, although theoretically possible, are realistically very small. And remember that blood is not normally found in saliva. Saliva would only pose a significant risk if there were VISIBLE blood in the mouth.

There has never been a case of HIV transmission through biting where only saliva was involved. However, there was a case of HIV transmission that was linked to blood in saliva. This case involved a person with HIV who had VISIBLE blood in their mouth, and they bit (and broke the skin) of another person. That other person became infected from getting bitten. However, this was clearly a case of blood-to-blood transmission, not transmission from saliva.

When a person tests positive for HIV, we ask them about their risk factors for HIV. In no case was there proof of transmission solely through saliva alone. Again, we have over 15 years of worldwide data to support the facts that saliva alone does not pose any significant risk for HIV. Saliva would only pose a risk if there were visible blood in the saliva. Those are the proven facts.

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).



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