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oral sex risk
Jan 13, 1997

Rick, a number of your earlier answers have indicated that no person has ever acquired HIV from receiving oral sex (ie exposure to saliva) but Mark Schoof's article "The Great Fellatio Debate", posted above, refers to 4 cases where HIV was contracted by men receiving oral sex. Are you aware of the cases referred to in the article and relied upon by Schoof in making that claim? Thanks for your help, this site is a great resource.

Response from Mr. Sowadsky

Hi. Thank you for your question.

I have personally spoken to Mark Schoofs regarding this question. He agreed with me that the risks of getting HIV from saliva are very, very low. In regard to the cases you mentioned, he told me that there have been rare cases where transmission theoretically could have occurred through receiving oral sex. He did state however that the chances of infection through receiving oral sex were still very low. We agreed that if there were blood in the mouth, then there would be a significant risk of infection through receiving oral sex. One of the cases you mentioned was a man who had also engaged in cunnilingus (giving oral sex to a woman). This is a known risk factor for HIV. For the other 3 cases, it's hard to know if the people were exposed to blood or not. But, we have not had any proven cases of HIV transmission through saliva alone. All the research data indicate that the risks from receiving oral sex are theoretically possible, but realistically, the risks are extremely small.

I did a review of the medical literature looking for cases of HIV transmission via saliva. The only thing I was able to find were papers that stated that there would be a risk if there were blood in the saliva. This is consistent with what we've been saying all along, since blood does contain high concentrations of HIV. If a person receives oral sex, and the "giving" partner has visible blood in their mouth, then there would be a risk. But from saliva alone, this would not be considered risky as far as HIV is concerned If saliva posed a realistic risk of infection, we would see cases of HIV transmission via kissing, since exposure to saliva is common during kissing. We have not however seen any cases of HIV transmission via kissing.

I would also like to add that as time progresses, I'm finding more cases of persons stating that giving oral sex (exposure to semen etc.) was their only risk factor for HIV. There are also reports in the medical literature of people becoming infected specifically through giving oral sex. The risks for acquiring HIV by giving oral sex is less than that of intercourse, but the risk is real, and people have become infected this way.

So in summary, Mr. Schoofs and I are in agreement that the risks from getting HIV from receiving oral sex (exposure to saliva) are very small. The risks are theoretically possible, but realistically very low. We also agreed that there would be a significant risk if there were visible blood in the persons mouth. However, people don't normally have blood in their mouth, so normally this is not a risky activity as far as HIV is concerned.

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



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