What is the risk of getting HIV?

One of the most common questions I am asked is

“How big is the risk of be getting HIV from…"

with … being a particular sexual act.

Today I want to explain how doctors evaluate risk when it comes to potential exposures to HIV.

To become infected with HIV, you must have a bodily fluid that contains HIV enter into your body. This can be via the blood stream or contact with a mucous membrane such as the lining of the anus or vagina.
Body fluids that contain HIV in high enough amounts to infect include blood, semen, vaginal secretions, anal mucosa secretions and breast milk.

Saliva is not a risk for transmitting HIV as it contains emzymes that kill HIV.

What Is The Risk Of Particular Sexual Acts?

Sexual Activity Risk of transmission of HIV*
Receptive Anal Sex With Ejaculation 1/70
Receptive Anal Sex No Ejaculation 1/155
Shared Injecting Equipment 1/125
Insertive Anal Sex With Foreskin 1/160
Insertive Anal Sex Circumcised 1/900
Receptive Vaginal Sex 1/1250
Insertive Vaginal Sex 1/2500
Oral Sex Extrememly Low
Needle Stick Injury 1/440
Mucuos Membrane or Broken Skin Contact <1/1000

*risk calculated assuming sexual partner is HIV positive and not on HIV treatment.
Using condoms with sex eliminates the risk of HIV transmission.
A person living with HIV on successful treatment (undetectable viral load) can not transmit HIV

Questions About Specific Sexual Acts.

Can I Get HIV From Massage?

Massage and rubbing bodies against each other presents no risk of passing on HIV.

HIV is not able to be transmitted through intact skin.

If you have any cuts, sores or open wounds it is best to avoid massage or contact with bodily fluids.

Massage is a fun, safe and therapeutic way to relax. Occasionally a massage have erotic elements so such as masturbation or oral sex of which are also considered safe from HIV risk.

Can I Get HIV From Masturbation?

Masturbation both solo and mutual is not a risk for acquiring HIV.

Even if bodily fluids such as semen or vaginal secretions come into contact with your skin, as long as there are no cuts, sores or open wounds you are safe.

Masturbation is an excellent choice for fun safe sex with yourself, partner or partners.

Can I Get HIV From Oral Sex?

HIV can not be transmitted via oral sex. There is a very small theoretical risk if there is any breaks in the skin, ulcers, sores or cuts on the genitals or in the mouth.

For a man receiving oral sex there is no risk of HIV transmission if the skin of the penis is intact.

While HIV can be transmitted in vaginal secretions the exposure to these are very low for a person giving oral sex to a woman. Saliva also contains enzymes that kill HIV.

A person giving oral sex to a man again has a low risk if there is no ejaculation or precum present. Volumes of precum is usually quite low and the enzymes in saliva would degrade any HIV present.

Ejaculation into the mouth poses a very low risk of HIV again due to saliva as well as stomach acid killing the virus. Spitting out semen and washing the mouth also removes virus particles.

If there are any ulcers, cuts, sores in the mouth or recent dental extractions it is best to avoid oral sex with ejaculation.

Use of condoms or dental dams for oral sex with both men and women essentially eliminate any risk of HIV being passed.

Good dental care is recommended such as daily flossing and brushing of teeth.

Can You Get HIV From Kissing?

Saliva contains proteins and a low salt content that actively reduce its infectiousness.

Even when HIV is detected there is too little to cause infection.

HIV is not transmitted by kissing including deep kissing. Spit cannot transmit HIV.