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Author Topic: Nobody likes to talk about it ... oral sex and HIV transmission.  (Read 36313 times)

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Offline srmn98

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Nobody likes to talk about it ... oral sex and HIV transmission.
« on: September 15, 2008, 04:24:00 PM »
http://www.poz.com/articles/oral_hiv_transmission_risk_1_15223.shtml

While I know that the discussion of oral sex and HIV transmission is a sore spot for many on this message board, the article above points out that there is still risk. This article is from poz.com.

I'm only posting it because it is my opinion that the aidsmeds moderators should change the "official" aidsmeds.com "stance" on oral sex and HIV transmission. It is low risk not no risk, there is a huge difference. Even if the risk is theoretical, then we should say it is theoretical but we should not state that risk is completely absent. People should have the opportunity to get the correct information here.

Sara



Offline Buckmark

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #1 on: September 15, 2008, 04:33:57 PM »
Sara,

It looks to me like the "official" information on the Poz web site is accurate regarding the risks involved with oral sex:

http://www.poz.com/articles/348_2126.shtml

http://www.poz.com/articles/348_2127.shtml

Many forum members, of course, have their own opinions.  Is there a particular discussion or thread which you are referring to?

Regards,

Henry
"Life in Lubbock, Texas, taught me two things:
     One is that God loves you and you're going to burn in hell.
     The other is that sex is the most awful, filthy thing on earth and you should save it for someone you love."
- Butch Hancock, Musician, The Flatlanders

Offline newt

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #2 on: September 15, 2008, 04:38:31 PM »
And which bit of

"most experts agree that fellatio, often referred to as "blow jobs," is not an efficient route of HIV transmission. However, this does not mean that it can't happen"

translates as no risk?

(extract from the 1st "official" am page noted above)

- matt
"The object is to be a well patient, not a good patient"

Offline keyite

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #3 on: September 15, 2008, 04:54:09 PM »
It is low risk not no risk, there is a huge difference.

Indeed. Some of us have deducted that there is no other likely route of transmission for our own infection. But take it from me, this particular discussion leads nowhere; opinions are far too entrenched, probably partly because so much is at stake.

Offline Tim Horn

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #4 on: September 15, 2008, 05:50:58 PM »
Sara:

And as the primary author of the sexual transmission information posted on both POZ.com and AIDSmeds.com (including an even more detailed lesson here: http://www.aidsmeds.com/articles/Transmission_9960.shtml). you certainly won't catch me saying that there's 'no risk' associated with oral sex. In the article, we indicate that there HAVE been cases of HIV transmission via oral sex -- we even spell out the circumstances by which individuals, participating in transmission studies, were most likely to be infected via oral sex.

Here's our official stance on the subject:

Of the different sex acts, the one that often causes the greatest amount of confusion in terms of risk – and raises the greatest number of questions – is penile-oral sex. The fact is, most experts agree that fellatio, sometimes referred to as "blow jobs," is not an efficient route of HIV transmission. However, this does not mean that it cannot happen.

Research attempting to evaluate the risk of fellatio has often faced important limitations. For starters, very few people participating in studies only engaged in penile-oral sex. Many people also had unprotected vaginal or anal intercourse, making it very difficult to determine if unprotected fellatio is an "independent factor" associated with HIV transmission. There are also people who test positive for HIV and claim that unprotected fellatio was their only risky behavior. However, it's virtually impossible to know if these people are always reporting their sexual behavior accurately. (Study volunteers often have a difficult time admitting the truth about potentially embarrassing behavior to healthcare professionals conducting scientific studies.)

Because unprotected fellatio can mean that body fluids from one person can (and do) come into contact with the mucosal tissues or open cuts, sores, or breaks in the skin of another person, there is a "theoretical risk" of HIV transmission. "Theoretical risk" means that passing an infection from one person to another is considered possible, even though there haven't been any (or only a few) documented cases. This term can be used to differentiate from documented risks. Having unprotected receptive anal or vaginal intercourse with an HIV-positive partner is a documented risk, as they have been shown in numerous studies to be an independent risk factor for HIV infection. Having unprotected oral sex is a theoretical risk, as it is considered possible, but has never been shown to be an independent risk factor for HIV infection.

Here's a good way to think about theoretical risk: In theory, it is possible that while walking down the street, a meteor will fall on your head and kill you instantly. This is because meteors do occasionally fall to earth. People live their lives above ground, so there is a theoretical risk of being hit be a meteor. In fact, there have been reports of a few people being hit by meteors. But because the risk is so small, given that few meteors fall to earth and the large number of inhabitants of this planet, the risk is purely theoretical. The same principle holds true with oral sex – millions of people all over the world are believed to engage in unprotected oral sex and there have only been a handful of documented cases of HIV transmission. In turn, fellatio, and other types of oral sex (see below), remains a theoretical risk for HIV infection.

There have been a number of studies that have closely followed MSM and heterosexual couples, in which one partner was HIV positive and the other partner was HIV negative. In all of the studies, couples that used condoms consistently and correctly during every experience of vaginal or anal sex – but didn't use condoms during oral sex – did not see HIV spread from the HIV positive partner to the HIV negative partner.

There have been three case reports and a few studies suggesting that some people have been infected with HIV as a result of unprotected oral sex. However, these case reports and studies all involved MSM – men who were the receptive partners (the person doing the "sucking") during unprotected oral sex with another HIV-positive man. There haven't been any case reports or studies documenting HIV infection among female receptive partners during unprotected oral sex. Even more importantly, there hasn't been a single documented case of HIV transmission to an insertive partner (the person being "sucked") during unprotected oral sex, either among MSM or heterosexuals.

Is insertive oral sex a possible route of HIV transmission? Yes. But is it a documented risk? Absolutely not.


Nothing we've written here -- or advocated in these Forums -- contradicts ACOG's recommendation. It is a low-risk activity that all sexually active individuals should consider the grand scheme of things.

Tim Horn

 
« Last Edit: September 15, 2008, 05:55:05 PM by Tim Horn »

Offline jkinatl2

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #5 on: September 15, 2008, 06:59:03 PM »
Goodness, oral sex DOES seem to be a sticking point with you, does it not?

http://forums.poz.com/index.php?topic=17812.msg226384#msg226384

http://forums.poz.com/index.php?topic=17115.msg219089#msg219089

http://forums.poz.com/index.php?topic=15469.msg210736#msg210736

http://forums.poz.com/index.php?topic=15469.msg210293#msg210293

http://forums.poz.com/index.php?topic=15469.msg210290#msg210290

http://forums.poz.com/index.php?topic=15469.msg210247#msg210247

http://forums.poz.com/index.php?topic=15469.msg209933#msg209933

http://forums.poz.com/index.php?topic=15891.msg202038#msg202038

http://forums.poz.com/index.php?topic=8610.msg104580#msg104580


As far as "nobody" liking to talk about it, some members here can't seem to get enough. And the end result is always the same. Science versus anecdote. And With three long-term studies behind us thus far, science really does seem to have a distinct advantage. I certainly do not intend to debate this with you again. Apparently, it seems to go nowhere.... until you decide to spring it back to life again as though nothing was said.



"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline emeraldize

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #6 on: September 15, 2008, 07:17:39 PM »
JK:

Sara tried to address the potential for deflecting rather than receiving an e-mail like yours, but it arrived regardless.Very regardless. While I know that the discussion of oral sex and HIV transmission is a sore spot for many on this message board, the article above points out that there is still risk.

Henry, Matt and Tim saw fit to answer Sara with out coming up with a line she didn't write as you included. As far as "nobody" liking to talk about it,...

And, they managed to handle their answers in such a way as to not sound haughty.Goodness, oral sex DOES seem to be a sticking point with you, does it not?

Can't you just put Sara's posts on Ignore and walk away? Why do you have to scour her past threads for proof of your assertions. I would think such time would be better spent stroking a ferret, reading a book, or listening to classical music or doing all three at the same time.

Sara is a very bright woman who would readily concede that this is a concern of hers. And she ought to be able to pursue her questions and concerns without such treatment from you.

I am so confident I don't even have to go looking for proof that Sara would never write to you as you have to her.

Em



« Last Edit: September 15, 2008, 07:37:30 PM by emeraldize »

Offline sharkdiver

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #7 on: September 15, 2008, 07:32:21 PM »
The title of the thread as well as the first statement pretty much sets up for criticism.  Maybe it should have been written as "I have a concern...." instead of being a bit passive aggressive.



modified for typo

Offline denb45

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #8 on: September 15, 2008, 07:53:22 PM »
The title of the thread as well as the first statement pretty much sets up for criticism.  Maybe it should have been written as "I have a concern...." instead of being a bit passive aggressive.



modified for typo

 :o well I never heard of the subject of Oral Sex being referred to as "Passive Aggressive".........that's WAY too Funny  ;D when you think about it, thought I'd just inject some humor in here, you all are way too clinical and Serious for my taste  :D but it did make me laugh......Thanks for making my day  ;)
« Last Edit: September 15, 2008, 07:58:41 PM by denb45 »
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline Dachshund

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #9 on: September 15, 2008, 08:03:12 PM »
Can't you just put Sara's posts on Ignore and walk away? Why do you have to scour her past threads for proof of your assertions. I would think such time would be better spent stroking a ferret, reading a book, or listening to classical music or doing all three at the same time.[/color]

Maybe you could do the same? Just sayin.

