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The Biologic Possibility of HIV Transmission During Passionate Kissing

John C. Petricciani, MD
JAMA. 1989;262(16):2231. doi:10.1001/jama.1989.03430160048020.
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To the Editor.—  Piazza et al1 recently presented evidence that microlesions of the oral mucosa occur during passionate kissing and that small amounts of blood could be found in saliva. They then suggested that because of the presence of blood in saliva after passionate kissing, human immunodeficiency virus (HIV) may be transmitted by the oral route and that kissing should not be considered safe.In contrast to those conclusions, there is considerable evidence pointing toward an extremely low probability that passionate kissing contributes significantly to new HIV infections. Perhaps the most compelling fact is that the risk of infection has been consistently less than 1% in follow-up studies of health care workers who were exposed to the blood of HIV-infected persons through accidental needle sticks.2 Since the risk of transmitting HIV through small amounts of blood by the direct parenteral route is so low, one would assume an


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