HIv and spit on penis

[mezones]

Hello doctor recently i did the mistake of sleeping with a prostitute of unknown hiv status. during the encounter she was giving me a hand job and spit on my penis for lubrication. i could not tell if there was blood or not on her spit. assuming she was hiv+ could i have contracted the virus from this incident. if so what do you think about me taking an hiv pcr test from labcorb. they say test results are conclusive at two weeks post exposure. is this true?

[Edward W Hook, MD]

Welcome to our Forum.  The event you describe did not put you at risk for HIV even in the unlikely event that your partner had HIV (most commercial sex workers do not).  There is no evidence that HIV is transmitted in saliva, either during exchange in the process of kissing or when saliva as used as a lubricant for masturbation.  Whether your partner had blood in her saliva or not makes no difference..  

As a result, there is no reason for testing. If you choose to test however, PCR tests are not recommended for HIV diagnosis. Rather currently available 4th generation, combination HIV p24 antigen/HIV antibody tests give the earliest conclusive results, providing definitive results 4 weeks following an exposure.

As I said however, you do not need testing for the events you describe.

I hope this comment is helpful to you. EWH

[Edward W Hook, MD]

I have nothing more to say and this Forum is not here for you to debate with me or Dr. Handsfield.  Your concerns are illogical and not supported by the experience of myself or other scientists in carefully conducted stuides.  If you cannot accept this, you need to figure out how to either deal with it or give up.  I'll have nothing more to say.  EWH

[mezones]

i really want to believe you doctor, as it seems as the most logical way to go. what i am having trouble wrapping my head around is how saliva that is tainted with blood that goes inside into my penis not be any risk?

[Edward W Hook, MD]

This question is repetitive and argumentative.  Further, we do not engage in debate with clients or 2nd hand debate through clients who find, or think they find conflicting information.  Spit is different from oral sex- there is no direct contact, no contact with the lining of the mouth and no direct action which might immediately and directly work secretions into a person’s tissue. Further, saliva is different from oral fluids, containing enzymes, antibodies, and chemical substances which reduce any theoretical infectivity.  Your fears are groundless as I told you before.

As for PCR tests for HIV, they are NOT recommended by us or most experts.  While they occasionally are positive slightly (a week to 10 days, max) before other, far better characterized, less expensive tests, they are plagues by false positive rates many times higher than for other tests and are far more expensive than other recommended tests.  The people who make these tests, and sell them tout there "superiority" but have not spent the hours we and other experts have working with persons led astray by false positive results.

You asked for my opinion.,  you got it- the exposure was no risk and no testing was needed.  Whether or not you choose to take my assessment and advice is up to you. EWH

[mezones]

hello doctor according to the FDA the HIV RNA test is approved for diagnostic purposes so long as it is followed up by an anti body test, however the paragraph in their website that states this is somewhat confusing and misleading i would say. it makes it sound like you only need a follow up test if the results of the rna test are positive, it does not say anything about what happens if the results are negative. the following is the actual quote from theFDA website: " The test, however, is not meant to be used as a stand-alone test for the diagnosis of HIV-1 infection.  A positive nucleic acid test should be viewed as a unconfirmed test result, indicating probable infection, and should be followed up later with traditional EIA antibody testing to confirm infection with the Human Immunodeficiency Virus."   After reading this it makes it sound like the test requires a follow up only if results are positive, but what about if they are negative? I am asking this because lately i have been worried about a recent sexual encounter with a CSW where she gave me a hand job and spit on my penis for lubrication. i'm worried the spit could have contained hiv and sipped into my penis. what i don't understand is that if unprotected oral sex is considered to be low risk for hiv infection, then what is the difference between that and my incident? i mean spit is spit right?

[Edward W Hook, MD]

No, even with a recent abrasion, there would be no risk.  EWH

[mezones]

that's good to hear doctor although i forgot to mention that i had a tiny rash/abrrasion on the top right of my penis head from excessive masturbation by my part in the past. is this a cause for concern given the spit could have come in contact with this?