Health Chats
HIV Prevention and Safe Sex
Tuesday Apr 07, 2009, 03:00PM - 04:00PM (EST)
If you've ever had a condom break or had unprotected sex, you've probably wondered about your risk of contracting HIV. If you believe you might have been exposed to HIV and want help to judge your risk, would like advice about HIV testing, or have questions about the effectiveness of condoms or the risks associated with specific sexual practices, join Dr. H. Hunter Handsfield in this hour-long chat and get answers to your questions.<br><br>
As the Director of the STD Control Program for Public Health and on the Board of Directors of the International Union against Sexually Transmitted Infections and American Social Health Association, Dr. Handsfield is a renowned expert in the study of infectious disease. In this live health chat, Dr. Handsfield will answer your questions about sexual activity with low risk exposure to HIV, such as oral sex, condom-protected intercourse, hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids, as well as symptoms of early HIV infection.<br><br>
Note: Questions about the treatment of HIV/AIDS or its complications, viral load or similar topics will not be addressed in this chat. Questions about STDs other than HIV will also not be permitted. If you have a question about STDs, please join Dr. Handsfield on March 31st for the <a href="/health_chats/register/6">Living with STDs Health Chat</a>.
H. Hunter Handsfield, MD:
Not my expertise, but most HIV biologists are pessimistic. I think the best to expect are partially effective vaccines, maybe in the next 5-10 years. Highly effective vaccines may never be developed. Of course, I hope I'm wrong.
sk123:
Can HIV be passed from an expecting mother to her unborn child? How does that work? Can HIV be passed in breast milk?
H. Hunter Handsfield, MD:
Yes, of course. Most transmissions to newborns occur during the delivery process itself, not in the uterus before delivery. It can usually be prevented by treating the baby with anti-HIV drugs for a few weeks after being born. Breast feeding carries risk, but not as high as some people assume. Among babies nursed by their HIV-infected mothers -- swallowing a few ounces of milk every day -- about 10% become infected by age 6 months. Nowadays, all pregnant women are routinely tested for HIV, so that the babies can be protected.
mamafg:
what is the percentage rate of people affected with hiv yearly in the unitedstates?
H. Hunter Handsfield, MD:
Around 50,000 new infections per year in the US. About 70-75% continue to occur in gay men.
mamafg:
Whats the possibility of risk while having oral sex with a cut or sore on your mouth?
H. Hunter Handsfield, MD:
Oral sex is low risk in general. The presence of a fresh cut increases the risk, but not by much. (If you double a teeny risk, you still end up with teeny risk.)
ovidiu9:
i made hiv test after 12month with a incident blood to blood contact i y got hcv. the hiv test was negtive. is posible to hepc coinfection delay seroconversion for hiv
H. Hunter Handsfield, MD:
With the possible exception of very severe illnesses or potent chemotherapy, no medical condition and no medicine delays HIV seroconversion or changes the reliability of HIV test results. That's an urban myth. Hep C certainly has no effect.
sportster334:
What the most reliable method of testing? I used the mouth test (i think it was called orasure). Is this as dependable as a blood test?
H. Hunter Handsfield, MD:
The rapid HIV antibody tests, both oral and blood, are just as reliable as standard lab-based antibody tests, except for one thing. They have a higher false positive rate, and of course it can be highly stressful for the unlucky person who doesn't have HIV but goes through several days of repeat testing to know s/he isn't infected. For that reason, the rapid tests are generally recommended primarily for people at fairly high risk, not the worried well who just want reassurance. But this isnt' a hard and fast rule.
sk123:
If we can prevent babies from getting HIV with an anti-HIV drug for a few weeks after the baby is born, why doesn't this anti-HIV drug work for adults?
H. Hunter Handsfield, MD:
It does work. You are confusing cure versus prevention. Anti-HIV drugs are effective in prevention even though they do not clear up an established HIV infection. Thank you for the opportunity to clarify that point.
Jack615:
Would unprotected sex with an hiv+ woman for 2 mins be long enough for me to catch HIV?
H. Hunter Handsfield, MD:
There are no data on the risk associated with different durations of sex. Logically, unprotected sex for 15 minutes would be higher risk than 2 minutes, but I cannot estimate the amount of the difference. Remember that even for "standard" vaginal sex, which probably lasts an average of 5-10 minues for most people, the average risk of female to male transmission -- if the woman is infected -- is around once in every 2,000 exposures.
auntiejessi:
How much does having ghsv2 increase the risk of getting HIV? Does this also increase if someone has ghsv1?