Offline aztecan

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #10 on: September 15, 2008, 09:01:47 PM »
http://www.poz.com/articles/oral_hiv_transmission_risk_1_15223.shtml

While I know that the discussion of oral sex and HIV transmission is a sore spot for many on this message board, the article above points out that there is still risk. This article is from poz.com.

I'm only posting it because it is my opinion that the aidsmeds moderators should change the "official" aidsmeds.com "stance" on oral sex and HIV transmission. It is low risk not no risk, there is a huge difference. Even if the risk is theoretical, then we should say it is theoretical but we should not state that risk is completely absent. People should have the opportunity to get the correct information here.

Sara

Sara, oral sex is considered very low risk behavior because HIV is inhibited by saliva and wiped out by stomach acid.

Is there a risk? Sure, theoretically. But I stand a better chance of getting run over trying to cross a street in Mexico City than I do catching HIV via oral sex.

There is a theoretical risk, sure, but that's a far cry from the risk associated with unprotected anal or vaginal sex. Hence, it is often recommended as a form of harm reduction for those who eschew condoms. That goes for the straights and the gays, by the way, because females actually practice a lot more anal sex than people realize or are willing to talk about.

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline anniebc

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #11 on: September 15, 2008, 10:04:16 PM »
Quote
quote author=emeraldize link=topic=23118.msg294192#msg294192 date=1221520659]
JK:

Sara tried to address the potential for deflecting rather than receiving an e-mail like yours, but it arrived regardless.Very regardless. While I know that the discussion of oral sex and HIV transmission is a sore spot for many on this message board, the article above points out that there is still risk.

Henry, Matt and Tim saw fit to answer Sara with out coming up with a line she didn't write as you included. As far as "nobody" liking to talk about it,...

And, they managed to handle their answers in such a way as to not sound haughty.Goodness, oral sex DOES seem to be a sticking point with you, does it not?


Can't you just put Sara's posts on Ignore and walk away? Why do you have to scour her past threads for proof of your assertions. I would think such time would be better spent stroking a ferret, reading a book, or listening to classical music or doing all three at the same time.

Sara is a very bright woman who would readily concede that this is a concern of hers. And she ought to be able to pursue her questions and concerns without such treatment from you.

I am so confident I don't even have to go looking for proof that Sara would never write to you as you have to her.

Em

With respect Em this is why some threads end up looking like a battle field, I don't know how many times we have to say this, please stick to responding to the OP..and not to those who respond..it doesn't help the OP, in fact 9 times out of 10 the OP gets forgotten about because everyone is too busy having a go at those who  respond..and I don't see how that could possibly help the OP..do you?

As you say Sara is a very bright women, she can stick up for herself and respond to JK in the way she wants to...if indeed she feels the need to.

Hugs
Jan


-----------------------------------------------------------------------
Never knock on deaths door..ring the bell and run..he really hates that.

Offline Bucko

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #12 on: September 16, 2008, 11:59:23 AM »
"Theoretical risk" means that it could happen but hasn't yet. The day I can imagine a blowjob totally bereft of saliva is the day I'll take the risk of oral sex more seriously when discussing risk assessment over at AII.

Something that hasn't been addressed is why this red-button topic gets wheeled out as often as it does. It seems to me as though there are three likely reasons:

1) There is a genuine scientific curiosity about potential risk factors, pursued with an open, questioning mind that has not yet formed an opinion one way or the other; or there is a lingering doubt that after over 25 years of study, not all avenues of potential infection are known yet. The former is the very basis of scientific method; the latter would require a number of proven "mystery cases" that haven't yet been discovered.

2) There is a distrust of the scientific method, in as much as after 25 years study the risk of oral sex remains "theoretical" and not "extremely low". Given how poorly science is taught in schools in the US and elsewhere, and the degree to which such scientific paradigms as evolution are ridiculed by certain "culture warriors", this is sad but understandable.

3) There is some need to further separate infections into categories beyond the various demographics already recognized: gender, racial, economic, etc. Every time the pie gets sliced again, little bits of stigma are deflected or reinforced, which is (rightly) perceived by the majority of people concerned with HIV/AIDS as self-defeating, especially when it's used (as it always is) to "divide and conquer".

Part of reason #3 bothers me is that it involves an internalized stigma that wishes to distance cocksuckers from bottoms, as if there's some added shame in being fucked (or perhaps it's restricted to "only" being fucked without a condom, the suggestion being that having unprotected sex is "stupid" or "self-destructive"). For gay men, this is erroneous and self-depreciating, but for women it's incomprehensible.

/modified for clarity/
« Last Edit: September 16, 2008, 12:04:08 PM by Bucko »
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The revolutionary smart set reads The Spin Cycle at least once every day.

Blathering on AIDSmeds since 2005, provocative from birth

Offline Miss Philicia

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #13 on: September 16, 2008, 12:21:37 PM »

Part of reason #3 bothers me is that it involves an internalized stigma that wishes to distance cocksuckers from bottoms, as if there's some added shame in being fucked (or perhaps it's restricted to "only" being fucked without a condom, the suggestion being that having unprotected sex is "stupid" or "self-destructive"). For gay men, this is erroneous and self-depreciating, but for women it's incomprehensible.


I'll take this further, at least in the context of this web forum:  even if we were to accept that one or two individuals got infected via oral sex (which is probably being generous, but let's just pretend for a moment), inevitably when the topic is brought up magically out trots at least a dozen or more individuals, further reinforcing what you just stated in my mind (not to mention that when they reveal details the "stories" are full of holes).
"I’ve slept with enough men to know that I’m not gay"

Offline Bucko

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #14 on: September 16, 2008, 01:15:14 PM »
I'll take this further, at least in the context of this web forum:  even if we were to accept that one or two individuals got infected via oral sex (which is probably being generous, but let's just pretend for a moment), inevitably when the topic is brought up magically out trots at least a dozen or more individuals, further reinforcing what you just stated in my mind (not to mention that when they reveal details the "stories" are full of holes).

And along with these "anecdotalists" comes their enablers. And quick on their heels are the sexual prohibitionists. There's no lack of desire to discuss this issue: it's just a lack of enthusiasm for what has become the inevitable pattern. Lots of heat gets expended, but ultimately everyone just retrenches. It's divisive and futile.
Blessed with brains, talent and gorgeous tits.

The revolutionary smart set reads The Spin Cycle at least once every day.

Blathering on AIDSmeds since 2005, provocative from birth

Offline loop78

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #15 on: September 16, 2008, 01:18:12 PM »
"Theoretical risk" means that it could happen but hasn't yet.

"Theoretical risk" means that passing an infection from one person to another is considered possible, even though there haven't been any (or only a few) documented cases.

Maybe the problem here is the use of the term "theoretical risk" regarding receptive oral sex (I guess all of us agree insertive oral sex carries no risk of hiv transmission).

For some, "theoretical risk" equals to "is never ever gonna happen in real life", for others "theoretical risk" means "extremely low risk but I might have been the one". Of course there is a vested interest in some people supporting either one: for some of the ones who support the first view, the interest is having a green ethical light to not disclose when having sex as long as anal/vaginal is protected; for some of the ones who support the second, it's a "holier than thou" feeling that helps them salvage their fragile self worth.

What I don't understand is why this such a hot issue. Well, I suppose it makes sense for those who think that they got it from oral sex, after all, if someone challenges that belief, that someone is claiming to know better than themselves the risks they undertook.

But why is this so controversial to those who don't believe in transmission through oral sex? I think they've internalized too that absurd caste system of hivers, otherwise they wouldn't even bat their eyes when someone says he got it through oral.

Edit: typo
« Last Edit: September 16, 2008, 01:20:47 PM by loop78 »

Offline Bucko

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #16 on: September 16, 2008, 02:05:10 PM »
Maybe the problem here is the use of the term "theoretical risk" regarding receptive oral sex (I guess all of us agree insertive oral sex carries no risk of hiv transmission).

For some, "theoretical risk" equals to "is never ever gonna happen in real life", for others "theoretical risk" means "extremely low risk but I might have been the one". Of course there is a vested interest in some people supporting either one: for some of the ones who support the first view, the interest is having a green ethical light to not disclose when having sex as long as anal/vaginal is protected; for some of the ones who support the second, it's a "holier than thou" feeling that helps them salvage their fragile self worth.

Anyone who isn't clear on the fact that "hypothetical" means that it hasn't happened yet would seem to have a problem understanding English. "Hypothetical risk" is not the same as "very low risk": words have meaning.

