POZ Community Forums
Main Forums => Someone I Care About Has HIV => Topic started by: skips on April 07, 2012, 07:28:55 am
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So many many months ago I posted about my then partner contracting HIV, which he contracted through what I would consider safe sexual practice (oral sex).
I don't know what I want from this post, I'm just worried about him. How do I know he'll be okay?
He started medication almost immediately after finding out, and his VL has dropped from 50,000 to about 500. This is great, obviously.
His CD4 isn't the greatest though, about 350.
I can't help but worry about him most of the time. How do I get comfort that he'll be okay? Is HIV really a chronic condition these days, and sticking to his medicine he'll be okay?
How do I ensure he has the best care possible?
We live in London by the way. Is private care the best?
Thanks in advance.
(He says that he still loves me, he just can't have sex with me now that he has HIV. He doesn't want to harm me.)
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Thank you to the 82 people who viewed and said nothing.
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You don't need private health-care in England - NHS is just fine and well up there with all the latest research and options, also governed by better policies so I'd avoid private. His numbers sound ok to me (take a look at mine below to compare) and he'll get even better now he's on medication.
I know it's a scarey time and you probably want loads of answers and re-assurance instantly. Believe me when I say that nothing happens quickly - he's not just gonna keel over and die, he'll be ok.
Not sure about the oral sex thing though....Although I've not taken the time to read your story so I don't know the background to this. I'd presume there was more to this than he's letting on.
He'll be fine, don't panic *hugs*
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Thank you to the 82 people who viewed and said nothing.
I can see that you are upset about your friend, but your post is a bit harsh, in my opinion. This website is read by many more people than its members alone; and of those members who did view it, not all may have felt able (or even perhaps had the opportunity) to comment at that time.
However your partner may have contracted the virus, you are where you are; the past is not the issue, however incomprehensible it may seem to you. Of course you are worried about him, and understandably so. But to address your question: How do you know he'll be okay? Well, already you can see that the medication which he has been prescribed is working. His viral load has reduced; his CD4 is not impossibly low even now, and may well rise in time. As TabooPrincess pointed out, he is not going to keel over and die.
You ask: Is HIV really a chronic condition these days, and if he sticks to his medicine will he be okay?
By way of answer to the first part of that question, in a nutshell, yes; HIV remains a chronic condition, as is (for example) diabetes, which I also have. But while I am no doctor, if your friend adheres rigorously to his medication, takes care of himself, and continues to be monitored by his clinic on a regular basis, there is every chance that he will be fine. To put it in context, someone who attends the clinic I go to is now in his nineties, and he is fine too.
You say you live in London. Is your friend entitled to treatment under the NHS? If so - again, as TabooPrincess has said - he will receive excellent care, and will not have to pay a penny towards his meds. There are a number of very good clinics in London: you do not have to go private.
I hope this helps.
/ ... edited for clarity.
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Mark - just to add, everybody in England (illegal or otherwise) is able to get treatment under the NHS for hiv. I guess it's considered a public protection issue or something.
To quote
Furthermore, people either entering and/or remaining in this country without proper authority are a matter for the Home Office and the Immigration Services, and it is up to these services to enforce immigration regulations robustly and swiftly. While they remain in this country, whether illegally or legally, people with untreated HIV pose a threat to the nation's public health, which is why the Department of Health's primary concern must be providing treatment for them to protect public health.
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Good call, TabooPrincess - I stand corrected.
M
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I can see that you are upset about your friend, but your post is a bit harsh, in my opinion. This website is read by many more people than its members alone; and of those members who did view it, not all may have felt able (or even perhaps had the opportunity) to comment at that time.
However your friend may have contracted the virus, you are where you are; the past is not the issue, however incomprehensible it may seem to you. Of course you are worried about him, and understandably so. But to address your question: How do you know he'll be okay? Well, already you can see that the medication which he has been prescribed is working. His viral load has reduced; his CD4 is not impossibly low even now, and may well rise in time. As TabooPrincess pointed out, he is not going to keel over and die.
You ask: Is HIV really a chronic condition these days, and if he sticks to his medicine will he be okay?
