[Question #4126] Oral Transmission of HIV

30 months ago
Hello

5 days ago I kissed a woman who may have been HIV positive -- due to circumstances I am concerned there is a significant possibility. This woman was not my typical partner. I am confident that I was HIV negative before this encounter. We kissed for less than 5 minutes, both of our mouths were open. Her tongue touched mine and vice versa. My tongue was in her mouth, hers in mine.  About an hour prior, I brushed my teeth, which oftentimes causes my gums to bleed. I did not have a chance to examine her mouth -- she could have had open sores or bleeding. Before and after this both of us drank beer.  No other sexual contact occurred. She did not touch my genitals and I did not touch hers. The CDC website indicates that HIV can be transmitted during kissing, particularly if open sores or bleeding is present. Should I be concerned that I have contracted HIV? Should I get an HIV test and if so what kind and when? Should I take any precautions before resuming unprotected sex with my significant other? Should I be concerned regarding the transmission of other STIs than HIV?
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Welcome to the Forum.  I will be glad to comment and hopefully, to provide you with reassurance that you are not at risk.  You do not say why you think this person might have HIV but statistically this is most unlikely.  Even if she is however, the CDC is being overly conservative.  There has never been a proven case of HIV acquired from kissing a person with the infection- this its the case even with open mouth kissing, after brushing teeth, if one of both or the kissers have gum disease, mouth sores or blood in their mouths.  Still no risk despite the one or two anecdotes the CDC is likely referring to.  . 

The CDC sometimes makes these sorts of overly conservative statements in the efforts to make sure they are never wrong.

My advice to you is to not worry about this.  I see no reason for concern and no reason for testing.  EWH
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30 months ago
Thank you. My reason for considering the possibility that the other person here had HIV is that I believe she was a sex worker— and this incident happened in Southeast Asia. However, my understanding from your earlier response is that this detail would not effect your guidance that I am not at risk, correct? 

Also, should I get tested for STIs other than HIV as a result of this incident? 
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
 Thank you for the additional information. It does not change my assessment or recommendations however. 

 In addition, for your information, even in so-called high risk groups, most people do not have HIV.   Even among high risk commercial sex workers  in sub-Saharan Africa HIV rates are almost always less than 20% (1in 5)  add in southeast Asia rates would be substantially lower. When this is combined with the very, very low likelihood of transmission if your partner was infected, there is really no reason for concern. 

I really see no medical reason for testing for any STIs however if you feel you must, the only STI  for which there is any scientific justification would be to have an oral swab taken to rule out gonorrhea.  

 I hope this further information is helpful. EWH. 
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