What I don't understand is why this such a hot issue. Well, I suppose it makes sense for those who think that they got it from oral sex, after all, if someone challenges that belief, that someone is claiming to know better than themselves the risks they undertook.

But why is this so controversial to those who don't believe in transmission through oral sex? I think they've internalized too that absurd caste system of hivers, otherwise they wouldn't even bat their eyes when someone says he got it through oral.

Edit: typo

I have no interest in promulgating any "caste system"; I'm actually fighting against it. Nothing gets my dander in a ruff quite like hearing of an "innocent victim" with HIV. It's not for a second that I doubt whether or not someone was infected "innocently", it's that I don't believe the opposite, which is that some people merit their infection. I honestly believe that we're all in this together, and separating us into groups diminishes our solidarity.

My main interest in holding up the scientific side of the argument is that I believe that knowledge equals power. I would not want my doctor holding emotional opinions in greater importance than scientific ones regarding my care. And it pains me personally to see supposition and anecdote give the same weight as scientific data.

I also have a very real stake in creating a counterpoint to sexual prohibitionism. Having lived with the consequences of guilt and shame over having been infected with HIV, I gladly drank that KoolAid for years to the detriment of my well-being, physically, mentally and emotionally. If I can help someone else negotiate his/her way through that minefield I will.
Blessed with brains, talent and gorgeous tits.

The revolutionary smart set reads The Spin Cycle at least once every day.

Blathering on AIDSmeds since 2005, provocative from birth

Offline Finnboy

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #17 on: September 16, 2008, 02:19:55 PM »
Anyone who isn't clear on the fact that "hypothetical" means that it hasn't happened yet would seem to have a problem understanding English. "Hypothetical risk" is not the same as "very low risk": words have meaning.

No offence, but the same could be said of anyone who thinks that theoretical risk means that it hasn't ever occurred. Theoretical simply means that there has been no clearly documented case of it occurring. Given the minuscule fraction of one percent of transmissions which are ever investigated in any detail, and where there isn't at least the possibility that transmission could have occurred by some other means, it would also be quite remarkable if a case ever was convincingly documented.

Don't get me wrong here, I am absolutely not in favour of over-egging the risks of oral sex; but let's not head off to the diametrically opposite extreme in order to try to belittle those we don't agree with.   

Oh, and by the way, it is also totally wrong to state that a "hypothetical risk" means that it hasn't happened: it means that the theoretical risk is there but that the theoretical risk does not necessarily translate into a risk which is real or true.

Offline Bucko

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #18 on: September 16, 2008, 02:33:14 PM »
No offence, but the same could be said of anyone who thinks that theoretical risk means that it hasn't ever occurred. Theoretical simply means that there has been no clearly documented case of it occurring. Given the minuscule fraction of one percent of transmissions which are ever investigated in any detail, and where there isn't at least the possibility that transmission could have occurred by some other means, it would also be quite remarkable if a case ever was convincingly documented.

Oh, and by the way, it is also totally wrong to state that a "hypothetical risk" means that it hasn't happened: it means that the theoretical risk is there but that the theoretical risk does not necessarily translate into a risk which is real or true.

Here's a link to the word "hypothesis" in a Dictionary.com search:
http://dictionary.reference.com/browse/hypothesis

The central point is that a hypothesis is an unproven supposition. If it were proven, it would be a fact. The fact is that we are the most monitored medical group in history. If there were any real proof that unprotected oral sex led to transmission of HIV, it would be published. The pandemic is in its third decade...where is the proof?

Edited to add: "theory" and "hypothesis" are considered synonymous according the sources I've consulted.

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Offline loop78

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #19 on: September 16, 2008, 03:03:15 PM »
Anyone who isn't clear on the fact that "hypothetical" means that it hasn't happened yet would seem to have a problem understanding English. "Hypothetical risk" is not the same as "very low risk": words have meaning.

Yes, and "theoretical" isn't the exactly the same as "hypothetical". Though both are very close in meaning, the former implies that it complies with the current general theory of how hiv is transmitted, though in practice it may or may not happen, the later implies something is just conjectural. And hypothesis is not something meant to be proven true or false.

I have no interest in promulgating any "caste system"...

Neither do I. We're all in this together. Someone who got it though needle sharing is no better or worse than a kid that got it from his mother, for example. Transmission happens because a situation where it can occurs. It's not a question of guilt. No more than getting a common cold.

My main interest in holding up the scientific side of the argument is that I believe that knowledge equals power. I would not want my doctor holding emotional opinions in greater importance than scientific ones regarding my care. And it pains me personally to see supposition and anecdote give the same weight as scientific data.

The problem is there is that right now, there is no scientific argument that assures whether the risk is real or not. We only know it's theoretically possible, given what we know of how hiv is transmitted, but so far it has not be proven if it happens or not in real life. You choose to believe it has not be proven because it doesn't happen, but that's a decision you've had to made (an informed, and in my opinion respectable decision), not something stated by science. Things are quite different for example with insertive oral sex, that isn't even a theoretical risk.

I also have a very real stake in creating a counterpoint to sexual prohibitionism.

I don't think that whether you believe there is no risk or just a extremely small one attached to oral sex has anything to do with sexual prohibitionism... In any case you can have as much protected sex as you want. You can be sure I do ;)

Offline thunter34

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #20 on: September 16, 2008, 03:07:44 PM »
Buckles...."protected sex"...LOL.   ;D
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Offline Finnboy

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #21 on: September 16, 2008, 03:16:48 PM »
Here's a link to the word "hypothesis" in a Dictionary.com search:
http://dictionary.reference.com/browse/hypothesis

The central point is that a hypothesis is an unproven supposition. If it were proven, it would be a fact. The fact is that we are the most monitored medical group in history. If there were any real proof that unprotected oral sex led to transmission of HIV, it would be published. The pandemic is in its third decade...where is the proof?

Edited to add: "theory" and "hypothesis" are considered synonymous according the sources I've consulted.

Sorry, but even those references (poor as they are) still don't support what you are saying - and when did unproven (i.e. something that is not indisputably the case) become synonymous with untrue?

Evidence has been published, but it isn't conclusive and doesn't prove beyond doubt. That doesn't mean it is untrue - and it most certainly doesn't mean that it hasn't happened - it just means that it remains unproven theory and that the risk is still hypothetical (i.e. possible real, but not necessarily so).

Given good oral hygiene, I don't for a single moment think that the risks of oral sex are anything other than infinitesimally small and hypothetical; but if anyone says that no-one has ever been infected through oral sex, then I will call them on it and challenge them to show me even a single credible peer-reviewed source which states anything of the kind (and if you can't back it up, then it is totally irresponsible to say it).

I also happen to think that Aidsmeds, and all credible online resources I can think of, state the risk in its proper context.
« Last Edit: September 16, 2008, 03:36:47 PM by Finnboy »

Offline Bucko

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #22 on: September 16, 2008, 04:15:03 PM »
Sorry, but even those references (poor as they are) still don't support what you are saying - and when did unproven (i.e. something that is not indisputably the case) become synonymous with untrue?

Evidence has been published, but it isn't conclusive and doesn't prove beyond doubt. That doesn't mean it is untrue - and it most certainly doesn't mean that it hasn't happened - it just means that it remains unproven theory and that the risk is still hypothetical (i.e. possible real, but not necessarily so).

Given good oral hygiene, I don't for a single moment think that the risks of oral sex are anything other than infinitesimally small and hypothetical; but if anyone says that no-one has ever been infected through oral sex, then I will call them on it and challenge them to show me even a single credible peer-reviewed source which states anything of the kind (and if you can't back it up, then it is totally irresponsible to say it).

I also happen to think that Aidsmeds, and all credible online resources I can think of, state the risk in its proper context.

The same can be said of Bigfoot and alien abduction, Finn.

The possibility (or hypothesis) of risk is not the same as a measurable risk. If it's not possible to quantify or even properly state a risk as it applies to real life, then, yes...it's Bigfoot territory. There is, after all, no solid proof that there is no such creature, and there are thousands of people insisting that it's real.

And you'll never find any scientific document anywhere that states conclusively that Bigfoot doesn't exist.

Oral hygiene notwithstanding, saliva deactivates HIV. I suppose it's theoretically possible to give a blowjob with no saliva present whatsoever, it's just incredibly, wildly unlikely.
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Offline Bucko

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #23 on: September 16, 2008, 04:15:44 PM »

The problem is there is that right now, there is no scientific argument that assures whether the risk is real or not. We only know it's theoretically possible, given what we know of how hiv is transmitted, but so far it has not be proven if it happens or not in real life. You choose to believe it has not be proven because it doesn't happen, but that's a decision you've had to made (an informed, and in my opinion respectable decision), not something stated by science. Things are quite different for example with insertive oral sex, that isn't even a theoretical risk.

There actually is sound scientific documentation regarding the transmission of HIV. We know that it is passed through unprotected anal or vaginal sex between serodiscordant partners. This understanding was not arrived at willy-nilly: it's based on sound scientific documentation. The same can be said for insertive oral. But if, after tracking the evolution of the pandemic since 1981, there are no confirmed cases of transmission through giving a blowjob, it seems pretty certain, as certain as anything is in science, which forbids absolutes.