By way of answer to the first part of that question, in a nutshell, yes; HIV remains a chronic condition, as is (for example) diabetes, which I also have. But while I am no doctor, if your friend adheres rigorously to his medication, takes care of himself, and continues to be monitored by his clinic on a regular basis, there is every chance that he will be fine. To put it in context, someone who attends the clinic I go to is now in his nineties, and he is fine too.
You say you live in London. Is your friend entitled to treatment under the NHS? If so - again, as TabooPrincess has said - he will receive excellent care, and will not have to pay a penny towards his meds. There are a number of very good clinics in London: you do not have to go private.
I hope this helps.
/ ... edited for clarity.
Apologies all round for the double posting - I corrected a word and it posted again. I'm having a bad day ...
;D
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Thanks for the replies, I feel a bit better, I suppose I will always worry though.
We're both British and live in London so yes he receives free health care (go NHS!!!) but I just wondered if private was any better.
As for the disbelief in catching it through oral sex, you can believe what you like but I know he's honest. He caught it through oral sex, swallowing cum. All anal sex was protected. I was shocked he caught it that way too.
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(He says that he still loves me, he just can't have sex with me now that he has HIV. He doesn't want to harm me.)
Did you two break up because he got HIV?
You can have sex without you getting it, too. That's a fear he needs to get over. You still want to be with him? You still love him that way?
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Did you two break up because he got HIV?
You can have sex without you getting it, too. That's a fear he needs to get over. You still want to be with him? You still love him that way?
Yes, we broke up because he contracted HIV. He now can't be with me because he can't have sex with me, because he has HIV. I'm fine with it, but he's not.
I still love him just as much as I always did. I'd do anything for him and it kills me not to be with him.
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Im sorry to hear that. It would be nice if you two could be together officially with the agreement that he needs time to work out the phobias about HIV. Sex is important for a couple but its not the only thing right.
Did you propose that?
But given that you are officially not a couple, I dunno maybe, be patient, maybe in a few months he will get more comfortable. Is he reading a bit about HIV and finding out that there isn't a risk if you have safe sex? In a short time he will be undetectable, maybe that will be the kicker.
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As for the disbelief in catching it through oral sex, you can believe what you like but I know he's honest. He caught it through oral sex, swallowing cum. All anal sex was protected. I was shocked he caught it that way too.
How do you know all his anal sex was protected? Maybe the condom broke.
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As for the disbelief in catching it through oral sex, you can believe what you like but I know he's honest. He caught it through oral sex, swallowing cum. All anal sex was protected. I was shocked he caught it that way too.
Skips,
If you are going to learn about HIV, you need to know the REAL methods of transmission. You don't become poz by swallowing cum.
Joe
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Skips,
If you are going to learn about HIV, you need to know the REAL methods of transmission. You don't become poz by swallowing cum.
Joe
I no longer linger in any meaningful capacity in either the Just Infected forum or this one, despite the wording on the forum rules themselves. I have been HIV positive since April, 1993, and have held a position as an HIV/AIDS educator more or less consistently since 1996.
Here's the deal.
We have not, for a decade or more, been in the least concerned about oral transmission. The money spent on flavored condoms and absolutely useless oral transmission guidelines were a joke. As soon as patient report-based HIV transmission theory studies started coming out (post-HAART, post 1995) the research data was clear.
I do what I can not to engage infected people in a war or transmission. You want to believe you got HIV from a haircut? Fine. Just take your meds and try not to ask for a lot of science.
But it's HARD for me to provide any real discourse when the elephant in the room lingers. And Goddess knows, it has cost me a lot of popularity in these forums. But I base my risk assessment AND my HIV medication/treatment information in the SAME first tiered peer-reviewed scientific data. To deny some of that is to question the Socratic method, period.
So here is what we routinely state in AM I INFECTED:
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.
Flame on. And I am sorry for butting in.
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This seems to be going somewhat off topic but I'll respond none the less.
You first have to trust that my ex is honest, if you don't, then stop reading.
All of his anal sex was protected. No condoms broke. If those two things are true, then my understanding is that he couldnt have caught HIV through anal sex.
His only possible exposure to HIV was through oral sex, swallowing cum. He always brushed his teeth before going to meet someone - my understanding is that a break in the mouth can allow transmission?
If there is some sort of breakdown in my logic then please, genuinely, educate me.
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This seems to be going somewhat off topic but I'll respond none the less.
