Expert: Kristen Brannock, MPH - 8/2/2004

Question
Hi...!
    Am a 21 year old boy.I have gone through many HIV Information sites but am confused about ORAL Sex transmission.Some say its quite risky while others say its not that risky.Am looking for an exact,"CORRECT" and a "CONFIDENT" Answer from some "HIV EXPERT" on whos information I can "RELY ON"
    I hope you wont disappoint me.Anyways I will try and keep my Questions short.
Today millions of people SMOOCH and do FRENCH kiss every day.It happens in daily life....in the movies...etc.I was just thinking..lets just assume "A" is one person and "B"is the other.People kiss..that means...One persons mouth comes into contact with the other person"s mouth.(Mucous Membrane-Mucous Membrane contact).     And say suppose..."A"is perfectly healthy and has a fairly healthy mouth (No "VISIBLE" cuts or bleeding in his mouth at the time of Kissing/Oral sex)...and "B" is HIV POSITIVE and she might have some bleeding cuts "PRESENT" b"coz of which her HIV infected blood comes into contact with "A""s mouth.Now if this happens...that means .."A""s Mouth (Mucous Membrane) came into contact with possibly the highest Hiv Concentrated Fluid among all...That means this case is similar to an ORAL sex transmission Case..where a persons mouth comes into contact with Infected Semen,Vaginal Fluid or Blood..*But remember...."A" has "NO VISIBLE CUTS/BLOOD" in his mouth.
QUESTION 1> In this situation What do you think ? In real practical Life ....Do you think "A" is at a risk of being infected ?(Because I know theorotically many things are possible but in real life its not like that.)
QUESTION 2> If your Answer is YES/NO plz Explain "WHY" ?
*Note > Am aware of the theorotical explanation:- that the mouth is a mucous membrane..etc...and it has many MICRO cuts present through which HIV can enter.I have also read that the mouth is porous and that it absorbs....and that saliva cannot be harmful but blood can....and so u dont need an open cut to get infected.
But then my question is that :-
QUESTION 3> In so many millions of cases of hiv transmission......I wish to know if there has been a documented case/Study/Experimented Results found, so as to PROVE THAT HIV can be passed through MICROSCOPIC cuts in the mouth?I mean to ask do we have a case reported where a person"A"having a fairly healthy (NO BLEEDING CUT in the mouth at the time of performing ORAL SEX).... performing oral sex on an hiv infected Person"B" ...has got infected even when "A"had no VISIBLE BLEEDING CUTS in his mouth ?

*NOTE- Am aware of the fact that there are a few documented cases of oral sex transmission.I also know about the story of the "Couple" in which the wife got infected through kissing.But I have heard that  in all those cases the person performing oral sex had some kind of dental problem/disease and so the person performing oral sex had Cuts with visible blood in their mouths at the time of performing oral sex....and probably thats why they got infected.

PLZ REPLY IN DETAIL,

Awaiting your response,

YOURS FAITHFULLY,

Paul.
EMAIL- sweetkiller21@yahoo.com
If you dont mind PLZ let me know ur email id so that its convenient to contact you.
P.S: Its a personal request that plz answer my questions the same way I have asked you point wise.(Eg: ANS 1> ANS2> etc..for my better understanding.Thanks)  

Answer
Oral sex does carry risk of HIV infection, however, it is not as risky as unprotected anal and vaginal sex.

For your first question, yes, person A is at risk. Person A does not need to have cuts in his or her mouth to become infected with HIV. The mouth is a mucous membrane which is permeable to the virus. However, the risk of the person varies depending on amount of blood, length of exposure, and the HIV+ person's viral load. This you already seem to know.

I do not know specifics of documented cases-however, I assume that there have definitely been cases of HIV transmission via unprotected sex-otherwise, it would not be considered a risk for HIV. There would have to be proof that it can be passed this way for experts to agree it is risky.