[Question #7685] HIV spread through kissing

2 months ago
Good evening doctors:
I met a woman on a regular dating app such as Bumble or Tinder.  She is Brazillian and aged 40 but she has only been in America for 5 years.  Before that she lived in Brazil and was divorced there after her husband cheated on her.  She is a very good mother and is health conscious, such as she eats well and goes to the gym a lot.  I'm not sure of her legal status although I believe she is here on a work visa.  She is learning English and takes classes.

We have dated 4 times and we have not had sex or even oral sex.  She has not made a move on me in regards to that and my hands have gotten close to her vaginal area over the jeans and she has pushed my hands away.  Which I think is a good sign and she is not slutty (pardon my language.)  

We have only done deep kissing and she has bit my bottom lip hard when she kisses me.  After our first date on the 20th, the next morning my bottom lip hurt and I thought I noticed a mark from where she bit me.  I didn't see any blood that I know of but I am afraid she may have bit me hard enough to draw some blood during one of the kisses.  It was in a car at night afterall.  We have since met 3 other times and she bites me hard on my bottom lip while kissing even after I say don't do it because I don't like it.

Should I be worried about catching HIV this way?  I know it's a lower risk but is it really a lower risk?

I have been tested last month for HIV before I met her and was negative.  I do have herpes-2 and genital warts that seem to come and go.
Edward W. Hook M.D.
Edward W. Hook M.D.
2 months ago

Welcome to the Forum and thanks for your question.  You are in the clear.  There is no evidence that kissing of any sort, including deep kissing with saliva exchange represents any risk whatsoever for HIV.  The same is true with biting of your lip.  No studies suggest that even biting of the lip represents a risk for HIV. 

Further there are no data that gum disease, mouth sores in either partner or dental problems change the fact that kissing is a no risk event.  I would not worry about this in the least and see no reason for testing related to the vents you describe above. 

I hope that this information is helpful.  Should there be any further questions, lease use your up to two follow-ups for clarification.   EWH

2 months ago
Thank you Dr Hook! So even if there were blood present or if she drew blood on my lip from her bite...that would still be basically a no risk event?  It just seems I get STIs with low percentage rates for men.  I got genital herpes from a monogamous relationship and now it seems I have Genital Warts HPV which only 1% get warts (or so I have read) I'm now that 1%.  See below.

I do have some questions about HPV and Genital Warts though.
I had unprotected sex in December with a friend of mine and she doesn't sleep around and about 4 weeks later noticed genital warts on an area not covered by a condom.  The base of my penis.  My DR froze them and gave me Imiquimod Cream 5% and they disappeared rather quickly once I applied the cream.  

1) Does that mean I got the infection from my friend?  I am really regretting I did that.
2) I have been through extreme emotional stress from a breakup from another woman I loved.  If the infection was an older one, could that have brought out the warts as stress can weaken the immune system?
3) my warts came back and I had them removed by freezing them yesterday.  I forgot and applied the Imiquimod Cream that same night.  Is that a bad thing to do? my DR said wait a week.
4) If a new partner is exposed to a genital wart...does that automatically mean they will develop a wart?
5) How many people exposed to low-risk HPV actually get genital warts? I read 1% and I feel even worse.  I am basically beside myself.
6) During the period I the warts are being "frozen" and getting ready to fall off am I as contagious as before they were frozen?

Thanks again for your kind answers.  The mental aspect of this is worse than the condition 

Edward W. Hook M.D.
Edward W. Hook M.D.
2 months ago
Let me start by wholeheartedly agree with your final sentence. Indeed, the mental aspect of HPV infections is certainly worse than the infection itself. HPV infections are an innocuous problem for most persons. Further that you acquired warts is not at all unusual for an unvaccinated person. We estimate that over 80% of unvaccinated sexually active persons will acquire HPV at some point. Of those people only a proportion will develop visible genital warts. That said, you’re one percent figure is too low and a more accurate figure would be closer to 5%. With that his background let’s address your questions.

1.  No, one month is too quick for warts to appear. More typically it takes 2 to 3 months following an exposure for genital warts to appear.
2.  Certainly emotional stress can make persons more vulnerable to infections.  As noted above however genital warts can certainly appear months after an exposure.
3.  Freezing of genital warts destroys the tissue and is irritating. So is Imiquimod.  The reason to wait a week following freezing is to allow the irritation from the freezing to resolve. You may have more irritation from the Imiqimod than you would have otherwise. I suggest you now wait a week until you resume using Imiquimod.
4.  No most exposures to put this with HPV did not result in infection.  This is true for most STI ‘s. Most exposures do not result in infection.
5.  Genital warts are far more common than you suggest and are not something to worry about. Other than the fact that they are visible, they are innocuous and do not lead to long-term consequences. I would not worry about this.
6. This is a difficult question to answer. The freeze/thaw cycles that occur when warts are frozen is a destructive process intended to destroy the DNA of the HPV virus and to destroy infected tissue. Most providers would not recommend sexual activity during the period immediately following freezing. On the other hand the likelihood of transmitting the infection is probably low.

I hope this information is helpful. EWH
1 months ago
Good evening:
I do have one other question, I did meet another 36 year old Brazilian woman and she is legally here in the US. She's been here for about 15 years and we had a first date.  She invited me up to her place and we started to deep kiss and I sucked on her breasts.  She then dry humped me with our clothes on.  I did tough her pants and they felt moist.  
After that she took off her clothes and I put my finger on her clitoris and that's all we did.  

I never put my finger in her vaginal opening and we never had sex or oral sex because I didn't want to.  

Now I am overthinking this scenario and wondering if I could have gotten HIV this way from kissing her or playing with her clitoris?  Afterwards, we laid together and I touched my phone and then went to the bathroom and washed my hands.

(I asked about her history and said she hasn't had sex in over a year and has no timeline when she has sex w someone as long as both feel comfortable.  She also said she has to have a follow up PAP done again and some other blood work.)

1) Should I worry about this with getting HIV?  
2) I have since got a mild case of covid would that affect an HIV test?

Also, for Terri:
3) I have HSV-2, does that make me immune to HSV-1? I notice discomfort where my lips meet on the side of my mouth and aren't sure if that's a herpes sore or not.  I didn't see anything but hurts if I open my mouth wide. I take Valtrex and haven't had a genital outbreak in over a year.
Edward W. Hook M.D.
Edward W. Hook M.D.
1 months ago
Welcome back to the forum for your final question. I will be answering each of your questions as clients are not permitted to ask for responses from more than one of the moderators.  The events that you describe are absolutely no risk events for acquisition of HIV or any other STI. STI‘s including HIV are not acquired by deep kissing, masturbating a partner, or kissing or sucking on a woman’s breasts. Thus even in the unlikely circumstance that your partner may have had an STI or HIV the activities you described put you at no risk whatsoever for infection. There is no reason for concern and no recent for testing.  Thus, in response to your questions:

1.  Nothing you describe put you at any risk for acquisition of HIV.
2.  There is are no data and no reason to think that having acquired Covid-19 would affect the accuracy of HIV  test results.
3.  The fact that you have HSV-2 will reduce but not totally eliminate your risk for acquiring HSV-1. Your herpes infection does provide partial immunity but not complete resistance to infection.

As you know, this third group of responses completes this thread. The thread will be closed shortly without further responses. Take care. Please don’t worry. EWH