Hi Doctor,

I was in a sexual foreplay with a woman with some BDSM involved.

She was sucking and slightly biting my scrotum as part of the foreplay. 

The sucking and biting of my scrotum has created small cuts on scrotum from woman's teeth.

The small cuts on scrotum had a small amount of blood coming out of them.

She was also sucking and slightly biting my nipples .

The sucking and biting of my nipples has created small cuts on nipples from woman's teeth. 

The small cuts on nipples had a small amount of blood coming out of them.

1.  What is the HIV risk from these small cuts with little blood on scrotum if they came in contact 

     with possible HIV blood from the woman's mouth during sucking and biting.

     Can HIV enter through these small cuts with little blood on my scrotum 

     if they came in contact with possible HIV blood from woman's mouth during sucking and biting?

2.  What is the HIV risk from these small cuts with little blood on nipples if they came in contact 

     with possible HIV blood from the woman's mouth during sucking and biting.

     Can HIV enter through these small cuts with little blood on my nipples 

     if they came in contact with possible HIV blood from woman's mouth during sucking and biting?

Thank you

The news is good: there is little if any chance of HIV from these events. HIV is rarely if ever transmitted from the mouth or by saliva, no matter what kind of contact occurs. For example, there has never been a proved case of HIV transmission oral to penis or by cunnilingus (oral-vaginal). Among other things, saliva inactivates HIV, perhaps contributing to the low risk. Even if blood is present in the mouth, there probably is little if any risk. In addition, HIV remains rare in females in the US and most industrialized countries -- a lot less frequent than you might assume from the media and various health education resources. For example, in most areas of the US, well under 1% of female sex workers has HIV, and it's usually under 1 in a thousand. So between those two factors -- a low chance your BDSM partner has HIV plus low risk even if she does -- you are at no significant risk of HIV from these events.

Those comments pretty well cover your questions, but to be explicit.

1,2) These are the same question except for the possibility of blood in the mouth in question 2. In effect, you're describing biting wounds as an HIV risk. Could HIV in theory be acquired by exposure of such bleeding cuts to the mouth of an infected person? Maybe, but most likely nobody in the world has ever acquired HIV in this manner and I doubt you'll be the first. Although in the early AIDS days (1980s-90s) it was commonly stated that being bitten by an HIV infected person could transmit the virus. However, I am unaware of any reports, ever, of actual HIV transmission through biting. With or without blood in the mouth.

So all is well. If this is your only potential exposure, you do not need testing for HIV and if you have a regular partner, you can safely continue sex without putting that person at risk. Having said that, it is recommended that all persons who are sexually active with non-monogamous partners be tested for HIV from time to time, and also that even people at no apparent risk for HIV be tested at least once. So if you have never been tested for HIV, or more than a year ago, you might consider doing it now -- for reassurance from the anticipated negative result. But not because of the events described.

A final option is to discuss this with your BDSM partner. She may reassure you that she has tested for HIV recently and doesn't have it; or perhaps would agree to getting tested at this time. You have no right to insist, but think how reassuring it would be if she tested negative at this time. It would prove you were not exposed. 

I hope this response is helpful. Let me know if anything isn't clear.

HHH, MD

Thank you for your detailed answer, I appreciate it.

About your specific answer  for my 2 questions(I quote the beginning of your answer):

The possibilty of HIV blood in woman's mouth was relating for the two questions not just for 

question number 2 as you mentioned.

(I am concering about blood in woman's mouth during the 2 cases of contact  with 

my cuts with little blood both on my scrotum and my nipples  :

It's not up to us to provide scientific citations for our professional opinions and advice. That said, there are no scientific studies or, to my knowledge, citations on this. The important thing is that nobody in the world has ever seen or apparently suspected transmission from oral to penile contact, and there must have been billions of such exposures, including millions when there was blood present. But no known trnasmissions. Sorry I can't give you more information than that. But I can assure you you're not going to be the first case! On top of which, there is little chance your partner had HIV, as I said in my original reply.

Thank you for your additional answer.

Sorry for multiple messages.

Just want to make sure you have got the whole picture of my scenario 

and the two different contacts that have happened to me.

So you say buttom line, the two contacts between woman's mouth and my scrotum and my nipples,

That completes the two follow-up Q&As that come with each initial question and so ends this thread. I hope the discussion has been helpful.