hello doctor i have been reading lots of conflicting information regarding the risk of hiv through oral sex. Those who say there is little to no risk always cite the el romero study that was conducted in Spain, which was meant to determine if hiv can be transmitted through oral sex as evidence that it just can't happen. i have read the study myself and i feel that there is a major variable that was not considered in this study that has lead the medical community as a whole to underestimate the risk of hiv through oral sex. Doctors failed to realize that the partner in this study who was Hiv+ was allready on anti viral medication thus making his viral load a whole lot lower than to someone in the real world who is positive and does not know about it, and yet is running around partaking in oral sex. would you clarify this for me doctor? the reason why i am worried is because i myself received an unprotected blow job from a prostitute and since have been worried? Thank you
Hi there,

Thanks for contacting AIDS Vancouver for HIV/AIDS-related information.

Just to clarify, here at AIDS Vancouver we are trained volunteers and not doctors. But what I can tell you is that receiving oral sex does NOT place you at a great risk of transmission.

Let me explain why: For HIV transmission to occur, body fluids (blood, semen, anal/vaginal fluids), plus a high risk activity (unprotected anal/vaginal intercourse, needle sharing), plus direct access to your bloodstream (i.e. through the vagina, urethra in the penis, other mucosal membranes, needle sharing) equals a risk of HIV transmission.

So, we consider oral sex to be of negligible risk. This means that although there is a possibility because fluids are being exchanged (in this case, your semen), there have been NO documented cases of transmission occurring in this way, even BEFORE antiretrovirals were available. So even if you are skeptical of the study, history confirms their findings. If oral sex was a common mode of transmission, we would be seeing a great deal more infections than we do.

So what makes unprotected vaginal sex more risky than unprotected oral? Sites like the vagina and anus provide a more efficient route of transmission (i.e. more direct access to the bloodstream) than the mouth. You should also note that there is an enzyme in saliva that inhibits the production of HIV, which makes transmission extremely difficult. Also note that rates of HIV among sex workers are not nearly as high as you imagine them to be. Commercial sex workers tend to take very good care of their sexual health, and using condoms for anal or vaginal intercourse is often a norm. With oral sex, not so often, since, as I have mentioned, the risks are negligible.

I trust I have answered your questions; however, if you have more, please don't hesitate to ask.

All the best


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