HomeAnswersInternal MedicinehivThe girl used her saliva for lubrication. Can I be HIV positive?

Can saliva cause HIV infection?

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Can saliva cause HIV infection?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At November 8, 2017
Reviewed AtApril 17, 2024

Patient's Query

Hello doctor,

My question is regarding possible HIV exposure six weeks ago. The condom protected vaginal and oral although she did masturbate me without a condom and used spit for lubrication. I took the fourth generation ELISA at four weeks and five weeks and both were negative. I was on a testosterone cycle and stopped two weeks prior to the meeting. I would like to know if my tests are conclusive. Would spit cause concern? Would my previous testosterone cycle have affected my tests? I would like to hear from you soon.

Hello,

Welcome to icliniq.com.

I am pleased to help you with your concern.

The risk of transmission of the HIV (human immunodeficiency virus) in the scenario you have described is extremely low, even if your sexual partner was an infected carrier.

There is very little evidence to support a high transmission risk via saliva and practically, it is not regarded as a concern unless there is an open erosion or an ulcer in the area exposed to the saliva. Testosterone does not affect the accuracy or result of the HIV ELISA (enzyme-linked immunosorbent assay) test. The strictest protocols advise a final HIV test six months after exposure to finally conclude non-transmission in the case of a very rare, long window period that is a negative test but actually infected. The chances that you contracted HIV from the above history are extremely low. I would suggest a final repeat ELISA in four months' time. If this test is also negative, it can be regarded as conclusive.

Patient's Query

Hi doctor,

Thank you for the reply.

I have read that the fourth-generation tests are accurate and conclusive in a month and more. My test was done using AB/AG assay and both were negative at four and five weeks. Most doctors would say six weeks is conclusive. What is your opinion?

Hello,

Welcome back to icliniq.com.

The fourth generation test does shorten the period to possibly conclusively to 12 weeks, that is, plus or minus 90 days. Considering the conclusively with either of the tests before 12 weeks is not correct if one uses conservative protocols, which allow for the very rare cases where patients mount a delayed immune response.

The history you gave detailing a single exposure and the negative assays at 30 days make the likelihood that you were infected extremely unlikely. But I would not be able to use the word 'conclusive' unless there is another negative test at 12 weeks. The fourth generation is fine.

I would advise a final repeat at 12 weeks and relaxing in the meantime.

Patient's Query

Hi doctor,

Thank you for the reply.

Yesterday, I did the combo test, and the result was negative. It is basically five months after my potential exposure. I have read that testosterone would defect the effect, although my last shot was taken 22 weeks ago. Even I was on a 12-week cycle of anabolics prior to the incident? I have taken at least 10 combo tests in the last five months along with at least 5 POC tests at clinics and all have been negative. Would you say in your opinion that I am conclusively HIV-negative?

Hi,

Welcome back to icliniq.com.

Yes, you can take your current non-reactive (negative) test result at five months, which is confirmed and, in keeping with multiple previous tests during that period, as conclusive. There is no good evidence (Grade 1/2/3) that proves a causal relationship between testosterone and window period alteration. Studies could be suggestive of some (unproven) exactly what influences some individuals at best. Medical evidence (studies) is a very difficult science just to interpret (read in) correctly in itself.

Congratulations, you can relax now and put this issue to rest.

Make sure you keep yourself safe, so you never have to be so concerned about possible infection again.

I wish you a good day and a healthy year further.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Jeremy David O' Kennedy
Dr. Jeremy David O' Kennedy

HIV/AIDS specialist

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