Aa
HIV risk assessment required
Dear Dr.
72 days ago I had a sex with an escort transgender in Dubai. She was from Eastern Europe. I had unprotected oral sex both giving and receiving and I had protected anal sex both receptive and insertive.
After 5 days I had burning feeling in my bladder where I had to urinate every 5 minutes or so. I tested negative for all possible STDs but I received doxycycline, Zithromax and metronidazole. And later I got 1 G of Cefaxone (intravenous) and later 500 mg of Cefixime for 5 days. I had HIV, HBC and HCV PCR qualitative test after 10 days (results: not detected), tested HIV combo after 21, 40, and 72 days (results: nonreactive). I tested negative for syphilis after 40 and 72 days (VDRL and TPHA tests). Two questions in my mind: Why the HIV 4th generation test is considered accurate after 30 days when it test for IgM and P24 Antigen, and the 3rd generation tests detecting IgM is considered conclusive after 90 days, although P24 antigen is produced only couple of days before antibodies. Second, do I need conclusive tests for the above STDs risks at the 90 days?
72 days ago I had a sex with an escort transgender in Dubai. She was from Eastern Europe. I had unprotected oral sex both giving and receiving and I had protected anal sex both receptive and insertive.
After 5 days I had burning feeling in my bladder where I had to urinate every 5 minutes or so. I tested negative for all possible STDs but I received doxycycline, Zithromax and metronidazole. And later I got 1 G of Cefaxone (intravenous) and later 500 mg of Cefixime for 5 days. I had HIV, HBC and HCV PCR qualitative test after 10 days (results: not detected), tested HIV combo after 21, 40, and 72 days (results: nonreactive). I tested negative for syphilis after 40 and 72 days (VDRL and TPHA tests). Two questions in my mind: Why the HIV 4th generation test is considered accurate after 30 days when it test for IgM and P24 Antigen, and the 3rd generation tests detecting IgM is considered conclusive after 90 days, although P24 antigen is produced only couple of days before antibodies. Second, do I need conclusive tests for the above STDs risks at the 90 days?
Thank you Teak and RainLover, your contributions gave me more comfort on understanding my situation and I agree there is a very very low risk in protective anal and unprotected oral, nevertheless I still believe it is not a "no risk" practice. Teak I admire your efforts in the forum
Oral sex.
No incident HIV infections among MSM who practice exclusively oral sex.
Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WePpC2072)??Balls JE, Evans JL, Dilley J, Osmond D, Shiboski S, Shiboski C, Klausner J, McFarland W, Greenspan D, Page-Shafer K?University of California, San Francisco, San Francisco, United States
Oral transmission of HIV, reality or fiction? An update
J Campo1, MA Perea1, J del Romero2, J Cano1, V Hernando2, A Bascones1
Oral Diseases (2006) 12, 219–228
AIDS: Volume 16(17) 22 November 2002 pp 2350-2352
Risk of HIV infection attributable to oral sex among men who have sex with men and in the population of men who have sex with men
Page-Shafer, Kimberlya,b; Shiboski, Caroline Hb; Osmond, Dennis Hc; Dilley, Jamesd; McFarland, Willie; Shiboski, Steve Cc; Klausner, Jeffrey De; Balls, Joycea; Greenspan, Deborahb; Greenspan
Page-Shafer K, Veugelers PJ, Moss AR, Strathdee S, Kaldor JM, van Griensven GJ. Sexual risk behavior and risk factors for HIV-1 seroconversion in homosexual men participating in the Tricontinental Seroconverter Study, 1982-1994 [published erratum appears in Am J Epidemiol 1997 15 Dec; 146(12):1076]. Am J Epidemiol 1997, 146:531-542.
Studies which show the fallacy of relying on anecdotal evidence as opposed to carefully controlled study insofar as HIV transmission risk is concerned:
Jenicek M. "Clinical Case Reporting" in Evidence-Based Medicine. Oxford: Butterworth–Heinemann; 1999:117
Saltzman SP, Stoddard AM, McCusker J, Moon MW, Mayer KH. Reliability of self-reported sexual behavior risk factors for HIV infection in homosexual men. Public Health Rep. 1987 102(6):692–697.Nov–Dec;
Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990 Nov;108(3):339–362.
There is no debate (among experts) about the HIV risks associated with oral sex. The risk is so low that almost nobody who cares for HIV infected patients has ever had a patient believed to have been infected that way. Among experts, it's a semantic issue about using terms like "no risk" and "very low risk". There is no difference between my or Dr. Hook's use of "low risk" and other experts' "no risk".
DR. HANSFIELD
"And oral sex is basically safe sex -- completely safe with respect to HIV and although not zero risk for other STDs, the chance of infection is far lower than for unprotected vaginal or anal sex. Please educate yourself about the real risks. If you stick with oral sex and condom-protected vaginal or anal sex, you have no HIV worries and very little worry about other STDs. " DR HANSFIELD
"I am sure you can find lots of people who believe that HIV is transmitted by oral sex, but you will not find scientific data to support this unrealistic concern..." DR HOOK
"HIV is not spread by touching, masturbation, oral sex or condom protected sex."- DR. HOOK
in the public HIV Prevention forum of MedHelp, TEAK and the other moderators maintain that oral sex in all forms is a zero risk activity. Would you agree with this assessment?
