Oral sex

Published: 07 April 2009
  • The risk of getting HIV through oral sex is low, but not non-existent.
  • Infection via receptive fellatio ('doing it') is biologically plausible and almost certainly happens occasionally.
  • Infection via insertive fellatio ('having it done to you') is probably exceedingly low risk and may be impossible.
  • Reports of infection via cunnilingus are extremely rare. 

 

In the second National Survey of Sexual Attitudes and Lifestyles (Natsal), over three-quarters of both men and women had experienced oral sex in the past year, a slight increase from the first survey ten years before.1 Moreover, oral sex is practised almost universally by gay and bisexual men in the UK – in the 2006 Gay Men's Sex Survey, 99% of all respondents who had had any sex in the past year had had oral sex, and 62% had taken semen in their mouth.2

As with other forms of HIV transmission, the risk due to oral sex has been evaluated according to its biological plausibility and by the number of reported, confirmed cases. This has been complicated by the challenge of identifying cases that could only have been due to oral sex and not by any other route.

The risk of HIV transmission through the mouth is certainly smaller than through vaginal or anal intercourse or through sharing injecting equipment. If undamaged, the tissues of the mouth and throat are thought to be less susceptible to infection than genital or anal tissues, and an enzyme in saliva also acts to inhibit HIV.

There are no reported cases of HIV transmission through kissing. Very few cases of transmission through oral sex have been reported amongst gay men despite the continued practice of oral sex (often with ejaculation into the mouth) by large numbers of men. Cases of transmission via cunnilingus are extremely rare, and the reliability of even these reports is questionable.

How to better quantify 'low risk' continues to be a vexing question.3

References

  1. Wellings K Sexual behaviour in Britain: early heterosexual experience The Lancet , 358: 1843–1850, 2001
  2. Weatherburn P et al. Multiple chances: findings from the United Kingdom Gay Men's Sex Survey 2006. Sigma Research, 2008
  3. Department of Health Review of the evidence on the risk of HIV transmission associated with oral sex, report of a working group of the UK chief medical officers' expert advisory group on AIDS. 12 June, 2000
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.