Can you get HIV from oral sex?

It is possible but the risk is very low. Studies estimate between zero and about 4 in 10,000 per act, even with a partner who has HIV and is not on treatment. Receiving oral sex carries even less risk than giving it.

Is oral sex with ejaculation risky for HIV?

Ejaculation in the mouth raises the risk a little, and bleeding gums or mouth sores raise it a little more, but the risk stays very low.

HIV Risk From Oral Sex

Giving, receiving, ejaculation, and what actually matters.

Oral sex is one of the lowest-risk sexual activities for HIV. The risk is so low that public health bodies such as the CDC describe it as "low" instead of giving a precise number. Studies estimate somewhere between zero and about 4 in 10,000 per act (0.04%), and that is with a partner who has HIV and is not on treatment.

Giving oral sex

If you give oral sex to a partner with a penis, the main possible route is semen or pre-cum entering your mouth. The risk is still very low. It is a little higher if your partner ejaculates in your mouth, and if you have bleeding gums, mouth ulcers, a sore throat or recent dental work.

Giving oral sex to a partner with a vagina (cunnilingus) carries an even lower risk. Very few cases have ever been reported. Menstrual blood can raise it slightly.

Receiving oral sex

Having your penis or vagina in someone else's mouth is one of the lowest-risk acts there is, because saliva does not transmit HIV. For practical purposes the risk is close to zero.

Oral-anal contact (rimming)

The HIV risk is extremely low. Other infections, such as hepatitis A and gut infections, spread much more easily this way.

What makes it a little riskier

Ejaculation in the mouth
Bleeding gums, cuts or sores in the mouth
Sores or another sexually transmitted infection on your partner's genitals
A partner who was very recently infected, when the amount of virus is highest

And what removes the risk: a partner with HIV who takes treatment and has an undetectable viral load does not transmit HIV (U=U).

Do I need PEP after oral sex?

Usually not. Most guidelines do not recommend PEP after oral sex alone, because the risk is so low. A clinician may still consider it in unusual situations, for example when there was blood involved and the partner is known to have HIV and is not on treatment. If you are unsure and it has been less than 72 hours, ask a doctor or sexual health clinic. See PrEP and PEP.

Should I test?

If you are worried, a test is the only way to know for sure. A 4th-generation lab test is highly reassuring at 45 days, and antibody tests, including most self-tests, are conclusive at 90 days. While you are at it, consider a throat test for gonorrhoea and chlamydia: these do spread easily through oral sex. Our testing guide explains which test to take when.

Want a number for your situation? The HIV risk calculator includes oral sex and lets you add ejaculation, partner status and other factors.