Is HIV transmissible through oral sex? Experts weigh in

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Oral sex is the act which involves the use of the mouth, lips or tongue to stimulate a partner’s genitals or anus.

According to Dr. Deano Reyes, an LGBTQ+ health doctor and the medical director of Hara Clinic, a holistic gender and sexual health clinic, people engage in oral sex for pleasure, sexual satisfaction, intimacy, and exploration. 

It serves as a non-penetrative alternative to intercourse, which helps reduce the risks of pregnancy or HIV transmission, and is a way for some people to connect physically and emotionally. 

“It's for pleasure, intimacy, and exploration as an alternative to penetrative sex. And siyempre ‘yung for straight couples, ‘yung the risk of pregnancy, for LGBTQ couples, ‘yung risk of HIV,” Reyes said.

There are also three types of oral sex which involve the penis, the vulva, and the anus.

“Fellatio, that is your oral stimulation of the penis or also known as blowjob. Cunnilingus is the oral stimulation of the vulva or the vagina. Tapos 'yung analingus, also known as rimming, is ‘yung oral stimulation of the anus,” Reyes explained. 

“In more colloquial Filipino terms, fellatio is subo, ‘yung pagsubo doon. Cunnilingus is ‘yung kain or ‘yung brocha. Kain ng pwet ay analingus.”

Oral sex is also a “very good way” to initiate foreplay, a form of sexual activity that precedes sexual intercourse.

“Mas may control ka over the rhythm, over the teasing, ‘yung mga ganun. That's why in many ways, oral sex is actually a very good way to initiate foreplay. It's good for foreplay before you go to the main event of actual full-on sex,” Reyes explained. 

For Ico Johnson, the vice president of My Hub Cares, an HIV and sexual health clinic in the Philippines, oral sex provides an alternative form of pleasure for people with sexual dysfunction or when penetrative sex is not possible. 

“Ang oral sex din kasi isang paraan kung saka-sakaling may inability to penetrate. Hindi penetrative ‘yung sex, ibig sabihin kung isang lalaki, kung siya ay disabled, maaaring nagkaroon ng spinal cord injury at maaaring may impotence na siya, so may other ways to pleasure a partner and ito ‘yung oral sex,” Johnson told GMA News Online. 

“Dito rin pumapasok na pag-uusapan ‘yung sex in the elderly kung saan hindi na talaga nakaka-penetrate [ang] isang lalaki sa kanyang asawa o ‘yung isang lalaki na nakaka-penetrate sa partner niya per se.” 

Sexual arousal and its benefits

Oral sex stimulates erogenous zones rich in nerve endings, triggering a release of dopamine, oxytocin, and endorphins—also known as the happy hormones. 

“Being able to stimulate that area will really start triggering that chain reaction of hormones and neurotransmitters that will make you feel good. So we talk about dopamine, oxytocin, endorphins, all of these brain chemicals that are linked to pleasure and bond,” Reyes explained. 

“So, just stimulating the penis will be able to do that. In many ways, people also prefer the control that is exerted over oral sex kasi your tongue can reach places that a vagina or an anus will not be able to.” 

Per Reyes, oral sex not only lowers the risk of HIV transmission and pregnancy, but also promotes greater sexual satisfaction, increased intimacy and trust, and serves as an alternative for LGBTQ+ couples or those who prefer non-penetrative options.

“It will also in many ways increase the intimacy and trust between partners. It's a very, very intimate thing for people to do. Ang mouth is also a zone or an area where we get to be very careful with. It’s also correlated with a lot of intimacy such as kissing.”

Myths and misconceptions 

Does drinking pineapple juice make semen taste better? Drinking pineapple juice can affect the semen’s taste due to its sugar content, but other factors like smoking play a bigger role in its taste, according to Reyes. 

“‘Yung explanation diyan actually is the high sugar content and the mild acidic nature of pineapple juice can circumvent ‘yung bitterness that semen can have. So it might make it taste a bit better,” he explained. 

“Pero ano kasi siya eh, there's a lot more other factors to that. So for example, smoking makes your semen taste bitter. So [that's] more important than pineapple juice.” 

Does semen make the skin glow? Contrary to some claims, there is no scientific evidence that semen is good for your skin or makes the skin glow.

Johnson, however, noted that sex can give a person a sense of fulfillment, adding that this can help one feel beautiful and complete. 

