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Gay oral with HIV+ / HIV needle injury?
Dear Doctor,
I was wondering if you would assess any risk factors in the following scenarios:
Scenario 1:
I met a man (who upfront told me he is HIV+). Knowing this, I took any precautions I thought were needed. I felt uncomfortable about any kind of anal sex, so we did NOT engage in anal sex. We did engage in deep kissing, and I am unaware of any blood, etc. I did slightly brush my teeth just moments before, but I had heard advice against doing so in regards to kissing someone who has HIV. However, later that night he did perform oral sex on me. Since he is HIV+, does that increase the already minimal risk of oral sex to testing degree? Again, we did NOT engage in anal, NOR did I perform oral on him.He has stated that he is currently on meds and is considered ‘undetectable’, if that has any possible influence on your decision.
Scenario 2: Foolishly enough I wanted (for the first time in my life, check out a gay sauna....which I will NEVER do again.) Though I did NOT have sex with anyone there, I was walking down a very dark hallway...closest to the wall..passing someone..when I stepped onto some sharp object. I attempted to turn around and see...but could not see anything on the floor..it was too dark. I returned to the 'room' that they give you when you sign in....and I took off my sock ( I was wearing socks..b/c I was thinking I could get athletes foot). Anyways..no sign of blood ...but a small..almost needle sized prick near my pinky toe. It hurt when I stepped on it. I was thinking needle?syringe?
I attempted to retrace the area again...but it was so dark. Afraid, I left.
Questions:
1. Would I have bled from a puncture? There was NO blood on the sock.
2. I did not feel the body of a needle, so ideally it could have been a stone/pebble.
3. Even IF it were a needle,
3a. It would have to be someone who was HIV+?
3b. Enough blood that was infectious?
3c. I would have to have bled...right?
Sorry for so much..short answers are fine. THANKS.
I was wondering if you would assess any risk factors in the following scenarios:
Scenario 1:
I met a man (who upfront told me he is HIV+). Knowing this, I took any precautions I thought were needed. I felt uncomfortable about any kind of anal sex, so we did NOT engage in anal sex. We did engage in deep kissing, and I am unaware of any blood, etc. I did slightly brush my teeth just moments before, but I had heard advice against doing so in regards to kissing someone who has HIV. However, later that night he did perform oral sex on me. Since he is HIV+, does that increase the already minimal risk of oral sex to testing degree? Again, we did NOT engage in anal, NOR did I perform oral on him.He has stated that he is currently on meds and is considered ‘undetectable’, if that has any possible influence on your decision.
Scenario 2: Foolishly enough I wanted (for the first time in my life, check out a gay sauna....which I will NEVER do again.) Though I did NOT have sex with anyone there, I was walking down a very dark hallway...closest to the wall..passing someone..when I stepped onto some sharp object. I attempted to turn around and see...but could not see anything on the floor..it was too dark. I returned to the 'room' that they give you when you sign in....and I took off my sock ( I was wearing socks..b/c I was thinking I could get athletes foot). Anyways..no sign of blood ...but a small..almost needle sized prick near my pinky toe. It hurt when I stepped on it. I was thinking needle?syringe?
I attempted to retrace the area again...but it was so dark. Afraid, I left.
Questions:
1. Would I have bled from a puncture? There was NO blood on the sock.
2. I did not feel the body of a needle, so ideally it could have been a stone/pebble.
3. Even IF it were a needle,
3a. It would have to be someone who was HIV+?
3b. Enough blood that was infectious?
3c. I would have to have bled...right?
Sorry for so much..short answers are fine. THANKS.
MEDICAL PROFESSIONAL
There is no meaningful difference beween a 1 in 10,000 chance and a 1 in 20,000 chance. The two values are within the statistical margin or errorr for any such estimate.
Yes I have seen persons who have acquired HIV through needle sticks outside of hospital settings- twice other than IV drug users. thread is now over.EWH
Yes I have seen persons who have acquired HIV through needle sticks outside of hospital settings- twice other than IV drug users. thread is now over.EWH
Those last two questions were merely for archival support.
In reference to your statement:
"The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high." I just happen to read a trillion and one previous threads on oral sex/HIV transmission (seems like a VERY common question here on the HIV forum). I was merely curious, and in the effort to help anyone who reads this thread in the future....I was reading in an old thread that the risk of receiving oral sex was 1/20,000. Again, merely curious because I had RECEIVED oral sex only and NEVER performed oral sex on this HIV+ partner.
Lastly, in your years experience as a MD in the field of HIV/STDs, have you ever once seen a person infected by HIV via needlestick/syringe injury outside of a hospital setting?
I do promise not to ask anymore questions....and I know.."this will be all for this thread". I just figured...if anyone in the future references this thread they need not ask you a trillion times like the oral sex question :)
"The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high." I just happen to read a trillion and one previous threads on oral sex/HIV transmission (seems like a VERY common question here on the HIV forum). I was merely curious, and in the effort to help anyone who reads this thread in the future....I was reading in an old thread that the risk of receiving oral sex was 1/20,000. Again, merely curious because I had RECEIVED oral sex only and NEVER performed oral sex on this HIV+ partner.