You first have to trust that my ex is honest, if you don't, then stop reading.
All of his anal sex was protected. No condoms broke. If those two things are true, then my understanding is that he couldnt have caught HIV through anal sex.
His only possible exposure to HIV was through oral sex, swallowing cum. He always brushed his teeth before going to meet someone - my understanding is that a break in the mouth can allow transmission?
If there is some sort of breakdown in my logic then please, genuinely, educate me.
Skips,
Please understand that nobody is attacking either you or your boyfriend, however you cannot get HIV from swallowing cum. It doesn't happen for so many reasons and if you read many of JKs references you can see the science for yourself. As to your logic, I see two distinct faults. First trusting that your ex is totally honest and the second that he has never had unprotected sexual intercourse, or that a condom never failed. Just because you want to believe something, does not make it true. Nor can you ignore what 30 years of HIV transmission research has show to be the only ways to contract HIV.
Again, you can't become poz by swallowing cum, so maybe your initial logic is somehow flawed, because the science never lies.
Joe
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Maybe the OP would get more educated replies if she didn't expressly forbid those of us with the most HIV experience and knowledge to post.
At some point in dealing with HIV infection you simply have to trust the validity of the science. Picking and choosing might work for progressive Lutherans, but it spells trouble in the world of HIV.
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It should be noted that while the list of references cited above is very helpful it is not generally "first tiered, peer reviewed" science.
Peer review generally applies to published journal articles, not to colloquia, notes, many presentations at meetings, interpretive or speculative papers ... Furthermore, while "first tier" is arguably defined by the community of researchers in a particular area, it generally references the status of the journal in which the science is published. Science, Nature, PNAS and the top few journals in a field are "first tier" "Oral Diseases" is not.
This does not make it bad science. But when someone asserts that scientific work has had a higher level of review and authority than is evident, it causes one to question the scientific training of those making the claim and limits the credibility one assigns to their intrepretation of the results of the studies.
In that respect, it should be noted that the authors of the articles cited DO NOT generally draw the conclusion that there is no risk of transmission via oral sex. Instead they note that they did not find transmission in their "modest" sample of individuals but that other studies have found transmission and thus characterize the risk as "rare", "very low"...
This seems to be going somewhat off topic but I'll respond none the less.
You first have to trust that my ex is honest, if you don't, then stop reading.
All of his anal sex was protected. No condoms broke. If those two things are true, then my understanding is that he couldnt have caught HIV through anal sex.
His only possible exposure to HIV was through oral sex, swallowing cum. He always brushed his teeth before going to meet someone - my understanding is that a break in the mouth can allow transmission?
If there is some sort of breakdown in my logic then please, genuinely, educate me.
Skips
You may find the following discussion material useful (it is from the scientists who published one of the main papers). Basically it points out that many individuals who engage in both protected anal sex and oral sex attribute any infection to oral sex -- whereas transmission rates are significantly higher among those who report both behaviors. (I've highlighted this portion in bold) One might speculate,based on this discussion, that it is much more likely that something went wrong in the protected anal sex your partner had, than in the oral sex.
The absence of HIV infections detected in this sample confirms previous
research that orally acquired HIV infection is rare. HIV prevalence and
incidence among MSM who tested at the same anonymous testing sites in
San Francisco during a similar time period (December 1999 to February
2001) were appreciably higher. The overall prevalence of HIV infection was
3.3% (95% CI 2.9-3.9), and among repeat testers the incidence was 1.9/100
person-years (95% CI 1.6-2.3). Among those who reported unprotected RAI,
HIV prevalence and incidence were 5.1% (95% CI, 4.1-6.3) and 3.5/100
person-years (95% CI, 2.7-4.5), respectively. Among those who reported
protected RAI, HIV prevalence and incidence was 2.3% (95% CI, 1.7-3.1) and
1.7/100 person-years (95%CI 1.2-2.3), respectively (T. Kellogg, San
Francisco Department of Public Health, personal communication). These
figures reveal the striking difference in the risk of HIV between those who
report exclusively fellatio and those who report higher-risk sexual behaviors.