I don't think that whether you believe there is no risk or just a extremely small one attached to oral sex has anything to do with sexual prohibitionism... In any case you can have as much protected sex as you want. You can be sure I do ;)

You are incredibly lucky to have not yet run up against sexual prohibitionism among the HIV+. I hope your string of luck continues...I really do.

But when I discuss this issue with laypeople (those not directly effected by HIV in their lives), the prohibitionist element becomes really apparent really quickly.

I wouldn't ever tell someone to push their limits of risk management beyond their comfort zone, and if chewing on a condom is satisfactory to you, then run with it, baby  ;D

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Offline Bucko

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #24 on: September 16, 2008, 04:15:55 PM »
Buckles...."protected sex"...LOL.   ;D

Shut up, you  ;D
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Offline Finnboy

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #25 on: September 16, 2008, 04:25:56 PM »
The same can be said of Bigfoot and alien abduction, Finn.

Oh, bring out the straw men why don't you, Bucko; it really doesn't do much for your credibility.

Using your utterly bizarre definition of 'theoretical', black holes don't exist; because their existence is theoretical and no-one has conclusively proven that they exist - yet, for some strange reason, you wont actually find many scientists who dispute their existence.
« Last Edit: September 16, 2008, 04:32:21 PM by Finnboy »

Offline RapidRod

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #26 on: September 16, 2008, 04:50:58 PM »
Let's put in perspective Finn:

When scientists describe the risk of transmitting an infectious disease, like HIV, the term “theoretical risk” is often used. Very simple, “theoretical risk” means that passing an infection from one person to another is possible, even though there may not yet be any actual documented cases. “Theoretical risk” is not the same as likelihood. In other words, stating that HIV infection is “theoretically possible” does not necessarily mean it is likely to happen –only that it might. Documented risk, on the other hand, is used to describe transmission that has actually occurred, been investigated, and documented in the scientific literature.

So out of the millions of blowjobs a day and deep kissing that goes on a day that they come up with only a few non documented cases claiming that their only risk was giving oral sex and the hundreds of people in the oral discordinate studies that NOT ONE has ever contracted HIV from unprotected oral sex. Now which are you going to believe? A scientific study where the folks were actually tested or are you going to believe someone that said they contracted HIV by giving oral sex? After 3 decades of this infection if it were true there would be hundreds of thousands infected by giving oral sex instead of the hand full that claimed to be infected in that manner.
« Last Edit: September 16, 2008, 04:53:15 PM by RapidRod »

Offline Finnboy

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #27 on: September 16, 2008, 05:03:33 PM »
After 3 decades of this infection if it were true their would be hundreds of thousands infected by giving oral sex instead of the hand full that claimed to be infected in that manner.

Much as I appreciate what you are saying Rob, you aren't actually arguing against anything I have said.

As it happens, I am a medical scientist and I know exactly what 'theoretical risk' means - and it certainly  doesn't mean that it hasn't happened. I am simply pulling Bucko up on his banal attempts to belittle other people, by questioning their comprehension of the English language - when in fact it is he who is guilty of redefining terms and warping them into what he would like them to mean.

If you think that is a good example, then that is up to you. I don't, because I think it undermines the rest of the argument which I believe to be fundamentally true: i.e. that the risk of transmission through oral sex is so low that it isn't even worth worrying about.

As for the "handful" you speak of, most health protection agencies quote better than 1% (some as high as 3%).
« Last Edit: September 16, 2008, 05:09:30 PM by Finnboy »

Offline Tim Horn

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #28 on: September 16, 2008, 05:11:52 PM »
Let's not resort to critiquing others' behavior or intentions, but rather focus on what's actually being said.

This has been an intriguing and informative dialogue -- let's keep it that way.

Thanks,

Tim

Offline thunter34

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #29 on: September 16, 2008, 05:12:12 PM »
Who wants popcorn?
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Offline denb45

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #30 on: September 16, 2008, 05:23:27 PM »
Who wants popcorn?

Me me  ;D  and give me some of them bon-bons too , looks like this topic/Movie is gonna be a long full length feature.........LOL!
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Offline Miss Philicia

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #31 on: September 16, 2008, 05:25:54 PM »
Who wants popcorn?

How stale and trite.  I'm making roast pork loin.
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Offline denb45

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #32 on: September 16, 2008, 05:28:31 PM »
How stale and trite.  I'm making roast pork loin.

Screw the moive....I'm going over to Philly267 for some tasty  roast pork loin.....yummy  ;D
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline Bucko

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #33 on: September 16, 2008, 05:29:41 PM »
Oh, bring out the straw men why don't you, Bucko; it really doesn't do much for your credibility.

Using your utterly bizarre definition of 'theoretical', black holes don't exist; because their existence is theoretical and no-one has conclusively proven that they exist - yet, for some strange reason, you wont actually find many scientists who dispute their existence.

My credibility at AIDSmeds is not usually questioned, Finn. Good for you!

Since you're such an authority on risk scenarios, maybe you should contact the mods and ask if you can put your authority to good use in the Am I Infected forum where you can put your thinking into action with real live people dealing with their risks. There's a vacancy there now.
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Offline Bucko

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #34 on: September 16, 2008, 05:30:25 PM »
Screw the moive....I'm going over to Philly267 for some tasty  roast pork loin.....yummy  ;D

Love me some pork roast.
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Offline Bucko

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #35 on: September 16, 2008, 05:34:21 PM »
Much as I appreciate what you are saying Rob, you aren't actually arguing against anything I have said.

His name is Rod.

As for the "handful" you speak of, most health protection agencies quote better than 1% (some as high as 3%).

Links of peer-reviewed science research that states that 1-3% of infections are caused by oral sex, please?
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Offline srmn98

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #36 on: September 16, 2008, 05:37:56 PM »
Hello,

Thanks, Tim for your reply. I do understand the "official stance" now, thank you. To be honest, I question the analogy about theoretical risk and a meteor falling on ones head. While I understand the analogy, and I understand theoretical risk, it is my understanding that the scientific community is still working on this particular issue. Instead of theoretical risk, I believe the answer to HIV transmission and oral sex is that we just do not know. We do not have enough information. I ask that it is made clear to people that we do not know for 100% sure what the risks might be.

Take this link for an example:

http://ije.oxfordjournals.org/cgi/content/full/dyn151

This is a scientific article published in 2008 in the International Journal of Epidemiology. It says:

"Conclusions: There are currently insufficient data to estimate precisely the risk from OI (orogenital intercourse) exposure. The low risk of transmission evident from identified studies means that more and larger studies would be required to provide sufficient evidence to derive more precise estimates."

All I am saying is that people should be aware that there is a debate, and that the scientific community is currently unsure of what the risk is. It is estimated to be low-risk. As we become more educated about HIV, and as we educate the general public about HIV, the less new HIV infections we will see. That's the only reason I am bringing this up.

Furthermore, my original point was this article from poz.com:

http://www.poz.com/articles/oral_hiv_transmission_risk_1_15223.shtml

Which says:

"ACOG notes that while generally considered low-risk for transmission when compared to receptive anal or vaginal sex, HIV cases have been linked to oral sex. "

Again, low-risk not no-risk. We can debate theoretical risk. But the scientific community is clear: we do not yet understand the risks. I for one won't gamble my partner's status on it, no matter how low the risk, until I have more information.

Best regards,

Sara




« Last Edit: September 16, 2008, 05:39:51 PM by srmn98 »

Offline Finnboy

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #37 on: September 16, 2008, 05:45:27 PM »
My credibility at AIDSmeds is not usually questioned, Finn. Good for you!

Since you're such an authority on risk scenarios, maybe you should contact the mods and ask if you can put your authority to good use in the Am I Infected forum where you can put your thinking into action with real live people dealing with their risks. There's a vacancy there now.

And your point is? Oh, sorry, nothing at all. What a surprise!

Offline anniebc

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #38 on: September 16, 2008, 05:56:29 PM »
Finn

I worked in the medical field for many years and my defintion of "theoretical" simply means "restricted to theory, but not practical...and I agree it certainly  doesn't mean that it hasn't happened, but I don't expect to be pulled up because of the way I express my defintion of a word.

I personally haven't felt "belittled" by anyone, but as Tim said this is an intreguing/informative thread, and I'm sure we can all learn a little something from it, so lets keep it on track.

Timmy you can put the popcorn away now.. ;)

Hugs
Jan :-*
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Offline anniebc

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #39 on: September 16, 2008, 06:00:13 PM »
Finn, Bucko..time for you guys to back off now..thanks for your cooperation.

Hugs
Jan :-*
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Offline jkinatl2

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #40 on: September 16, 2008, 06:20:56 PM »
Sara

What confuses me is that we have this discussion regularly, and the same information is given you each time. And each time, you act as though it has never been brought to the table.

