anxious
Hi, 

I want to ask regarding the risk of transmission from giving and receiving oral sex. Furthermore, i am unsure if he was able to release in my mouth. Should i consider taking Pep with this scenario? Also, what do you mean by bleeding. cut inside the mouth? 

Hoping for your response. Thank you so much. 
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helpline-volunteer
Hi there, 

Thank you for your inquiry. From what we gather from the question, you were asking about the possibility of HIV transmission from giving and receiving oral sex (presumably unprotected in each event). 

From the information provided, this scenario is determined to be of Low Risk (Evidence of transmission occurs through these activities when certain conditions are met). This scenario is determined to be of Low Risk because there is a possibility that, in the event, the requirements of our HIV Transmission Equation may have been fulfilled (see below). The HIV Transmission Equation states that in order for HIV transmission to occur, certain circumstances must be met. In order for HIV transmission to occur, there must be a presence of HIV positive fluid (blood, semen, vaginal fluid, anal fluid, pre-cum, or breast milk), with direct access to the bloodstream, through a High, Low, or Negligible Risk event.

The reason that we classify performing oral sex as a Low-Risk activity, is because the mouth may contain open or bleeding wounds, which could provide HIV positive fluid direct access to the bloodstream. Above you had asked what we mean by bleeding cuts inside of the mouth. By this, we mean that superficial cuts or small scrapes in the mouth are not particularly of concern. It is more the case of active bleeding sores or cuts in the mouth that we concern ourselves with when it comes to HIV transmission and oral sex.

When it comes to Low-Risk activities, our Recommendation is to seek appropriate HIV screening. You asked above if you should consider taking PEP (Post-Exposure Prophylaxis) for the scenario you provided. If you feel that you have been involved in a High, Low, or sometimes Negligible Risk activity then you may seek PEP as a post-exposure measure of protection against HIV transmission, provided it is within the recommended 72-hours post-exposure timeframe.

In fact, if you are repeatedly involved in Low or High-Risk activities, it may be advised that you seek biomedical options for personal protection such as PrEP (Pre-Exposure Prophylaxis) and PEP (Post-Exposure Prophylaxis).

Further, you do not mention the status of the partner involved in the activity. Those who are living with HIV may have been medically diagnosed and adhere to regular ART (Anti-Retroviral Therapy). Those who regularly adhere to ART may achieve an extremely low viral load, making them undetectable. Individuals who are of undetectable status are unable to transmit HIV to their sexual partners (as proven in the below partner studies) (1, 2).

The following is an image of our HIV Transmission Equation:
Helpline Transmission Equation .jpg 
Final Recommendation: There is evidence that transmission occurs through these activities when certain conditions are met. It is important to be aware of one's HIV status. Please seek HIV screening from your health care provider.

Sources:

Partner Study (1, 2)

All the best,

AIDS Vancouver Online/Helpline, Cody

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