“I think [sex] completes a person. Kasi siyempre, sex is a normal human behavior and kung wala ka ng aspect na 'yun, the tendency is, siyempre parang hindi ka complete. So, when you are fulfilled, parang okay, there's a certain satisfaction na na-reach mo and it completes you. So maybe that's the reason,” Johnson explained. 

“Medyo blooming ka. It completes you. it's more psychological. Kasi nga, siyempre, you feel beautiful, you feel pretty, you feel fulfilled. Kasi nga, may nagbigay sa 'yo ng pleasure." 

It is safe to swallow semen but… Swallowing semen during oral sex is generally safe, according to Johnson, but only if your partner is healthy and free from any infections. It is best to discuss your partner’s health status openly.

“Safe naman siya. Safe in terms of kung walang other infections, it's safe. Kung healthy ‘yung individual, meaning ‘pag wala siyang other infections, then we can say that it's okay, pero kung meron siyang other infections, then it becomes unsafe,” he noted. 

Can you get HIV and other STIs from oral sex? Yes, you can, although the risk is lower than penetrative sex.

But while the risk of HIV transmission through oral sex is low, there is still a possibility of acquiring other STIs like Human papillomavirus (HPV), gonorrhea, chlamydia, syphilis, and herpes, according to Reyes. 

"May mga certain STIs that are specifically strained for oral sex such as herpes simplex [virus type] 1 (HSV-1)," he said.

HPV — the same virus responsible for cervical cancer in women — has also been linked to most cases of oropharyngeal cancer

Reyes also shared data from the Centers for Disease Control and Prevention (CDC) that showed oropharyngeal squamous cell carcinoma rates increased 2.7% per year among men and 0.8% per year among women between 1999 to 2015 in the United States. 

He added, "Ang nakikita rin naming data ngayon is that tumataas ang cases of oropharyngeal cancers amongst MSM and transgender women who participate in oral sex. So 'yung HPV or virus responsible for cervical cancer amongst women tumatama na rin 'yan for men and transgender women, pero ang natatamaan is the throat." 

PSA: You can still get HIV through oral sex

Although the risk of getting HIV is low through oral sex, it is never zero, as the virus can enter the bloodstream through cuts or wounds in the mouth.

“The hallmark of HIV or parang how you transmit HIV talaga is you need portal of entry. There has to be a way for the blood or bodily fluid to enter into your bloodstream. So ang pinakaculprit diyan is kung may sugat ka in ‘your oral cavity. Sa gums mo, sa dila mo, sa cheeks mo. ‘Yun 'yung pinaka potential entry point ng HIV,” Reyes said. 

Johnson also noted that the risk of getting HIV through mouth sores is low. 

"Kung ikaw ay giver, kung ikaw ang nag-provide ng oral sex at kung nagkaroon ng exposure sa vaginal fluid at saka sa seminal fluid at ikaw ay may mouth sore, the chances for HIV to enter the bloodstream is very low kasing may barrier pa rin tayo ng saliva kaya masyadong mababa," he said. 

"You would get other STIs na skin-to-skin lang maaari ka nang mahawaan, katulad ng gonorrhea, ng syphilis, ng chlamydia, ng HPV," he added. 

Condoms, dental dams, and oral hygiene 

Despite the low risk of HIV transmission and other STIs through oral sex, however, Reyes and Johnson emphasized the importance of practicing safe sex to prevent infection.

As a sexual health doctor, Reyes advised against brushing or flossing within an hour before sex to avoid the risk of bleeding gums, which can increase vulnerability to infections. One can opt for mouthwash to maintain oral hygiene instead. 

“Stop doing that. Don't do that. Kasi pwede mong masugatan talaga ‘yung gums mo. Magbrush ka ng teeth mo, dudugo ka. So ‘yun, pwede maging ‘yun ‘yung portal of entry mo,” he explained. 

“Kung gusto mong magpa-fresh before oral sex, mag-mouthwash ka na lang. Huwag ka mag-brush ng teeth, huwag ka mag-floss at least like an hour before sex,” he added. 

Reyes also recommended using flavored condoms which can give a more pleasurable experience.

“Condoms are there for a reason. Meron tayo mga flavored condoms. So wala namang taste buds ang puwet or ang vagina, so bakit ba tayo may mga condoms na chocolate-flavored, watermelon-flavored? It's for the oral sex, para mas ma-enjoy mo ‘yung experience of giving a blowjob maski may condom,” he said. 

