Oral sex can be both enjoyable and safe! Learn essential information about the risk of contracting HIV from oral sex, along with strategies for safer practices.

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Oral sex entails using one partner's mouth to stimulate another's genital regions. This can involve licking, sucking, or gently biting areas like the vulva (including the clitoris and labia), vagina, penis, or anus. Engaging in oral sex can be an incredibly enjoyable and intimate experience with your partner(s). Just like with any form of sexual activity, the potential for pleasure significantly increases once concerns or fears about HIV transmission have been alleviated.

Even if someone with HIV isn't receiving treatment, the risk of contracting HIV through oral sex remains very low.

Even if someone with HIV is not undergoing treatment, the risk of getting HIV through oral sex remains very low.

Oral sex is not likely to transmit HIV under most circumstances. Extensive research has shown that individuals with HIV who are on antiretroviral therapy and achieve an undetectable viral load (meaning the virus is present at such low levels that it can't be detected by standard tests) are unable to transmit HIV to their sexual partners. This is valid for all forms of sexual activity, including oral sex, as well as sex without the use of condoms or other barriers. This concept is widely recognized in the HIV community as Undetectable Equals Untransmittable, or U=U.

When someone with HIV isn't undergoing treatment, oral sex remains a very low-risk activity for acquiring HIV. However, if the person is not on HIV medication and has a detectable viral load, the slight risk of transmission increases if either partner has conditions like bleeding gums, mouth ulcers, gum disease, genital sores, or other sexually transmitted infections or diseases (STIs or STDs).

Several studies have attempted to determine the precise risk of HIV transmission through oral sex, but this is challenging. When HIV is transmitted, pinpointing whether it was due to oral sex or another higher-risk activity is challenging.

The likelihood of HIV transmission varies based on the type of contact. HIV is most commonly spread via unprotected anal sex, unprotected vaginal sex, and sharing uncleaned injection drug equipment. "Unprotected sex" refers to sexual activity without the use of condoms, other barriers, or HIV treatment-as-prevention methods.

HIV treatment as prevention (TasP) involves maintaining an undetectable viral load, as mentioned earlier. On the other hand, PrEP, which stands for pre-exposure prophylaxis, is a medication prescribed to individuals who are HIV-negative to help them stay that way. When there's a potential risk of HIV transmission, PrEP has been proven to reduce this risk significantly.

HIV can be found in vaginal secretions, semen or ejaculate (often referred to as "cum" and "pre-cum"), and blood. HIV cannot ever be transmitted through saliva (spit).

For HIV transmission to be possible:

• There has to be another fluid aside from saliva.
• There has to be measurable HIV present in that fluid when the person is not on HIV medication and has a noticeable viral load.
• For the fluid to infect the HIV-negative person, it must have a way to enter their bloodstream, such as through mouth sores or genital ulcers—simply swallowing the fluid isn't enough.

For more details, check out our fact sheet on HIV Transmission.

It’s crucial to understand that engaging in oral sex without condoms or barriers can still lead to contracting other STIs, including syphilis, herpes, gonorrhea, and human papilloma virus (HPV). It’s also worth mentioning that having an undetectable viral load or taking PrEP only protects against HIV, not other STIs.

If an HIV-positive partner has an undetectable viral load, there is no risk of passing the virus through oral sex, regardless of employing the tips below.

If a partner living with HIV isn't on medication and/or has a detectable viral load, the risk of HIV transmission through oral sex remains low. The advice below can help reduce that risk even more. If you're unsure about your or your partner’s HIV status and aren't using PrEP — or if the partner with HIV is not receiving treatment or has a detectable viral load — oral sex can be safer if you and/or your partner:

• seek medical attention for any additional STIs you might have
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• Hold off on having oral sex until any mouth sores, like oral herpes lesions, as well as genital cuts, scrapes, or sores have fully healed.
• Hold off on flossing, brushing your teeth, or doing anything that might cause cuts or bleeding in your mouth until after oral sex. If you want to freshen your breath beforehand, try using a breath mint instead.
• Refrain from ingesting pre-cum, semen, vaginal secretions, or menstrual blood.
• Use latex or polyisoprene condoms for oral sex on a penis (fellatio) - consider trying flavored versions that aren't lubricated. If you opt to perform oral sex without a condom, it's better to finish manually or to spit out the semen instead of swallowing it.
• Use a dental dam or an opened condom for oral sex on a vagina (cunnilingus) or for rimming (licking the anus). Dental dams are latex square sheets. Apply a water-based lubricant to one side of the dental dam or the inside of a cut-open condom. Next, stretch the dam or condom over the vulva or anus with the lubricated side down. This creates a thin barrier between your mouth and the genital or anal area. Some individuals opt to use plastic food wrap as a barrier. While plastic wrap has been shown to block herpes infections, there is no research proving it prevents HIV transmission.
• Hold off on performing oral sex on someone's vagina until their menstruation (period or cycle) is over to avoid coming into contact with blood.
• Looking after your mouth is essential.
• Consider exploring different activities if your partner’s penis is causing discomfort in your throat or tonsils (this can sometimes happen with “deep-throating”), or if you experience any injuries around your mouth.

For additional details on safer ways to enjoy sexual pleasure, such as oral sex, check out our Safer Sex fact sheet.

Oral sex can be enjoyable, gratifying, and highly secure. It's crucial to determine for yourself — and discuss with your partner(s) — the measures necessary to ensure all sexual activities are safer. If an HIV-positive partner is on antiretroviral medication and has an undetectable viral load, HIV transmission through sex, including oral sex, is impossible. However, other STIs can be contracted during oral sex, and preventive steps should be taken.

If you'd like to talk about these concerns, consider reaching out to a sex educator or healthcare provider at your local HIV service organization or treatment center. To locate a nearby organization, click here.

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