Your post in September, 2007

http://forums.poz.com/index.php?topic=15891.0

made us (ann, myself and others) think you had no idea HIV could not be spread through cunnilingus. Ann provided you with this information regarding saliva:

Quote
Oral Dis.   2006   May   ;12   (3):219-28 16700731   
Oral transmission of HIV, reality or fiction? An update.
J   Campo , M A   Perea , J   Del Romero , J   Cano , V   Hernando , A   Bascones
Human immunodeficiency virus (HIV) and many other viruses can be isolated in blood and body fluids, including saliva, and can be transmitted by genital-genital and especially anal-genital sexual activity. The risk of transmission of HIV via oral sexual practices is very low. Unlike other mucosal areas of the body, the oral cavity appears to be an extremely uncommon transmission route for HIV. We present a review of available evidence on the oral-genital transmission of HIV and analyse the factors that act to protect oral tissues from infection, thereby reducing the risk of HIV transmission by oral sex. Among these factors we highlight the levels of HIV RNA in saliva, presence of fewer CD4+ target cells, presence of IgA antibodies in saliva, presence of other infections in the oral cavity and the endogenous salivary antiviral factors lysozyme, defensins, thrombospondin and secretory leucocyte protease inhibitor (SLPI). Oral Diseases (2006) 12, 219-228.

http://www.aidsmap.com/en/news/2AF5DF5C-ECEF-4854-80BA-09F86B483A02.asp

http://gateway.nlm.nih.gov/MeetingAbstracts/102255339.html

The Romero study used male/female relationships almost exclusively, with either male or female partner positive. The viral loads varied widely, as did the treatment options (or lack thereof) during the ten years of the study.

The Page-Shafer "HOT" study used homosexual males with different partners, studied both receptive and insertive oral sex.

The abstract of the study is also here:

http://www.aegis.com/conferences/iac/2002/TuPeC4872.html

An updated abstract of the Romero study is in:

Oral Dis.   2006 May   ;12   (3):219-28 16700731

An earlier Page-Shafer study regarding oral HIv transmission:

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.
AIDS. 16(17):2350-2352, November 22, 2002.
Page-Shafer, Kimberly a,b; Shiboski, Caroline H b; Osmond, Dennis H c; Dilley, James d; McFarland, Willi e; Shiboski, Steve C c; Klausner, Jeffrey D e; Balls, Joyce a; Greenspan, Deborah b; Greenspan, John S b

Other relevant studies, many of which reference either/both Romero and/or Page-Shafer, among others:

http://www.aidsonline.com/pt/re/aids/fulltext.00002030-199904160-00021.htm;jsessionid=G1nGq7PY37yynzdYy7CHvpqRwHKzNFS7J3gPvGYzGKp6Tz2nvFdx!1330140564!181195629!8091!-1?nav=search&searchid=1&index=21&results=1&count=10

Note the methodology for the Page-Shafer and Romero studies, and how they differ significantly from earlier studies which relied on post-infection patient report. In my opinion, that methodology dramatically increases the validity of the report.

You can certainly access her own words by researching the topic.


You will note that in the Page-Shafer report here:

http://www.aidsonline.com/pt/re/aids/fulltext.00002030-200211220-00022.htm;jsessionid=GT0FbfDqLhNwBTLGJyHGHt3QJTLdjnl0CVn2bBGBZJykttGfWxBR!-1082563917!-949856145!8091!-1?nav=search&searchid=null

the participants of that study were all men who came to the clinic in SF for HIv testing, who reported protected anal/vaginal sex, no needle sharing/IV drug use, yet admitted (I hate phrasing it like that) to having had receptive oral sex without a condom. The setup for this study skewed the natural inclination of patients to misremember or inaccurately recount their sexual activities, as it used as a benchmark people who claimed to have had protected anal/vaginal, yet unprotected oral sex.

Were there ANY new infections detected in the study, followup interview would have been initiated to assist in determining the mode of transmission, which would possibly taint the study with the broad brush of anecdotal evidence. However, it is important to note that there were ZERO new infections in the study period, which rendered unnecessary any followup interview or speculation.

I said this in a post in March, 2007. And I believe it bears repeating especially since ap oster postulated a few reasons why people are "adamant" one way or another in this discussion/debate.

I have changed some wording to reflect the current state of affairs, therefore shall not put this in quotes.

Post-infection patient survey is exceedingly unreliable, but until the advent of HAART, there were NO serodiscordant couples remaining sexually active long enough to compile and follow. We were, at best, extrapolating from the softest science (patient report) and presenting it as hard data. While I understand that position from a "better safe than sorry"  aspect, it's simply not anywhere close to the quantifiability of the serodiscordant studies.

A vested interest? Sure, because once you postulate that exposure to saliva can infect, you transition HIV from an infectious agent to a communicable one. With all the stigma and isolation that such an event presupposes.

I get so frustrated sometimes, because the science is THERE. Its OBVIOUS. And frighteningly few seem to bother to look at it.

It is obvious with simian and primate studies, with long term monitoring, with epidemiology in the heterosexual community as well as the gay community.

It's obvious with the lack of documented cunnilingus transmission, with the lack of casual contact transmission, with the long-term serodiscordant studies, and with the biological evidence of the mechanisms for HIv infection: to wit, the necessity for HIV to contact specific lymph cells and dendritic cells, which are almost utterly absent from the oral cavity.

The dozen or so proteins and enzymes in saliva which inhibit HIV (at least two of which have been synthesized and used in Astroglide lubricant).

As people with HIV, we have not only an opportunity, but a DUTY to understand our infection and the transmission vectors. Otherwise, we should not be shocked when our families and friends withdraw, when we are given plastic forks at Thanksgiving, when our hands are not held when we die.

As someone who has been an HIV educator for almost 15 years, my vested interest is in keeping the science as current and correct as possible.

As for the "theoretical versus hypothetical" thing being thrown around, I might remind people that it HAS been proven that on at least ONE and possible TWO occasions since the advent of recording/documenting such instances, people HAVE been struck by meteorites.

Therefore being struck by a meteorite is LOW RISK, but certainly not ZERO risk.

There is scant room for ZERO in science. Certainly not medical science.

I believe Tim Horn answered Sara's question rather definitively. I am rather perplexed at the condescension and flame-baiting that has ensued thereafter.

Jonathan
(who will always subscribe to the philosophy "the plural of anecdote is not data"

Since there is no way to end this discussion without hard feelings, I respectfully withdraw at this point. Having exhausted my science for the moment (though I have reams on the HIV inactive properties of saliva and other studies which bear tangential relevance to the discussion) I will leave it to others to take up the slack.

To the best of my knowledge, there are no other long term serodiscordant studies currently in progress, so in that arena, the science seems to be static.

Also, I have spent the last few months transitioning from prevention/transmission science to treatment.... because I suddenly find myself with a vested and selfish interest in remaining alive, and it seems to have come to that.




« Last Edit: September 16, 2008, 06:25:34 PM by jkinatl2 »
"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline loop78

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #41 on: September 16, 2008, 06:58:25 PM »
But if, after tracking the evolution of the pandemic since 1981, there are no confirmed cases of transmission through giving a blowjob..

"Confirmed" is so difficult in this area. Obviously, there's no way of proving how someone got it but trusting the risk encounters they report. There are documented cases of people who claim they got it from giving oral, but obviously you cannot prove they had another risk that they didn't report. Some of them obviously underreport other risky behaviour, but all of them? I'm not gonna bet anything important on that until I have conclusive evidence. ;)

You are incredibly lucky to have not yet run up against sexual prohibitionism among the HIV+. I hope your string of luck continues...I really do

Me too, Bucko. I hope all of us are that lucky. Sexual prohibitionism would not solve anything. After all, I think the risk of transmission, socially speaking, are not the pozies who practice safe sex, but those of unknown status who don't.

I wouldn't ever tell someone to push their limits of risk management beyond their comfort zone, and if chewing on a condom is satisfactory to you, then run with it, baby  ;D

Just for the record, I'm not the one who would have to chew on a condom, but my partner ;)

Anyway, I was gonna ask for a link to those studies, to check them directly, but Jonathan kindly did so before I finished typing this message. I checked them, and my conclusion is the same, and I'm quoting: "The risk of HIV attributable to fellatio is extremely low" and "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".

I understand there are reasons why getting a sample size big enough to reach a conclusive answer is difficult, however, given how much there is to be gained, both in terms of public health and of stigma eradication, I cannot understand why some effort is not put in this field.

Anyway, Johnathan, I don't think anyone here is supporting the idea of saliva being a fluid capable of transmission. At least I've never said such a thing: the discussion is limited to the case of receptive oral. No one has questioned insertive oral is not capable of transmitting hiv, as in that situation the negative person is only exposed to the saliva of the positive one, and all of us agree saliva is not capable of transmitting hiv. Let's not blow things out of proportion.

