HIV - Prevention Expert Forum
Insertive oral sex - person performing oral sex had blood in saliva
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Insertive oral sex - person performing oral sex had blood in saliva

Hi, I have a question about HIV risk from oral sex when the person performing it has blood in their saliva/mouth...

I was receiving (unprotected) oral sex from a guy and I pulled out and a stream of bloody saliva fell out of his mouth (he has oral health issues - bleeding gums). He does not know his HIV status and has engaged in unprotected sex with various partners so I am not sure if he has HIV or not... my question is what risk am I at (as the insertive partner in oral sex), with there being blood in his mouth/saliva. I searched the other expert questions and saw it repeated that oral sex is considered low risk, but if there is actual blood in the mouth/saliva, wouldn't that increase the risk?

Thanks in advance
239123_tn?1267651214
Welcome to the forum.  I'll try to help.

You seem to understand that oral sex in general carries very low risk for HIV transmission.  One calculation is that if the oral partner is infected, the insertive (penile) partner has perhaps 1 chance in 20,000 of being infected.  That's equivalent to receiving oral by infected parnters once daily for 55 years before transmission might be likely.  Could blood in the mouth elevate that risk?  Maybe, but probably not by much.  If the risk were doubled, the chance would still be only 1 in 10,000.  And even this may overestimate the risk, since saliva kills HIV.

So you needn't worry about this particular event, and I do not recommend HIV testing.  However, I would recommend that in the future you ask your partners about HIV status (and share your own) before having any sexual contact, even when safe sex is planned -- and avoid proceeding (or be especially careful about sexual safety) with those who are positive and not on treatment, don't know, or seem evasive.  The risk ends up a little higher than planned, as it did this time.

I hope this has helped.  Best wishes--  HHH, MD
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