I TOTALLY AGREE / DR GARCIA
"HIV is not spread by masturbation, through oral sex, through kissing or other casual contact." Dr. Hook
"The observation on thousands and thousands of observations is that HIV is not spread by oral sex (of any sort)." DR HOOK
"I would not say your risk ,if he had HIV is "slim to none"- that's too high. I would say they are effectively zero. How much of his ejaculate or other genital secretions you may have swallowed makes no difference. EWH "
"As far as HIV is concerned, there is no known risk of getting HIV from performing oral sex on an infected partner, even if that person's genital secretions get into your eyes or if you swallow." Dr.Hook
HIV is not spread by oral sex, giving or receiving, even if sores, gum disease or blood is present
DR HOOK
The fact is that there are no cases in which HIV has been proven to be transmitted by oral sex, including fellatio.. EWH
No incident HIV infections among MSM who practice exclusively oral sex.
Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WePpC2072)??Balls JE, Evans JL, Dilley J, Osmond D, Shiboski S, Shiboski C, Klausner J, McFarland W, Greenspan D, Page-Shafer K?University of California, San Francisco, San Francisco, United States
Oral transmission of HIV, reality or fiction? An update
J Campo1, MA Perea1, J del Romero2, J Cano1, V Hernando2, A Bascones1
Oral Diseases (2006) 12, 219–228
AIDS: Volume 16(17) 22 November 2002 pp 2350-2352
Risk of HIV infection attributable to oral sex among men who have sex with men and in the population of men who have sex with men
Page-Shafer, Kimberlya,b; Shiboski, Caroline Hb; Osmond, Dennis Hc; Dilley, Jamesd; McFarland, Willie; Shiboski, Steve Cc; Klausner, Jeffrey De; Balls, Joycea; Greenspan, Deborahb; Greenspan
Page-Shafer K, Veugelers PJ, Moss AR, Strathdee S, Kaldor JM, van Griensven GJ. Sexual risk behavior and risk factors for HIV-1 seroconversion in homosexual men participating in the Tricontinental Seroconverter Study, 1982-1994 [published erratum appears in Am J Epidemiol 1997 15 Dec; 146(12):1076]. Am J Epidemiol 1997, 146:531-542.
Studies which show the fallacy of relying on anecdotal evidence as opposed to carefully controlled study insofar as HIV transmission risk is concerned:
Jenicek M. "Clinical Case Reporting" in Evidence-Based Medicine. Oxford: Butterworth–Heinemann; 1999:117
Saltzman SP, Stoddard AM, McCusker J, Moon MW, Mayer KH. Reliability of self-reported sexual behavior risk factors for HIV infection in homosexual men. Public Health Rep. 1987 102(6):692–697.Nov–Dec;
Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990 Nov;108(3):339–362.
There is no debate (among experts) about the HIV risks associated with oral sex. The risk is so low that almost nobody who cares for HIV infected patients has ever had a patient believed to have been infected that way. Among experts, it's a semantic issue about using terms like "no risk" and "very low risk". There is no difference between my or Dr. Hook's use of "low risk" and other experts' "no risk".
DR. HANSFIELD
"And oral sex is basically safe sex -- completely safe with respect to HIV and although not zero risk for other STDs, the chance of infection is far lower than for unprotected vaginal or anal sex. Please educate yourself about the real risks. If you stick with oral sex and condom-protected vaginal or anal sex, you have no HIV worries and very little worry about other STDs. " DR HANSFIELD
"I am sure you can find lots of people who believe that HIV is transmitted by oral sex, but you will not find scientific data to support this unrealistic concern..." DR HOOK
"HIV is not spread by touching, masturbation, oral sex or condom protected sex."- DR. HOOK
in the public HIV Prevention forum of MedHelp, TEAK and the other moderators maintain that oral sex in all forms is a zero risk activity. Would you agree with this assessment?
I TOTALLY AGREE / DR GARCIA
"HIV is not spread by masturbation, through oral sex, through kissing or other casual contact." Dr. Hook
"The observation on thousands and thousands of observations is that HIV is not spread by oral sex (of any sort)." DR HOOK
"I would not say your risk ,if he had HIV is "slim to none"- that's too high. I would say they are effectively zero. How much of his ejaculate or other genital secretions you may have swallowed makes no difference. EWH "
"As far as HIV is concerned, there is no known risk of getting HIV from performing oral sex on an infected partner, even if that person's genital secretions get into your eyes or if you swallow." Dr.Hook
HIV is not spread by oral sex, giving or receiving, even if sores, gum disease or blood is present
DR HOOK
The fact is that there are no cases in which HIV has been proven to be transmitted by oral sex, including fellatio.. EWH
HIV is unable to reproduce outside its living host (unlike many bacteria or fungi, which may do so under suitable conditions), except under laboratory conditions; therefore, it does not spread or maintain infectiousness outside its host.
HIV is transmitted by;
Unprotected penetrative anal and/or vaginal sex
Sharing works with other IV drug users
Mother to child
HIV is transmitted by;
Unprotected penetrative anal and/or vaginal sex
Sharing works with other IV drug users
Mother to child
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