Dangerous misconceptions about HIV (human immunodeficiency virus) do the rounds — and many of those "myths" greatly contribute to the stigmatization of people who live with HIV.
Research reveals, for instance, that a third of US young adults wrongly believe that they could "catch" HIV by drinking from a glass of water previously used by someone with HIV, or sitting on a toilet seat that was occupied by a HIV+ person.
A quick primer: What's HIV?
HIV, or human immunodeficiency virus, is lifelong, once acquired. When untreated, the virus attacks the body's CD4 cells, also called T cells, which play a key role in the immune system, leaving patients vulnerable to infections and cancers caused by them.
HIV has three stages. Soon after initial infection (a stage called "acute infection"), a person may experience flu-like symptoms in response to the infection. This stage is highly contagious. HIV then enters its "clinical latency" stage — also referred to as the dormant or inactive phase — during which they may not have any symptoms.
Untreated HIV infections can remain in this stage for more than a decade, but they can also enter the final stage, AIDS (acquire immunodeficiency syndrome) much more quickly. Once a person develops AIDS, they are incredibly vulnerable to opportunistic infections and cancers. Without treatment, the average person lives just three years after AIDS is diagnosed.
What bodily fluids can transmit HIV, and how?
A pretty broad but not unlimited range of human bodily fluids can transmit HIV:
- Blood
- Semen and pre-ejaculate fluids
- Rectal fluids
- Vaginal fluids
- Breast milk
Not just any kind of contact will transmit HIV. For transmission to occur, there has to be direct contact. That can mean contact with an open wound, or HIV-containing blood being directly injected into the blood stream, or contact with a mucus membrane. These are found in all sorts of places in the body, but for our purposes, the main ones are found in the genitals, rectum, and also the mouth.
If saliva can't transmit HIV, that means kissing is safe, right?
Yes, usually, and that's why kissing is unlikely to be on the radar of anyone considering safe sex for mixed status couples.
However, there's a theoretical chance that certain kinds of kissing — you know, the kind that goes by terms like "making out", "French kissing", "tongue kissing", and "deep kissing" — could facilitate contact with blood. This is because it's possible that both kissers have very small and bleeding injuries in their mouths, caused by things like gum disease and cheek-biting.
Research into this mode of transmission is already very dated, with two different studies published in 1989 (here and here, for your reference). A few years after these studies came out, this literature was joined by one single case study in which HIV was most likely transmitted this way. Both partners reported sexual intercourse exclusively with condoms, and both had bleeding in the oral cavity when the previously HIV negative partner tested positive.
If you just want to peck a friend or relative with a different HIV status than you on the cheek, or receive a cheek-kiss, you're also good to go.
But wait — the fact that it's extremely unlikely to get HIV from deep kissing doesn't mean it's actually safe!
There's (much more recent) evidence that oropharyngeal gonorrhoea can be transmitted via deep kissing. The same goes for another very nasty sexually transmitted infection, syphilis. We haven't even mentioned cytomegalovirus, a common virus that can sometimes lead to mononucleosis, and different kinds of herpes (HSV-1 and HSV-2) yet.
It's still up for debate which kinds of viral hepatitis may be transmitted through kissing, and plenty of infections not considered sexually-transmitted can be "caught" through kissing. Anyone who wants a complete list can look at this research paper on viral diseases that can be transmitted through kissing.
In this day and age, I'm sure readers are already aware that coronaviruses made the list, and that social distancing for COVID-19 means no kissing — as well as no hugging, shaking hands, or really being anywhere near anyone who doesn't already live with you.
A final word
There's an exceedingly small risk of acquiring or transmitting HIV through deep kissing, with only one documented case in existence. Mixed status couples with gum disease or similar issues that are likely to cause oral bleeding will want to discuss the possibility with their doctors though, in case the HIV positive partner has a higher viral load.
Passionate kissing is not, however, the risk-free activity we've all grown to believe it is, since it can facilitate the transmission of viruses that absolutely do have the potential to kill, including COVID-19. This should be on your radar, especially if you live with HIV.
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