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HIV Prevention (Expert Forum)
What are the known facts
by justc, Jun 09, 2006 12:00AM
Dear Dr. H
I have been following the Q&A forum on HIV and sefe sex. Your advice on wide ranging issues is surely a great help to the people who ask the questions and also very informative to others.
I have some general questions, hope you dont mind, which I guess may be of interest to other also. Please accept my apologies if you have answered the same in past, but may have been in different threads.
1) I have read on many websites that some people may go without any symptoms of HIV for quite some time, while others do get one or more symptoms. Is there any data on what percentage do these people represent who go without symptoms for quite a while?
2) I have understood from replies to many questions on this forum that sex without ejaculation may be less risky than otherwise. The ejaculation in these cases (riskier) is considered more risky if inside her (anal / vagina / mouth) vs. if the man was to pull out and ejaculate on the body (for instance(so long as ejaculation was not inside her)?
3) In the people who do show symptoms, do these symptoms always stay for 6 to 7 days and go away, or is it possible that these symtoms could only last a day or lets say overnight? Specifically the syptoms (symptoms) I am referring to are rash, and headache?
4) One of the early symptoms is fevers? Is Chills (without fever) a symptom?
5) Do you know of anonymus testing sites in Paris (France) and are self testing kits available in the drug stores in Paris?
Apologies again for the long post. Thank you and please continue with the good work.
I have been following the Q&A forum on HIV and sefe sex. Your advice on wide ranging issues is surely a great help to the people who ask the questions and also very informative to others.
I have some general questions, hope you dont mind, which I guess may be of interest to other also. Please accept my apologies if you have answered the same in past, but may have been in different threads.
1) I have read on many websites that some people may go without any symptoms of HIV for quite some time, while others do get one or more symptoms. Is there any data on what percentage do these people represent who go without symptoms for quite a while?
2) I have understood from replies to many questions on this forum that sex without ejaculation may be less risky than otherwise. The ejaculation in these cases (riskier) is considered more risky if inside her (anal / vagina / mouth) vs. if the man was to pull out and ejaculate on the body (for instance(so long as ejaculation was not inside her)?
3) In the people who do show symptoms, do these symptoms always stay for 6 to 7 days and go away, or is it possible that these symtoms could only last a day or lets say overnight? Specifically the syptoms (symptoms) I am referring to are rash, and headache?
4) One of the early symptoms is fevers? Is Chills (without fever) a symptom?
5) Do you know of anonymus testing sites in Paris (France) and are self testing kits available in the drug stores in Paris?
Apologies again for the long post. Thank you and please continue with the good work.
Doctor's Answer
by H. Hunter Handsfield, M.D., Jun 09, 2006 12:00AM
, Jun 09, 2006 12:00AM
Thanks for the kind words. I'll go straight to your questions.
1) Including mild cases, 80-90% of people with initial HIV infection develop symptoms, called acute retroviral syndrome (ARS). About half have fairly prominent symptoms. ARS symptoms typically last 2-4 weeks, then most people have no symptoms until they get symptoms of health problems due to immune deficiency--anywhere from 1 to 10 years later, sometimes longer.
2) There are no clear data (at least none that I know) on the risk of HIV transmission with and without ejaculation. Common sense says the risk should be higher with deposition of semen inside the vagina or rectum (and perhaps mouth), so many experts just say it's more risky. But at a scientific level, it is not known for sure.
3) I am unaware of data that ARS symptoms ever clear up in less than several days; certainly never overnight.
4) Fever is almost always present; its absence is strong evidence against ARS as a cause of a person's symptoms. True chills cannot occur without fever; chills are the result of rapid fluctuations in body temperature in someone with fever. (Just feeling chilly from time to time isn't the same thing. If it is, most of the women I know develop ARS every time they enter a conference room where the guys feel warm!)
5) Sorry, I know nothing about HIV testing options in France. In general, anonymous testing no longer makes sense in most industrialized countries. When so much of the population has been tested anyway (almost half of all Americans have had an HIV test, and I imagine it isn't so different in France), simply being tested or having a negative result rarely results in stigma or prejudice. And if positive, a person must get health care--and anonymous health care for HIV simply isn't possible, except in the super-wealthy who can pay cash without having to invoke health insurance. (But in fairness, I don't know for sure about these issues in Paris or elsewhere in France. And there are exceptions to these rules in many places--small towns, developing countries where being marked as HIV infected can result in abandomnent by a spouse or death by beating, etc.)
Best wishes--- HHH, MD
1) Including mild cases, 80-90% of people with initial HIV infection develop symptoms, called acute retroviral syndrome (ARS). About half have fairly prominent symptoms. ARS symptoms typically last 2-4 weeks, then most people have no symptoms until they get symptoms of health problems due to immune deficiency--anywhere from 1 to 10 years later, sometimes longer.
2) There are no clear data (at least none that I know) on the risk of HIV transmission with and without ejaculation. Common sense says the risk should be higher with deposition of semen inside the vagina or rectum (and perhaps mouth), so many experts just say it's more risky. But at a scientific level, it is not known for sure.
3) I am unaware of data that ARS symptoms ever clear up in less than several days; certainly never overnight.
4) Fever is almost always present; its absence is strong evidence against ARS as a cause of a person's symptoms. True chills cannot occur without fever; chills are the result of rapid fluctuations in body temperature in someone with fever. (Just feeling chilly from time to time isn't the same thing. If it is, most of the women I know develop ARS every time they enter a conference room where the guys feel warm!)
5) Sorry, I know nothing about HIV testing options in France. In general, anonymous testing no longer makes sense in most industrialized countries. When so much of the population has been tested anyway (almost half of all Americans have had an HIV test, and I imagine it isn't so different in France), simply being tested or having a negative result rarely results in stigma or prejudice. And if positive, a person must get health care--and anonymous health care for HIV simply isn't possible, except in the super-wealthy who can pay cash without having to invoke health insurance. (But in fairness, I don't know for sure about these issues in Paris or elsewhere in France. And there are exceptions to these rules in many places--small towns, developing countries where being marked as HIV infected can result in abandomnent by a spouse or death by beating, etc.)
Best wishes--- HHH, MD
What's your idea of mild symptoms?
If one were to get a fever that lasted only one day/overnight, I would think that would mean it was some kind of mild self-limiting infection. But an ARS fever, if it hits, would sustain itself for 5+ days, at the very least, it seems.
By the way, Dr. Bob says that if a man came to him with a fever/flu-like illness after having unprotected vaginal sex, he would assume that it was a virus, but most likely not HIV (knowing that the man did indeed have unprotected sex -- he cites the 5 in 10,000 exposures statistic). Do you agree with that?
Still, your reasoning makes sense; certainly there is a quantitative difference in fluid exposure. Nevertheless, there are no data to show whether or not there is a difference in transmission efficiency with and without ejaculation.
HHH, MD
my mind is out of control and i literally play the phone call of the doctors telling me i have hiv, i go for my test this week, - please help me out with some information and your thoughts.. thanks so much ....
scared 569