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Being Alive

Preventing HIV Transmission During Cunnilingus and Rimming


Being Alive 1992 Feb 5: 14

What is the risk of HIV transmission during cunnilingus (oral sex on a woman) or analingus (rimming)? The risk is fairly low, and there are no documented cases of HIV having been transmitted in either of these ways. However, because HIV is present in the vaginal fluid, menstrual blood and feces of an infected woman or man, public health care workers recommend use of a barrier to protect the person doing the oral sex/rimming. Barriers are also particularly advisable for use during rimming, because of the risk of transmitting other microorganisms, parasites, and the like.

WHAT BARRIERS CAN BE USED? There are no barriers which have been manufactured or tested specifically for their ability to prevent HIV transmission during oral sex. However, some experts believe that both plastic wrap (Saran Wrap, Glad Wrap, etc.) and latex dental dams are effective for this purpose. (Contrary to community rumors, either the microwaveable or non-microwaveable versions of plastic wrap can be used. Please note that plastic bags, "baggies," trash bags, etc. are not recommended, as they are considerably weaker than plastic wrap.) Why are these barriers believed to be effective? Plastic wrap prevents fluid leakage, and if there is no fluid leakage, there can be no viral transmission. Also, testing of Glad Wrap brand (and we assume this to be true of other brands as well) has shown it to prevent passage of the herpes virus, which is approximately the same size as HIV. Latex condoms have been proven to be an effective barrier to HIV transmission, so one assumes that latex dams function the same way. However, it is important to remember that neither of these types of barriers have been specifically proven to prevent HIV transmission during oral sex (because such tests have not been done, and would be very difficult to conduct.) WHICH IS BETTER DENTAL DAMS OR PLASTIC WRAP? Both dental dams and plastic wraps have pros and cons. Plastic wrap is cheaper, more easily and widely available, thinner, better at conducting heat and sensation, see-through, easier to use (because it can be used in larger pieces). However, dental dams are made of a material (latex) which has been specifically shown to prevent passage of HIV, while plastic wrap has not. They are thicker than plastic wrap, and therefore less likely to be torn by fingernails or teeth.

HOW ARE THESE BARRIERS USED? - Use a new piece of plastic wrap, or a new dam, each time.

- If using plastic wrap: tear off a big piece, so you can cover all the necessary parts. (Be careful not to tear it with your fingernails or teeth. A double thickness of wrap may help prevent tearing.) - Put some water-based lubricant on your partner's vulva or anus (whichever you intend to lick).

- Put some of the same lubricant on one side of the plastic wrap/dam.

- Hold the lubricated (sticky) side of the wrap or dam against your partner's vulva or anus.

- Now you are free to do whatever you like with your mouth, and both of you will stay safe.

- When you are done, throw the piece of wrap or the used dam away. If you are in the middle of sex and you've forgotten which side is which, throw it away, and use a new piece.


Information in this article was accurate in February 5, 1992. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.