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Can there be an HIV and Gonorrhea transmission at the same time through saliva?

Question: 

Hello and good day!

I had an unprotected insertive oral sex with a man whom I didn't know the HIV status. After 2 days, I noticed a discharge being secreted by my penis. I immediately went to my doctor and he said that I probably got this through unprotected insertive oral sex. At the moment, I am not in my medication for my discharge. He also recommended to have my HIV test after 6 weeks. Here are my questions and hoping that you'll consider anwering them.

1. Is it possible to acquire HIV through saliva and insertive oral sex?

2. Can the gonorrhea bacteria and HIV virus combine at the same time that I may possibly also be infected by both?

Thank you very much for considering my inquiry. I am looking forward to hearing from you.

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV after receiving unprotected insertive oral sex. From the information given, this scenario is determined to be Negligible Risk (there is no evidence or no documented cases of transmission. However, there is a theoretical possibility of transmission under certain extenuating circumstances).

The scenario mentioned above does not meet the three components of the HIV Transmission Equation. In typical circumstances, receiving oral sex does not satisfy the transmission equation because saliva is not a bodily fluid that can carry the HIV virus. If a large amount of blood is present in the saliva during the activity (from actively bleeding gums, etc.) and that blood gains access to your bloodstream through the head of your penis, then there is a theoretical possibility of HIV transmission when receiving oral sex. This is why it is very important to use protective barriers when engaging in any and all sexual activities.

To briefly address your second question, even if both HIV and gonorrhea were present in the saliva, it would not make it more likely for you to get either infection. Please note that this is not the case if you already have an active gonorrhea infection, since the presence of an active STI increases your risk of acquiring an HIV infection (1). Additionally, it is important to note that you are much more likely to get gonorrhea (and other STIs such as chlamydia) than HIV from receiving oral sex, thus it is imperative that you access STI testing after engaging in sexual activity.

Recommendation: There are no evidence or no documented cases of transmission. Refer to a healthcare professional for more personalized answers.

Regards,

AIDS Vancouver Helpline/Online, Marie