A strength of this study is that participants were queried about behaviors
before HIV testing. Consistently, studies that rely on individuals identifying
'how they got infected', report a higher proportion of orally acquired infections
than can be reliably established [4,5]. HIV-positive MSM may inaccurately
report higher-risk exposures for reasons including social desirability and
recall. Men may also report having only oral sex as a risk behavior because
that is the only 'unprotected' sexual behavior they engage in, not
acknowledging anal sex when a condom was used. Vittinghoff et al. [3]
hypothesized that condom breakage or slippage could account for the higher
per-act infectivity of protected anal sex compared with unprotected fellatio.
Our results are based on a modest sample size; therefore, we cannot rule out
the possibility that the probability of infection is indeed greater than zero. Our
data and those of others (D. Osmond, San Francisco Young Men's Health
Study: 3%, unpublished data) show that the proportion of individuals who
engage exclusively in fellatio is very low, thus obtaining precise and reliable
estimates of the per-partner and per-contact risks of acquiring HIV from
fellatio will be difficult. The likely importance of heterogeneity of susceptibility
and infectiousness add further uncertainty to quantifying risk.
Our calculations showing very low PAR% are consistent with the findings of
extremely low individual risk. In addition, if one considers that only a fraction
of those who report fellatio are actually exposed to semen (35%), the PAR%
will be considerably lower.
These data confirm that the risk of HIV infection attributable to fellatio among
MSM and in the MSM population is especially low. It is important that health
professionals, including HIV counsellors have valid information to impart to
their sexually active clients. If individuals believe that the risk of HIV from
fellatio is high or on a par with well-documented high-risk exposures such as
anogenital sex, they may not feel that sexual behavior choices make a
difference. Acquiring HIV through fellatio is significantly less risky than from
anal sex, and therefore one's choice of sexual practices do matter.
http://www.sidastudi.org/resources/inmagic-img/dd1765.pdf
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Wait, the page-shafer and romero studies were not first tiered peer-reviewed science?
Says who? They absolutely were.
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SO you are comfortable lumping in pre-HAART reported sexual behavioral science with not one, but THREE POST-HAART studies which circumvented the use of what has long been established as being an unreliable source of accurate information?
Hell, while you are at it, let's put kissing back on the menu.
Also, "oral sex: means one of four distinct activities. Can you at least be accurate in discerning which one you reference?
I'm sorry, but the studies I quoted are absolutely peer-reviewed. They involved hundreds of couples followed for ten, five and three years respectively.
I find it both odd and disingenuous that, YEARS after these studies have been used as evidence of the relative risk (or lack thereof) or oral copulation as risks for HIV transmission, you JUST NOW choose to weigh in.
You want to discredit me? Go on, do it. I will happily resign from monitoring the AM I INFECTED forum.
But until you present clear evidence that I am doing harm by asserting the science I assert, then I shall continue to do so on this forum and outside of it.
The Page-Shafer studies and the Romero studies are NOT:
colloquia, notes, many presentations at meetings, interpretive or speculative papers .
They are indeed published works at the top tier of their respective fields. That I also add a discussion is irrelevant- it only adds to the conversation, not waters it down.
And what of the studies which discredit patient report as a reliable source of sexually transmitted disease information?
You wan to undercut the basics? Where were you a decade ago when I started this discussion?
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Can I suggest the debate about studies be taken elsewhere? Beating Skips (or each other) over the head with scientific journals is not going to change the fact that his boyfriend is hiv positive. They're both very new to this and they'll come to grips with how hiv came into their lives in their own time.
In the meantime, all we can do is be supportive, while doing out best to not be preachy. I know, difficult balance to achieve at times.
Skips, the most important thing right now is that your boyfriend is getting the medical and emotional support he needs. Calling him out on how he was infected won't achieve either aim, so let it be. At least for now.
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jkinatl2 - FOUR ways?!! ???
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jkinatl2 - FOUR ways?!! ???
1. Person performing oral sex on male
2. Male receiving oral sex (insertive partner)
3. Female receiving oral sex (Cunnilingus)
4. Performing oral sex on a female.
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jkinatl2 - FOUR ways?!! ???
Can you think of a fifth or sixth? If you can, we're all ears!
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Lol for some reason I could only think of 3 - but it's obvious now!
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ive read these comments 4 the ease of mind the issue isn't how he got it or anything its in the past the issue now is learn how to manage his immune system and stick with the medication but i do know stressing others out doesn't do a bit of good