It is also advised to avoid ejaculation in the mouth unless those involved have been tested for STIs or are taking Pre-Exposure Prophylaxis (PrEP), a daily medication that offers 99% protection against HIV. 

Meanwhile, Johnson suggested using dental dams, a thin, flexible sheet usually made of latex or silicone used as a barrier during oral sex to reduce the risk of transmitting STIs. 

“Ilalagay ‘yan sa vulva or doon sa area na vagina or sa anus so para siyang thin film na kung saan, alam mo ‘yun ‘yung condom na very thin na hindi mo maramdaman na meron. Maaaring ‘yun pero it's still pleasurable for the receiver. ‘Yun ang isa pang paraan para makaiwas dun sa HIV at sa STIs,” he said. 

He also emphasized the importance of cleaning one’s genital area before engaging in oral sex to promote comfort and maintain oral health. 

Johnson and Reyes likewise encouraged people of all sexes to get the HPV 9-valent vaccine, also known as Gardasil 9, which helps protect against nine types of HPV.

Meanwhile, there are still no vaccines to prevent STIs like gonorrhea, chlamydia, and syphilis, so regular testing remains the best way to stay protected.

‘Landi responsibly’ 

Since oral sex carries a risk of transmitting HIV and STIs, Reyes stressed the importance of regular testing, which can be done in different medical facilities in the country.

“I encourage all my patients, every three months, pa-screen tayo ng HIV and syphilis. Then every six months, pa-screen tayo ng all the other STIs na pwede, like chlamydia, gonorrhea, or ganoon,” Reyes noted. 

Having multiple or casual sexual partners is okay, but as the medical doctor humorously put it, “Pwede naman maging malandi, but landi responsibly,” and encouraged those who engage in casual sex to get tested more than often. 

“A lot of STIs are asymptomatic. Especially kunwari oral sex lang ‘yan. Kung sa mouth and throat lang ‘yan. You won't feel anything. You won't even know it's there. So you need to get screened and tested to make sure na clear ka of your illnesses,” he said. 

“Kung meron man, kunwari nag-positive ‘yung test, relax lang. Gagamutin lang natin ‘yan.” 

Consent matters, communication is key 

Aside from safety and preparation, one of the most important aspects to consider before engaging in oral sex is mutual consent and open communication with one's partner.

“Consent is absolutely crucial to any sort of sexual activity. Aspects of consent that make it valid, so kailangan consent is freely given. 'Di ka napipilitan to do it," Reyes said.

When it comes to consent, both partners should be fully informed about their choices; consent should also always be reversible and respected at any point.

“Consent is very important. How can you have pleasure kung wala kang consent? So napaka-importante ‘yung consent kasi kung ayaw mo, ayaw mo. So basically no is no. At the end of the day, kailangan maging pleasurable. It's a union between two bodies, kailangan nakakaintindihan ‘yung katawan niyo,” Johnson added. 

If you're thinking about having oral sex but are not sure if your partner's into it, just have an honest conversation. Communication is key, after all.

“So tatanungin mo lang naman sila, like, are you into this? Gusto mo ba ng blowjob? Mahilig ka ba sa blowjob? Pwede mo ba ako bigyan ng blowjob? Pwede mo ba subo? Comfortable ka ba dito? Those are very simple ways to do it," Reyes shared.

Staying informed

In a predominantly Catholic country like the Philippines, sex and intimacy can still prove to be thorny taboo topics.

Per Johnson, self-stigma is a “barrier in preventing STIs and HIV," noting, "Be educated and be aware and be empowered. Empowerment comes with being educated and aware." 

Reyes also believes it is high time to normalize open conversations about sex.

“We really need to start normalizing the conversations of sex. Being able to have safe conversations with healthcare providers, having comprehensive sex education, which doesn't mean promoting sex,” he said. 

Emphasizing the importance of a Comprehensive Sexuality Education, the safe sex advocate and medical doctor said this can equip the youth with the knowledge they need about sex and help them make informed decisions.

“Internationally, pinapakita na comprehensive sex education platforms integrated into school systems decrease the number of kids having sex,” said Reyes. 

“Kasi pag alam mo na ‘yung may nangyayari, pag mas informed ka na, doon ka na makakamake na decision na parang, ‘Ay, ayoko pala ‘yan gawin.’ As opposed [to] kung wala kang education or wala kang knowledge, papasukin mo na lang ‘yung sex situation not really knowing the potential risks and consequences you might have.” 

—CDC, GMA Integrated News