H. Hunter Handsfield, MD:
Hello, antiejessi. For those who don't know, she helps moderate the STD (and HIV?) community forum.
H. Hunter Handsfield, MD:
Sorry, hit return too soon. Here is the rest.
H. Hunter Handsfield, MD:
And did it again! Habit.... Someone with a brand new HSV-2 infection has roughly 4-5 times increased risk of catching HIV if exposed. (The greatest danger is probably when a person catches HSV-2 from a person who has both infections.) After a few months, the increased risk in HSV-2-infected persons is around double. HSV-1 doesn't have any effect on HIV risk. The reasons for the difference between HSV-1 and -2 isn't known, but it has something to do with the frquency of recurrent outbreaks and asymptomatic genital HSV shedding.
ChitChatNine:
Do you feel the schools are doing a good job educating our kids about HIV and Safe Sex? Our schools start talking about HIV in 2nd / 3rd grade during health class talking about it as a virus you can catch from blood, etc. From what I understand, our high school is going to talk about condoms in Soph yr. vs. Jr. year.
MedHelp:
Hi...we are receiving many repeat questions that Dr. Handsfield has answered in the chat...please scroll up and review before posting. Thank you
H. Hunter Handsfield, MD:
Good question. But I can't generalize. One hears of both excellent and horrible school education programs. The least helpful probably are those where religion plays a prominent role in the local community and influences the content and general approach to sexuality education. I don't mean that as a political statement, just an objective fact.
MagicHands:
Do you know which area (specifically city) in the U.S. has the highest rate of HIV? I live on long island and i heard we're number 1 highest. Is this true?
H. Hunter Handsfield, MD:
This depends a bit on the risk group involved. Among the highest overall rates are in metropolitan areas of eastern cities like NYC, Baltimore/Washington, Miami, and others.
goatgirl:
I had a few exposures that I am worried about. I have had protected vaginal/oral sex with 6-7 sex workers (All in Canada - Escort Services) over the last year (something I really regret now and will never do again) All instances were with a condom, with no noticeable breakages. The last occurance was in June of this year where I also performed unprotected oral sex on this sex worker. I didn't think anything of it, until I read that oral sex was a possible transmitter of HIV. Approxiamately 8.5 - 9 weeks after this exposure I had a 5 day bout with Diarrhea, and automatically assumed it was due to ARS. I had no noticeable fever, no swolen lymph nodes, or anything else that I can really remember. (I may have had a sore throat but I cannot really remmeber)
H. Hunter Handsfield, MD:
In general escorts (i.e., expensive commercial sex workers) have low HIV rates in the US and other industrialized countries, so you probably have not been exposed. Your symptoms are meaningless -- see above and search the forum. But this is a good time to say, as on the forum, that all people who are sexually active outside mutually monogamous relationships should have occasional HIV/STD testing, like every year or two. Since it's on your mind, this probably is a good time. But not specifically because of these exposures or your symptoms.
PoconoPatti:
I was hoping you could explain to me why oral sex is not a risk for HIV transmission?
H. Hunter Handsfield, MD:
The answers are not completely understood, but they have a lot to do with the fact that some tissues are less susceptible to HIV than others; and with the amount of virus in the oral secretions of people with HIV. Which raises an important principle: Lots of non-health-professionals assume that "just one virus" is enough for transmission. Not true. The transmission risk for almost all infectious diseases, including HIV, varies with the amount of infectious agent and how it is introduced. One of the few silver linings around HIV/AIDS is that the virus is much less easily transmitted, and it takes much larger doses of the virus for infection, than things like colds, flu, viral gastroenteritis, pneumonia, TB, and most other infectious diseases. As bad as HIV is, we're lucky this virus didn't evolve in a way that it could be easily transmitted..
worriedlikecrazy:
Its states in some articles that the HIV infection rate in Guys are actually going down and in Hetrosexuals they are increasing - do you confirm with these statements?
H. Hunter Handsfield, MD:
Unfortunately, you're wrong. HIV rates are more or less stable in gay/bi men in the US; no different than 10 years ago. It's very depressing to those of us interested in disease prevention among men who have sex with men. Heterosexual transmission rates are higher, but only in a few segments of the American population.
vampy85:
Hi Dr. , why does ejaculation increase the risk of HIV ? I ejaculated when the vaginal fluids were on the tip of my penis , does that give a possibility for hiv. Thank you
MedHelp:
Hi, please not this health chat is only on the topic of HIV. Other STD questions can not be answered. Thank you.
