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Mucous Membranes/"Visible Blood"

May 30, 1996

In several of your essays you say that HIV must enter thr bloodtsream through abrasions, cuts, or other breaks in the skin. What about mucous membranes, specifically, the interior of the mouth? Is that a permeable mucous membrane? I have heard that it is, and that HIV can theoretically pass through it, BUT, that saliva is acidic enough (or basic enough, I'm not sure which) to kill significant amounts of HIV first. The second half of my question, also about oral HIV infection, has to do with your references to "visible blood" in the mouth. Do you mean to say that if the degree of a partner's oral bleeding is such that it's not visible to the naked eye, one is that much safer from oral infection?

Response from Mr. Sowadsky

Thanks for your question. The linings of the mouth are indeed a mucous membrane, and HIV can enter your bloodstream through your mouth, especially if you have cuts, abrasions, open sores (like canker sores), or if you have gum disease (a breakdown in the integrity of the gums). There has not been any evidence that the saliva is too acidic or too basic, to kill the virus. There was one research study that stated that a substance in saliva can inhibit HIV in saliva, but that study has not been repeated, or verified to date. But there have already been cases of HIV transmission through giving oral sex, so even if saliva did have some factor in it, this factor would not eliminate the risk of infection through giving oral sex. So if semen, vaginal secretions or blood gets into the mouth, saliva would not adequately protect you against infection. If you were to see visible blood in your partners mouth, that would pose a significant risk for HIV and other bloodborne diseases (for example Hepatitis B). This is especially true if the blood has a direct access to your bloodstream. Simply put, the less blood that's there, the less the risk. If you are exposed to saliva without visible blood, there would not be any significant risk of infection. But once you see any red color from blood, think of that red color like a red light....stop! But the less blood you're exposed to, the less the risk. If you have any further questions, feel free to contact me again.

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