Need clarification about insertive fellatio with blood in mouth from CDC site

[AHVincent]

The situation:

Got a blow job from  a girl (might be a prostitute) in Thailand, noticeable ammount of blood on penis, about the same as having sex with a woman on her period.

No wound on penis.

Now according to all posts there is no danger with this exposure, however the CDC sites mentions that there could be a risk according to their PEP algorythm over here:

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5402a1.htm#fig1

That page states that there is susbstancial risk from exposure to blood from mucous membrane....

It's very hard to get a clear answer on this, is blood dangerous or not?

Does saliva deactived the virus completely?

Was there a risk at all?

The doctors in Thailand all recommend PEP so I don't know what to do!

[jkinatl2]

There has never been a case of HIV documented to have been transmitted through insertive fellatio. This is because it is all but impossible to overcome the powerful anti-viral components in saliva.

CDC also sites deep kissing as a possible risk, despite all the evidence that shows it is not - nor has anyone ever been documented to have been infected in this manner.

Insertive fellatio is NO risk.

Neither is kissing, by the way.

Why does the CDC not update transmission vectors to accommodate science from the last fifteen years? You ought to ask them. We certainly have, multiple times.

[AHVincent]

Hi Jkina,

Yes indeed, that CDC article should be updated then.

I see from your signature that you are a doctor.

Any research on the ratio of saliva to blood?

I mean, would a ratio of let's say 99 units of blood to one unit of saliva be sufficient?

Any links on the saliva deactivation resarch?

Thanks

[jkinatl2]

Hi Jkina,

Yes indeed, that CDC article should be updated then.

I see from your signature that you are a doctor.

Any research on the ratio of saliva to blood?

I mean, would a ratio of let's say 99 units of blood to one unit of saliva be sufficient?

Any links on the saliva deactivation resarch?

Thanks

My signature quotes a doctor. My research quotes multiple doctors, but I am a lowly AIDS Educator with 20 years in the field and ten of those here, answering questions, checking research and contributing to the LESSONS section of the forums.

As to your question, it has not been studied (to my knowledge). Over a dozen elements, enzymes and proteins, have been identified (so far) that render the glycoprotein shell surrounding the HI Virus inactive. They do so by dissolving that glyciprotein (GT 120) which connects HIV to cd4 and dendritic cells, then dissolving GT 41, a transmembrane glycoprotein that acts as a "stalk" to support GT120. At the same time, salivic enzymes weaken the lipid proteins which surround the viral particle and support GT41.

Once that happens, you are left with a bald matrix, a deccimated capsis membrane and an extremely vulnerable, inert RNA strand with no ability to inject itself into a cell.

There has been no research that I am aware of that tests the ratio of blood to saliva as regards infection transmissibility. Perhaps this is because saliva, infectious particles, and viral load are fluid (no pun intended) variables that cannot remain static in a single sample, much less as a base from which toi derive a constant.

And yes, I submit that were the CDC not a governmental agency whose references (when they choose to disclose them) are often three levels deep into Catholic Church-funded "science" that denies the role of condoms in preventing HIV, then the science would be paramount rather than the politics.

*Modified for spelling as AIDSMEDS chose to crash when I attempted to post this.

And to add sone reading material:

Secretory leukocyte protease inhibitor (SLPI) in mucosal fluids inhibits HIV-I.
Wahl SM, McNeely TB, Janoff EN, Shugars D, Worley P, Tucker C, Orenstein JM.
Source
Laboratory of Immunology, NIDR, NIH, Bethesda, MD 20892, USA.

http://www.ncbi.nlm.nih.gov/pubmed/9456660

Mucosal and Plasma IgA from HIV-1-Exposed Uninfected Individuals Inhibit HIV-1 Transcytosis Across Human Epithelial Cells1
Claudia Devito*, Kristina Broliden2,*, Rupert Kaul†, Lennart Svensson‡, Kari Johansen‡, Peter Kiama†, Joshua Kimani†, Lucia Lopalco§, Stefania Piconi¶, Job J. Bwayo†, Francis Plummer†∥, Mario Clerici3 and Jorma Hinkula‡


http://www.jimmunol.org/content/165/9/5170.short

Secretory leukocyte protease inhibitor: a human saliva protein exhibiting anti-human immunodeficiency virus 1 activity in vitro.

T B McNeely, M Dealy, D J Dripps, J M Orenstein, S P Eisenberg, and S M Wahl

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC185219/

Identification of a CD36-related Thrombospondin 1–binding Domain in HIV-1 Envelope Glycoprotein gp120: Relationship to HIV-1–specific Inhibitory Factors in Human Saliva

René Crombie*‡, Roy L. Silverstein*, Clarinda MacLow*‡, S. Frieda A. Pearce*, Ralph L. Nachman*, and Jeffrey Laurence*‡


http://jem.rupress.org/content/187/1/25.abstract

[AHVincent]

Thank you so much Jkina,

So basically no risk right?

Even if the person had a mouthful of blood?

I'm sorry and don't mean to be a pest....I just want to be asolutely certain.

Additionally, the girl is coming to see me tomorow and I'll have her checked.

[Ann]

Additionally, the girl is coming to see me tomorow and I'll have her checked.

Vince,

You'll "have her checked"? What a rude, insensitive invasion of a person's privacy. You have no right to insist that anyone take any sort of medical test for your own peace of mind.

If you have questions about your own hiv status, the ONLY way to find out is to test YOURSELF.

Unless you repeatedly punched this woman in the mouth before she blew you, there could not possibly be enough blood present to cause concern - and even then it would be unlikely for you to test positive.

If you still have doubts, a negative test result at six weeks should put your mind at ease.

I have to wonder how many women you've had unprotected anal or vaginal intercourse with in the past, but didn't worry because you judged them to be "nice girls" (ie not sex workers).

We see it all the time here; men go around having unprotected anal or vaginal intercourse with all sorts of women, but they only worry about hiv when they believe (or know) the woman to be a sex worker. That is precisely how a lot of straight guys end up with hiv. 

If you have been having unprotected anal or vaginal intercourse with anyone other than this woman, for all you know you could already be hiv positive, unless you've been doing the responsible, adult thing and getting tested regularly.

You need to understand that hiv can and will affect ANYONE, regardless of whatever judgements you pass on them. Hiv does not discriminate and neither should you.


Here's what you need to know in order to avoid hiv infection:

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence.

ALTHOUGH YOU DO NOT NEED TO TEST SPECIFICALLY OVER THIS BLOWJOB (aside from peace of mind), anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

Ann