Lastly, in your years experience as a MD in the field of HIV/STDs, have you ever once seen a person infected by HIV via needlestick/syringe injury outside of a hospital setting?
I do promise not to ask anymore questions....and I know.."this will be all for this thread". I just figured...if anyone in the future references this thread they need not ask you a trillion times like the oral sex question :)
MEDICAL PROFESSIONAL
Glad to help. EWH
THIS HELPED A LOT! WHAT A RELIEF!!
Thanks for such a detailed response! I'd send another $20 if I could!
;)
Thanks for such a detailed response! I'd send another $20 if I could!
;)
MEDICAL PROFESSIONAL
Welcome to the forum. Two different situations but both are virtually no risk. Let's address them one-by-one.
First instance- HIV-infected partner who you kissed and who performed oral sex on you. No risk. Kissing is no risk, even deep kissing and even with gum or dental disease. The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex. Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex. Having recently brushed your teeth does not change this. By the way, if he was on therapy and had an undetectable viral load, this further reduces any risk of HIV transmission by him since the probability of transmission is related to the viral load with transmission being ar more likely in untreated persons and very, very low in persons whose HIV viral load it totally suppressed by therapy.
2nd Instance. Possible puncture would at a gay bath. This is a high risk location. In studies of HIV prevalence, the likelihood of HIV is higher in persons who attend gay baths. This has been shown in numerous studies going back to the beginning or the epidemic. Your risk of HIV from having stepped on something sharp enough to be uncomfortable is low. If it were a used needle which had previously been used by an HIV infected person there would be an appreciable risk however, the wound you experienced was not deep enough to draw blood. Had it been a needle, it likely would have drawn blood. My guess is was a piece of gravel, broken glass or something else but I doubt that it was a needle.
Finally, with regard to your other question, no, HIV does not need to be injected into the blood stream to cause infection. It needs to be introduced deep into tissue but getting directly into the blood stream is not needed.
to summarize about your original questions. They are low risk. No risk in the first instance described and low risk in the second. As for testing, you'll have to decide. I would not say the immediate, emergent testing is needed but at some time in the next year or so you, like anyone with multiple sex partners owe it to yourself to get tested and screened for other non-HIV STDs, like gonorrhea and chlamydia. We consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly.
Hope this helps. EWH
First instance- HIV-infected partner who you kissed and who performed oral sex on you. No risk. Kissing is no risk, even deep kissing and even with gum or dental disease. The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex. Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex. Having recently brushed your teeth does not change this. By the way, if he was on therapy and had an undetectable viral load, this further reduces any risk of HIV transmission by him since the probability of transmission is related to the viral load with transmission being ar more likely in untreated persons and very, very low in persons whose HIV viral load it totally suppressed by therapy.
2nd Instance. Possible puncture would at a gay bath. This is a high risk location. In studies of HIV prevalence, the likelihood of HIV is higher in persons who attend gay baths. This has been shown in numerous studies going back to the beginning or the epidemic. Your risk of HIV from having stepped on something sharp enough to be uncomfortable is low. If it were a used needle which had previously been used by an HIV infected person there would be an appreciable risk however, the wound you experienced was not deep enough to draw blood. Had it been a needle, it likely would have drawn blood. My guess is was a piece of gravel, broken glass or something else but I doubt that it was a needle.
Finally, with regard to your other question, no, HIV does not need to be injected into the blood stream to cause infection. It needs to be introduced deep into tissue but getting directly into the blood stream is not needed.
to summarize about your original questions. They are low risk. No risk in the first instance described and low risk in the second. As for testing, you'll have to decide. I would not say the immediate, emergent testing is needed but at some time in the next year or so you, like anyone with multiple sex partners owe it to yourself to get tested and screened for other non-HIV STDs, like gonorrhea and chlamydia. We consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly.
Hope this helps. EWH
By the way...
(1)I was doing my best to review the "search" option on this site as best as I can. The oral question was not the problem..the problem was that I could not find anyone that received oral sex from an HIV+ person in their posts.
(2) I searched my best to find threads that dealt with "needle/syringe" exposure. The best one I came up with was the following from this site:
http://www.medhelp.org/posts/HIV-Prevention/Discarded-Needle/show/1237700
Would it indeed be true that infected blood ACTUALLY has to enter a vein in order to become infected?
THANK YOU!
(1)I was doing my best to review the "search" option on this site as best as I can. The oral question was not the problem..the problem was that I could not find anyone that received oral sex from an HIV+ person in their posts.
(2) I searched my best to find threads that dealt with "needle/syringe" exposure. The best one I came up with was the following from this site:
http://www.medhelp.org/posts/HIV-Prevention/Discarded-Needle/show/1237700
Would it indeed be true that infected blood ACTUALLY has to enter a vein in order to become infected?
THANK YOU!
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