I do think, as some others have pointed out, this is an informative and and intriguing thread. I have not felt "belittled" by anyone (even though English, in fact, is not my native language), so I know it's quite possible to keep the thread flame free.

Hugs to everyone.

Offline newt

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #42 on: September 16, 2008, 07:12:16 PM »
....as an alternative diversion, people could close their browser, pull up a deckchair (perhaps with a Jaeger rug as it's September), crack open the whisky n listen to the new Ben Taylor album.

This is an "unsolvable" topic and as I said before, which part of...? I do not discount people's personal experience (cos even 1% or a part of 1% of a million is a lot of people), the science, studies, theoretical v real n all the rest, but jeez, life is short n there's a new Ben Taylor album out.

- matt
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Offline loop78

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #43 on: September 17, 2008, 04:19:43 AM »
Just wanted to add a link to the transcript of a 2003 roundtable about hiv and receptive oral sex.

Kimberly Page Shafer, the author of the study Johnathan linked participates.

I thought it was interesting, though in my opinion, most of the experts overestimate the risk of oral sex.

Here you have it: http://hivinsite.ucsf.edu/InSite?page=pr-rr-05

Offline mecch

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #44 on: September 17, 2008, 02:39:17 PM »
Hi All,

I got HIV in April 2008 through oral sex.  The guy who I sucked was in seroconversion stage.  He was also impotent and before we began sex, he injected his penis to get hard.  That drug was given to him by a doctor. 

Anal sex was protected. Oral sex was without ejaculation. There was no sperm exchange.  It can be surmised that HIV was transmitted through pre-cum and/or minute amount of blood transmission.  Furthermore, my doctor said I very highly likely had oral transmission and in my throat.  This is because of the way the doctor interpreted my seroconversion illness (one ulcer in mouth, ulcerated esophagus, and headache). 

Also - if you must know, my partner was hung quite large, and we both used poppers but no other drugs. 
I searched the net and found very little evidence that this can happen, other than one study in SF that suggested that popper use may make mucosal cells more receptive to an invading HIV, and that big dicks and popper use were correlated with a very low but real HIV oral transmission risk.

So, after 25 year sticking to what I thought was safe sex, and even having had poz boyfriends, I did seroconvert and it was through oral transmission.

I can imagine this is rare and it might have been blood, not precum.  We will never know for sure which.



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Offline Miss Philicia

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #45 on: September 17, 2008, 02:57:31 PM »
If he injected his cock with something and you sucked it, that's not great proof of typical oral transmission possibilities, is it?
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Offline thunter34

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #46 on: September 17, 2008, 03:39:26 PM »
POPPERS!!!
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Offline srmn98

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #47 on: September 17, 2008, 04:07:35 PM »
Hello again,

Jonathan, I appreciate your response and respect your decision to abstain from continuing this conversation. It does not need to become personal, nobody needs to have their feelings hurt to have an intellectual conversation. Let me clear the confusion, I feel the same way about this topic that I did when we discussed it last time, although perhaps now I am better able to state my position as I have come much further in accepting my HIV status. I am not proposing that saliva is infectious, I am speaking about oral sex performed on an HIV positive partner by and HIV negative partner only.

The first study you quote from 2002 has a sample size of 135 HIV negative people. Of these, only 10% (6 people !!) had a viral load of above 10,000 copies. This is a very small sample size. We think now that lower viral load means less transmission. This study does not take the viral load factor into consideration -- or at least it does not provide us with enough cases to determine risk with certainty.

To be clear, a scientific study where most of the participants have low viral loads does not tell us if HIV can be transmitted by receptive oral sex. It tells us it is unlikely when the participants have low viral loads. How about the real world, where possibly some 250,000 Americans are living with HIV but they do not know it ? Their viral loads are likely higher than those in the study who are on treatment. When determining risk we need to take the real world scenarios into account. The current and older research has not logistically been able to do this. We need more studies for a definitive answer !!!  That's all I'm saying.

Science changes quickly -- if we believed everything we thought was true about HIV/AIDS back in 2002 today we would be much more limited in the entire fields of treatment and prevention. Some studies hold up, some studies do not. Either way, I am only quoting a current 2008 study and for those of you that disagree, disagree with the authors of the study: Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, UK.

The science is not obvious. Science is rarely obvious, but instead constantly evolving-- science is alive not dead and packed away in the record books.

Best regards,

Sara







Offline rocket

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #48 on: September 17, 2008, 05:11:58 PM »
 I agree Sara,those studies had people who had low viral loads,only proving that oral transmission does not occur with a low viral load. Like you said,in the real world this simply isnt true.

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #49 on: September 17, 2008, 05:12:56 PM »
If he injected his cock with something and you sucked it, that's not great proof of typical oral transmission possibilities, is it?

Well, given how rarely we think oral transmission happens, there must be certain atypical factors or special circumstances that cause oral transmission to occur when it does. It would be useful to know what all or most of them are so there could be more valuable prevention information than just "oral transmission happens very rarely or hypothetically". Perhaps using one of these drugs was one of them.

Someone in their seroconversion period with a high VL would probably also be at higher risk of transmitting HIV orally to someone else if someone performs oral on them. That's the stated reason in the above case. It seems like an obvious hypothesis. I don't know if it's been verified, but it doesn't sound like something you could easily test and repeat in any study. Many people don't find out about their HIV during their seroconversion, usually afterwards, and then their VL decreases.

Another factor that's already known to increase the oral risk and listed on the AM/poz page is if the giver has openings in their mouth from recent brushing or flossing.

I read a lot about stomach and saliva acids in this thread that neutralizes the HIV from precum, semen and blood. Perhaps those taking acid reducing medications are more at risk for HIV too when giving oral ?

I am another one who thinks he was probably infected with HIV orally, but like most, I can't prove it. But I do know that I had at least one known risk factor (brushing/flossing) that I didn't know about then - I just knew that oral sex was "very low risk". I wish I had known about that risk factor before, as perhaps I wouldn't be a member of AIDSMEDS now if I did. I hope the other risk factors for oral sex are discovered too.

I have posted in other threads about my story more in detail, and I won't repeat it all again here. I'll just say that it does not feel good for your personal story to be called into question or dismissed altogether just because oral sex was not the only risk factor, which is what happens a lot around here when somebody mentions oral sex. I'm glad my doctor has a different attitude about it. I also notice that very few are stepping up to tell their own story about oral sex in this thread. I think that says a lot about how taboo the subject is.

Offline Miss Philicia

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #50 on: September 17, 2008, 05:16:17 PM »
Like I said, it seems obvious that you'd not want a blood leaking recently injected cock either in your mouth or part of a study on oral transmission, but whatever.  I'm not "dismissing" it as being a possibility in that ONE instance.

As far as other stories on this board about transmission -- yeah, many of them ARE full of holes.
« Last Edit: September 17, 2008, 05:21:07 PM by philly267 »
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Offline thunter34

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #51 on: September 17, 2008, 05:22:35 PM »
Count me as another one who got HIV through oral sex...





OK....I didn't really expect any of you to buy that.  I, for one, will readily own to taking it up the pooper...absolutely raw and uninhiBBited, as they would say on the web.  But do count me as another one who is really getting curious to know just how many people on this board swear they got the bug via blowjobs or cunnilingus.  Good grief...you people seem to be coming out of the woodwork.  Either such transmissions are truly rampant...or it's damn remarkable how many of you found your way here. 
AIDS isn't for sissies.

Offline srmn98

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #52 on: September 17, 2008, 05:26:59 PM »
I think the topic of who got HIV via oral sex could be started in another thread, I would like to keep this thread on topic which a theoretical / scientific discussion of whether transmission is possible via receptive oral.

thanks,

sara


Offline Ann

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #53 on: September 17, 2008, 06:01:03 PM »
Let's not resort to critiquing others' behavior or intentions, but rather focus on what's actually being said.

This has been an intriguing and informative dialogue -- let's keep it that way.

Thanks,

Tim

I want to remind everyone of Tim's words. As far as I'm concerned, "critiquing others' behavior" includes criticising people who think they may have become infected through giving oral sex.

The fact is, if the person being blown is unknowingly recently seroconverted with a viral load through the roof, it is entirely possible that together with other mitigating factors, infection may result. I didn't say probable, I said possible.

At the end of the day, how a person believes they became infected is entirely a personal, private matter. As long as they're not going to the national media and shouting it from the rooftops, I think we should just let them to their beliefs. After all, a person's beliefs do not change over 25 years of scientific study.

I don't want to see this thread getting personal again. OK? Thanks. If it does, it will be locked.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

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HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline thunter34

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #54 on: September 17, 2008, 06:05:19 PM »
Can we start a poll in another thread about how many people here think they got HIV solely through oral sex?  I'd really like to know.
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Offline keyite

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #55 on: September 17, 2008, 06:08:00 PM »
I'll just say that it does not feel good for your personal story to be called into question or dismissed altogether just because oral sex was not the only risk factor, which is what happens a lot around here when somebody mentions oral sex. I'm glad my doctor has a different attitude about it. I also notice that very few are stepping up to tell their own story about oral sex in this thread. I think that says a lot about how taboo the subject is.

