Dear Alice,

I have been sexually active with a woman who believes she has HIV. We have not had intercourse or oral sex. We tongue kiss, caress, and heavy pet. We have not exchanged any body fluids (semen, blood) except saliva. I bite my inner lips (a nervous habit). Should I be taking any precautions that I haven't been already? I suppose I'm most worried about blood swapping in our mouths.

—Lip biter

Dear Lip biter,

Fortunately, a little tonsil hockey carries minimal risk of transmitting HIV. To alleviate some of your worry, it might help to understand more about how HIV is spread. The virus may be transmitted when infected blood, semen, or vaginal and cervical secretions enters the body. Transmission routes may occur through contact with mucous membranes or an open wound, the injection of infected blood or blood products (i.e., with shared needles), perinatal transmission (from infected mother to fetus, especially during childbirth), and breastfeeding (from infected mother to baby).

The critical point is that there must be HIV-infected fluids (listed above) entering your body. You mentioned that you kissed a person who "believes" she has HIV. Does she know for sure? The only verification is taking an HIV test. Feeling sick or having had HIV risk doesn't warrant an assumption of having HIV. You could alleviate much of your concern if both of you get tested for HIV — being as informed as possible about each other's status is an important part of making decisions about your sex life. If your partner ends up not having HIV, keeping in mind the window period, then you have no risk of HIV infection from this partner. However, if your partner really has HIV, you may consider precautions to reduce your risk of HIV infection.

For the second part of the critical point, HIV-infected fluids must enter your body. Kissing is a very low risk activity, in part, because it seems saliva has an inhibitory factor that prevents HIV from being actively transmitted. Infected blood has to come into contact with open cuts or sores in your mouth to increase the risk, and even then the risk would still be low compared to other sexual activities. The two of you may talk about your sexual histories and the potential risks together, and then negotiate what you two are comfortable with. If you engage in, for example, oral sex and your biting actually breaks the skin inside your lip, oral sex may increase the risk. The risk increases because the concentration of HIV is high in infected vaginal fluids and semen. In order to be safer, you may want to consider using dental dams or some other physical barrier or only performing oral sex when you know your lip isn't bleeding. Check out the Safer Sex Archives for more safer, yet sexy tips.

To know your partner's and your HIV status, consider taking an HIV test. Most city and state health departments offer a variety of HIV tests for free and results are usually ready within an hour. Most testing locations come with counseling to help you reduce your risk for HIV and other STIs.

For now, you sound like you're proceeding carefully. For the future of your sex life, consider further investigation through HIV testing and continue your safer sex practices to have fewer lip biting worries!


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