hiv and oral statistics

[lesterh56]

I have been reading through the posts here where the standard response given is that there is NO RISK from oral sex and that there has not been any confirmed case of transmission this way. This is contrary to some well respected sites such as CDC and Avert where they claim there ARE DPCUMENTED cases.

http://www.avert.org/oral-sex.htm

"At the 4th International Oral AIDS Conference held in South Africa, the risk of transmission through oral sex was estimated to be approximately 0.04 per cent per contact". This equates to 4 in 10,000 or 1 in 2,500 which is just slightly higher than the stats given by the expert doctors on this site for penile vaginal sex.This is not a no risk event.

This is not meant to scare anyone but the facts should be shown here.

[Teak]

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 belive 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

"The observation on thousands and thousands of observations is that HIV is not spread by oral sex (of any sort)." DR HOOK

[lesterh56]

Teak with all due respect to you some of these research reports are 10 to 15 years old. The CDC site was updated this year. Surely we must acknowledge that new information comes to light. What then is your take on how experts in South Africa reach a number of 1 chance in 2,500? More and more people are claiming to be have become infected via oral, can they all be lying?

[lesterh56]

If we happen to go by what the CDC states about testing then we must also accept that there are documented cases of oral transmission and that there is is risk. Even though the risk is less than anal or vaginal, itstll exists and is documented. That is current information according to Canadian health authorities too.

[Vance2335]

No there are no documentated cases. They are after reports. Basically after someone tests positive they are interviewed. Interviews are flawed by nature. Documenated is based on studies done where people are activily participating in the studies not an after interview study.

And why would that number be going up now? People have known about HIV for over 30 years and prevention has been stressed for at least 20 years. But for some reason now the estimated risk number goes up.

Show me a study that can refute a 10 year study done with couples (1 HIV- the other HIV+) then it will make us question what we say.

[lesterh56]

The problem is one that has been cited by many reserachers. Often participants in sexually activity perform anal or vaginal sex in addition to oral so it is difficult to know how the transmission actually occurred. Also we are basing an assumption on 19,000 acts of oral sex with no transmission and one study. That might be the best data to date but people are still claiming to be infected via oral so there can't be that many people lying about it.

If you look at the CDC website, it says that what is known is that HIV is transmitted via oral. That's a pretty definite statement coming from them.

" What is known is that HIV has been transmitted through fellatio, cunnilingus, and anilingus." This is directly from their website.

[Teak]

* Anyone who continues to post excessively, questioning a conclusively negative result or no-risk situation, will be subject to action by MedHelp. Conclusively negative results or a no-risk situation will be based upon the criteria established by MedHelp’s doctors. Action will be taken as follows:
    * After excessive posting, a warning will be issued by MedHelp
    * Continuing to post regarding the negative result / no risk situation will result in a 3 day suspension
    * Continuing to post upon your return will result in a permanent ban.

[Emily_MHManager]

Our forum standards are set by many things, and yes, the CDC is one of them, but we also go by what our Experts say.  In an above post, Teak lists several quotes from our experts, who are world-renowned for their work in the field.  

At best, it is a theoretical risk (there are all kinds of theoretical risks in this world that we never debate), and in reality, as our doctors have said time and again, transmission does not happen this way.  We can't speak for the CDC.  If you'd like, you can ask someone at the CDC for the studies or cases of HIV being transmitted via oral sex.

This thread is now closed.  There is no reason to keep debating this.

Emily

****************************** CLOSED THREAD  **********************************
                                NO MORE POSTS, PLEASE