Ain't that the truth. Older threads are literally littered with people repeating this same story, and without fail they get dismissed. This time round though, the accusations of 'internalised stigma' and promoting a 'caste system' were certainly a fascinating development.

As for the science, many have previously asserted that science will struggle to capture events that happen relatively rarely. I believe that to be true. Again, like others, I also believe a very high viral load will be a significant factor in oral transmission - several HIV health professionals I have spoken to have taken a similar view.

A very high viral load is typically associated with those that are undiagnosed - either themselves very recently infected or very late stage. How exactly do you propose to put together a scientific study that (ethically) evaluates the possible transmission via oral sex in those circumstances?

Offline Ann

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #56 on: September 17, 2008, 06:11:08 PM »
Can we start a poll in another thread about how many people here think they got HIV solely through oral sex?  I'd really like to know.

Tim, if you do and then proceed to use it as a whipping post for those people, you'll find yourself timed out. To be honest, I'd rather not see such a poll - not in light of the attacks some of these people have had to put up with in the past.

It's ultimately up to you but I'll warn you now - tread carefully - you're on thin ice in this thread as it is.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline mecch

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #57 on: September 17, 2008, 06:13:58 PM »
It was NOT a dripping bloody cock.  I did take park in a post conversion interview with professional epidemiologists.  The point I was making is that there are very occassional or rare risk factors involved in oral transmission - maybe the passif, as mentioned above, had dental work, or flossing, or a cancer sore or whatever. Maybe the active has VERY high viral load.  Maybe the active gets niked during the blow job. Maybe a cock ring cuts the lip of the passive. Whatever.  (The risk seems to me something comparable to the risk of super-infection - there are how many cases out of the millions of HIV in the world - just a couple of dozen known? But it does exist!)

In other words, the standard safe sex guidelines work almost all the time - but statistically a few people are going to convert through oral sex, since there are millions and millions of oral sex acts - a few people will fall into that small risk.

F.Y.I. - The only reason I didn't think twice about his impotence injection was that I had previously had a lover, hiv neg he said, and a nurse and responsable guy, who used to do the same thing, so I was kind of used to it, so this time with a different guy, it didn't raise my red flags of caution. Its a very small needle, like for insuline. There is no blood really.  

Stupid decision, this time, eh?  But maybe it was precum anyway.  He did not know he was recently poz.  Precum of a guy in serocoversion is not something you want, if he has a viral load in the milions, for example.  But then I know some real oral cum pigs who never contract HIV.

By the way, the more now I read about safe sex for positive guys, the more it seems that ORAL safe sex guidelines are not refined enough for many gay mens sex practices.  Many positive guys, treated or untreated, shed a lot of viruses via their mouths and their butts, besides HIV.  Some of those viruses in turn, may be cofactors in HIV infection, so it might go in a circle.  Lets say a negative guys get anal warts from safe sex with a positive guy. Happens all the time. Then eventually the negative guy might have a risk factor for HIV, for instance, if a untreated positive guy then fingers this negative guy, who might have bloody warts in his butt. (Yuk but hey).

Obviously, standard safe sex guidelines are generally quite protective. Very rarely, or in very special circumstances, it seems they are not.  

Finally, what about genetic predispositions?  Some people smoke and never get lung cancer. Other people smoke and get it.  
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Miss Philicia

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #58 on: September 17, 2008, 06:20:15 PM »

Obviously, standard safe sex guidelines are generally quite protective. Very rarely, or in very special circumstances, it seems they are not.  

Which is why they should be called "safer sex" not "safe sex" as there is no 100% safe sex except with a porn DVD and the palm of your hands.
"I’ve slept with enough men to know that I’m not gay"

Offline Ann

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #59 on: September 17, 2008, 06:27:27 PM »
Whoa, hang on here:

Many positive guys, treated or untreated, shed a lot of viruses via their mouths and their butts, besides HIV.

Saliva is not infectious. Show us the studies where hiv has been shown to be "shed" through the oral mucosa.

Then eventually the negative guy might have a risk factor for HIV, for instance, if a untreated positive guy then fingers this negative guy, who might have bloody warts in his butt.

Fingering is NOT a risk for hiv infection. Period. End of story.

Conceding that giving a blowjob - under the rare combination of mitigating factors which include a very high viral load of the insertive partner - could be a possible route to infection, is a far cry from the stuff you're coming out with now. Cool it and bone up on your transmission lessons.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline mecch

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #60 on: September 17, 2008, 06:30:05 PM »
HIV is not shed in the mouth. But HPV viruses are. I said "besides HIV" so my lousy grammar i meant "not including HIV"
Fingering is a risk factor for HIV, in my opinion. Don't be silly. If a guy is wacking off, and has cum or precum on his fingers, you dont want that in your butt, particularly if the guy has a high viral load.  So fingering is only safe when the finger is "clean". 
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline thunter34

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #61 on: September 17, 2008, 06:35:55 PM »
Thank you, Ann.  I was just looking at that about the fingering.

How the heck did I get "on thin ice as it is" in that thread when I have only posted two posts in it?  And neither of mine were attacks on anyone.  I just said it was damn amazing how many found their way to AM...and it IS.  

You don't really have to answer that - this thread is too dicey for my tastes as it is.  Maybe you just meant that we are all inherently skating at our own peril in this thread.  I can definitely see that!

I really would like to know about how many here really feel they got HIV via oral, but as I think on it I am not too sure how much a poll would tell us anyway.  I've never created one on here, and thought the anonymous aspect of it might help....but then there is really nothing from preventing a bunch of WW's from sliding in and casting a quick vote for "yes", is there?  And people can cast multiple votes, can't they?
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Offline mecch

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #62 on: September 17, 2008, 06:36:22 PM »
Why am I being censored for voicing my views, except perhaps if the way I express them has been misunderstood. I read very scholarly journal articles about viral shedding in HIV+ people, and spoke to my infectious disease/HIV specialist in my country, and these are real, unaddressed, unspoken concerns.  Thinking that the epidemiology of HIV transmission starts and stops with one virus is rather outdated, when so many other infectious cofactors can be involved, besides also behavioral factors.  
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Ann

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #63 on: September 17, 2008, 06:39:28 PM »
Mecch, thank you for the clarification on the first point. I did read you wrong.

But on the second point, I'm not being silly, I'm being factual. Hiv just does not remain viable and able to infect once outside the human body. Last time I checked, the skin on my hands is on the outside of my body. Fingering has NEVER been implicated in hiv transmission and never will be. It just doesn't happen in the real world.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Ann

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #64 on: September 17, 2008, 06:46:14 PM »
How the heck did I get "on thin ice as it is" in that thread when I have only posted two posts in it?  And neither of mine were attacks on anyone.  I just said it was damn amazing how many found their way to AM...and it IS.

Actually, you posted five times in this thread before I said you were on thin ice. Aside from the jokey hijacks of a serious thread, you also said this:

Count me as another one who got HIV through oral sex...

OK....I didn't really expect any of you to buy that.  I, for one, will readily own to taking it up the pooper...absolutely raw and uninhiBBited, as they would say on the web.  But do count me as another one who is really getting curious to know just how many people on this board swear they got the bug via blowjobs or cunnilingus.  Good grief...you people seem to be coming out of the woodwork.  Either such transmissions are truly rampant...or it's damn remarkable how many of you found your way here.


That reads to me like the thinly veiled thowing down of a gauntlet. You know, the whole coming out of the woodwork imagery. We know how you feel about this subject and we know what you're getting at. Don't take us for fools. 

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline mecch

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #65 on: September 17, 2008, 06:50:58 PM »
Well, I would say in all likelihood, transmission by fingering does not happen very much at all. But as someone mentioned above, no study is going to get into the details of the rare circonstance in which it would present a risk.  
This makes me think of a friend of mine who did seroconvert through unprotected fisting, with no sperme involved.
But fingering is getting off the oral topic, isn't it. I take a very holistic view that seemingly unrelated behaviours and risk factors might converge into an unfortunate result.  
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline thunter34

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #66 on: September 17, 2008, 06:54:40 PM »
Well, excuse me.  I didn't ever think "Buckles...protected sex....LOL" or "Who wants popcorn?" would ever be catagorized as inflammatory.  Now did I think the last post would either...it IS damn amazing that for an event that YOU have helped teach me to be so incredibly rare that so many people would be leaping out from all corners to declare they were infected that way.

And those "jokey highjacks" were meant to help diffuse the tensions in this thread, not escalate them.  I would have thought that would have been pretty obvious, but I guess not.

Whatever.

kthxbye.
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Offline Ann

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #67 on: September 17, 2008, 06:55:40 PM »
Why am I being censored for voicing my views

Mec, you're not being censored. If you were being censored, your post would have been deleted or edited, or you would have been banned or otherwise silenced. You haven't been.

