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Avatar universal

HIV Transmission Through Bleeding Gums

Dear Doc,

I wrote you before concerning protected sex with a sex worker in Thailand. (10/22/05).

I appreciate the answer and I know now, that transmission to me through the sexual acts was indeed low.

By reading some of your responses, I think it angers you when people follow up. But I want to commend and thank you for your work. You are the expert opinion that people often seek to give them the facts to make an informed decision. As a by product, I think your responses help people to deal with their fears. Nothing will stop the fear like a negative HIV test, but honest factual data goes a long way.

Anyhow, I am wondering about the possibility of HIV transmission through the kissing acts I described before. I have read that if both parties have bleeding gums it is possible for transmission of HIV.

As I said before, I think there was a little kissing, (but I had been drinking), and we both brushed our teeth before starting.  

I do have problems with my gums that cause bleeding when brushing, so I know my gums were bleeding slightly. Obviously, I do not know her dental status or if she has gum bleeding as well.

It is my understanding that a very high number of people have some type of gum deterioration with bleeding of the gums, so I ask you this:

Assuming she has the same bleeding gum problem and we kissed one another with the exchange of saliva and possible blood in her saliva, could I have contracted HIV?

How much blood transfer during kissing would be required for me contract HIV?

Would the presence of blood in the Saliva make a difference concerning the unprotected Oral sex?

Does any of this change your previous calculations or advice?

Thanks.
8 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
I get short-tempered only, I think, when the questions are repetative or go beyond what can be reasonably expected from an online forum--which, as the introductory information says, is not a substitute for direct care from a personal health care provider.

In this case, it has been said repeatedly, and is widely known, that transmission of HIV from the mouth to the genitals (fellatio, cunnilingus) either doesn't occur at all, or is so rare that it doesn't matter; and that HIV is never transmitted by kissing.  After that, it is just common sense:  At least half the population has bleeding from the gums from time to time, and at any particular moment several percent probably have gum disease with minor or overt bleeding.  Therefore, the statistics on low transmission by oral sex or kissing have already taken bleeding into account, and still the risk is zero.  That is, if blood in the mouth was a risk during oral sex or kissing, there would HAVE to be more cases transmitted by that route than have been observed.

In theory, of course the presence of blood raises the risk somewhat.  But doubling or even a ten-fold increase in transmission risk is still zilch (ten times nothing equals nothing).  So the bottom line is that there are no statistics to tell you exactly how much the risk might increase in the presence of blood; or how much blood would have to be present to raise the risk to a level that matters.  No matter what, it is too low a risk to worry about.

Good luck--  HHH, MD
Avatar universal
Also, what symptoms are the "big ones" to look for during the 2-4 week ARS time period?

Avatar universal
I don't think it makes him mad when people follow up but it makes him mad to hear the same question asked in different ways.  Like he'll tell someone "you have a one in a million chance" and they'll reply with some tiny twist to their story, asking if that changes anything.  Over and over.  Must get frustrating  and everyone seems to think one/1,000,000 means they ARE the one.
I know i've see something in here about oral, kissing, and bleeding gums (like theoretical bleeding gums), and he told them even if someone was activly bleeding and you did all that there was STILL almost zero risk.  But it seems people see almost zero risk and think it means something like significant risk.  
Avatar universal
On saturday night I engaged in open mouth kissing for about 3 minutes with a female, I am male. Nothing too intense but we did french kiss. Over the weekend I took pictures of us. In one of the picures i took, she a a big bright smile. I noticed a red mark in her upper gum line, near her left canine tooth. i didn't notice any bleeding or taste any blood when we were kissing for the short period. In the picure I didn't notice any blood on her teeth or around her lips/ It appeared more like a scab or a red mark. Do people develop scabs on their gums? i'm worried that I could have gotten Hiv from kissing her. She told me that her gums were not bleeding but, in the picture I took, i did notice a small red mark. As a result i am very concerned that i could have gotten hiv. I sometimes bite the inside of my cheek when I get nervous, so i'm fearful that her blood could have come into contact with my cheek. We only touched tongues for a little bit and the kissing didn't last very long. what should  I do.
239123 tn?1267647614
MEDICAL PROFESSIONAL
Nothing.

HHH, MD
Avatar universal
Well, I went to the doctor today because I noticed a large mass in the back of my tongue.

They gave me the following:

Findings:

Red, fleshy solid tumor of hazelnut size with irregular/verrucous surface on base of right tongue, medial of tonsillar area.

Diagnosis:

Squamous Cell Carcinoma?
Ectopic Thyroid Tissue?
HPV Infection?

I am in Cambodia and the doctors here are foreignors. I saw a dermatologist from Germany. I explained my situation and the doctor told me he did not think it was connected with HIV. Especially growing to this size within 3 weeks of possible exposure. The mention of the HPV infection possibility has me a little freak out though.

Based on "your" expertise and the circumstances of my Low Risk Exposure, are these diagnosis' anything that could be associated with ARS and/or Early Symptoms of HIV?

Thanks for your help..
239123 tn?1267647614
MEDICAL PROFESSIONAL
Sorry, I have no opinion or comment about the mass lesion of your tongue, except to say it doesn't sound like anything I would associate with ARS and probably doesn't have anything to do with HIV.  A biopsy probably will be required for diagnosis.  Follow your local doctors' advice.  Good luck--

HHH, MD
Avatar universal
A related discussion, was there an exposure was started.
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