However, you cannot expect people to not respond in kind with their own views. As long as there are no personal attacks or blatent misinformation being bandied about, we do not engage in censorship here.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Ann

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #68 on: September 17, 2008, 07:01:08 PM »
Tim, don't twist my words. I said JOKEY HIJACKS, I never once mentioned the word inflammatory. And in a serious thread like this, jokey hijacks tend to make people feel like they're being belittled. Sometimes the best way to help calm a situation down is to say nothing. If you wish to make jokey asides to someone, there's always the PM function and guess what, you can PM more than one person at a time. Try it next time instead of hijacking a serious thread. Thanks.

I do still firmly believe that oral infection is rare. However, that does not mean we will allow members to give a hard time to other members who believe they were infected this way. Yes, it can sometimes make our job harder in Am I. But we can handle that. I'm not worried about it and neither should you be.

Ann


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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline mecch

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #69 on: September 17, 2008, 07:13:39 PM »
Hi Ann
Delay in post and typical asychronous communication led to misunderstandings so I only saw your acceptance of my clarification after I posted about being censored :)  All is well.

However,
"Cool it and bone up on your transmission lessons" is a kind of censorship - well at least an editorial. 25 years of being HIV neg and with three poz boyfriends, I know well my transmission lessons. Finally I got caught with my defenses down.  

Also, on the topic of oral transmission, a word to all:  there are studies on the psychological denial recently seroconverted people can have about the acts that led to the transmission. So people are appropriate to be suspicious or inquisitive about POZ people who claim seemingly unlikely routes of transmission (such as oral sex) - when everone wants to believe it had to have been purposeful unprotected anal or vaginal sex, or sharing needles.  People tend to enjoy/expect/assume others human foibles and mistakes.  

However, as most countries national epidemiologists accept Oral transmission as a slight risk (I think Australia says not at all...?) then some people who did get HIV orally should be given the benefit of the doubt.  

What does it matter in the end.  

The point of the discussion is that education needs to be clear about SAFER versus SAFE sex, give more details about all the circumstances to avoid, and also, i think, as a gay man, that safe sex for positive people has to get a lot more attention and this includes issues surrounding ORAL sex and transmission of cofactors to HIV.  There is no research yet explaining the reason why such a large population of Poz gay men should also be poz for HPV, and which came first, and the relation between the two viruses in TRANSMISSION of each, if there is any.  (There are studies of course on HPV progression related to HIV progression)  Same for herpes, EBV and misc hepatitus.


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Offline Ann

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #70 on: September 17, 2008, 07:29:11 PM »
there are studies on the psychological denial recently seroconverted people can have about the acts that led to the transmission.

Thank you, mecch, this is exactly why myself and the other admin/mods here do not like to see people being browbeaten over the way they believe they were infected when it comes to giving blowjobs. Sometimes people are really fragile about this and who are we to shatter them further? In the context of a support forum, it serves no purpose. All we can do is point out that it's not probable, but it is on the fringes of possibility.

Ann
 
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Offline madbrain

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #71 on: September 18, 2008, 08:45:54 PM »
Ann,

The fact is, if the person being blown is unknowingly recently seroconverted with a viral load through the roof, it is entirely possible that together with other mitigating factors, infection may result. I didn't say probable, I said possible.

At the end of the day, how a person believes they became infected is entirely a personal, private matter. As long as they're not going to the national media and shouting it from the rooftops, I think we should just let them to their beliefs. After all, a person's beliefs do not change over 25 years of scientific study.

I'm glad you acknowledge the first point. Is it proven ? Are there scientific studies in the last 25 years that tried to study that case, and calculate the odds of infection orally from a person experiencing seroconversion ? I am not aware of one, but I would be glad to read it if there is one. And it might very well change my mind.

Maybe the remaining science on oral HIV transmission will never be done, given how rare these events seem to be. I still wish we knew more about it.

And I do not think this subject is only about the beliefs of those of us who think they were infected with HIV orally. Ultimately, we all have to deal with HIV, regardless of how we got it. I don't think there is any more shame to have regardless of whether the transmission path was anal sex, oral sex, vaginal sex, IV drugs, the mother, or a blood transfusion. For me personally, oral sex is the theory that makes the most sense based on all the facts I have. I would like to be able to disprove that theory just as much as I would like to be able to prove it.

I do think this issue is not just about those already infected, but also about making more accurate recommendations for safer sex and knowing which cofactors increase the usually very low risk of oral transmission, and by how much, for those who are currently HIV negative.

« Last Edit: September 18, 2008, 09:01:57 PM by madbrain »

Offline madbrain

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #72 on: September 18, 2008, 09:06:00 PM »
Which is why they should be called "safer sex" not "safe sex" as there is no 100% safe sex except with a porn DVD and the palm of your hands.

My wrist says even that is not 100% safe ;)

Offline Ann

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #73 on: September 19, 2008, 08:08:58 AM »
I'm glad you acknowledge the first point. Is it proven ? Are there scientific studies in the last 25 years that tried to study that case, and calculate the odds of infection orally from a person experiencing seroconversion ?

No, there are no specific studies that I'm aware of. I base what I say on the fact that in the three long-term serodiscordant studies, not one of the negative partners became infected despite not using barriers for oral (when condoms were being used consistently for intercourse). Some of the positive partners were on meds and undetectable, but not all; some were not on meds and did have detectable viral loads. However, none of them were newly infected with out-of-control viral loads, either.

It would be difficult to ethically do a study on oral sex in the recently infected with high viral loads. I can't see it ever happening.

Please understand that I'm not saying I think this is a common occurrence. However, I do believe there are a few unfortunate souls out there who have given a blowjob to someone who didn't know they were recently infected. Perhaps the blowjob-giver also had tonsils. Maybe those tonsils were slightly inflamed. Maybe they had a small cut in their mouth. Maybe their gums were in a really crappy condition. Maybe, maybe, maybe.

I really do have to stress that I think this is a VERY rare occurrence. There are too many factors which would need to come together, with a sky-high viral load being important.

Rather than scare-mongering about oral sex, I think the world's population would be better served by getting people to understand the REAL risks of unprotected intercourse and importantly, get people to TEST REGULARLY. Most new infections are the result of the positive person NOT KNOWING their positive hiv status.
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Offline Finnboy

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #74 on: September 19, 2008, 10:45:13 AM »
I do think this issue is not just about those already infected, but also about making more accurate recommendations for safer sex and knowing which cofactors increase the usually very low risk of oral transmission, and by how much, for those who are currently HIV negative.

Every current safer sex resource I am aware of is quite clear about the co-factors which are likely to increase the otherwise very low risk of infection through receptive oral sex; but, given that we are dealing in such rare and difficult to observe occurrences, it is next to impossible to put numeric values to the change in risk associated with those co-factors.

There just comes a point where it is up to the individual to make some decisions for themselves and just accept responsibility for the fact that nothing fun is without ever risk. If risk is going to freak them out, then they should be using a rubber – not expecting society to give them assurances which they can later use to absolve themselves of any responsibility, when things don't work out the way they would have liked.

Offline Ann

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #75 on: September 19, 2008, 10:59:55 AM »
This bears repeating:

There just comes a point where it is up to the individual to make some decisions for themselves and just accept responsibility for the fact that nothing fun is without ever risk. If risk is going to freak them out, then they should be using a rubber – not expecting society to give them assurances which they can later use to absolve themselves of any responsibility, when things don't work out the way they would have liked.

I find it rather telling that in all the years I've been working in the Am I forum, never has someone tested over giving a blowjob and found they'd been infected. Conversely, we have had several people (six or so) test over unprotected anal who tested positive. Never oral though, and we see a lot more people worrying over giving blowjobs than we do unprotected anal.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline srmn98

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #76 on: September 19, 2008, 12:39:06 PM »
I'm glad this thread has resulted in some good discussion. Thank you all for participating.

The whole point of starting this thread, for me, was to put it out there that there is a certain amount of risk in unprotected receptive oral. We think the risk is low, I think we can all agree on that, but we (largely) agree that transmission is a possibility in certain cases.

The fact that transmission is possible is the main thing I wanted to make clear. People can decide for themselves what risk they are comfortable with. I agree that we all must take responsibility for our actions. I find that easier to do when presented with all of the information.

Ann-- On another note, think using words like "never" when it comes to transmission issues is tricky. I think saying "to my knowledge" or "as far as we know" is more accurate. When we say "never has somebody tested over giving a blowjob and found they'd been infected" -- it sounds as though that case has never happened. Realistically, with how things go on this particular website, people get attacked for saying that they were infected orally, so it is possible that people just don't want to go through the harassment that often occurs. The moderators lately have been doing a good job of curbing this harassment but I still think it is a deterrent for people to say they were infected orally. Mecch, in this forum, said exactly that-- he believes he was infected via giving a blowjob. So people do say it, although he said it in "living with" not in "am I." I do agree with you that it is interesting that people do seem to worry a lot more over oral -- I'm not sure why that happens but it seems to be the case. Perhaps people abstain from vaginal/anal contact when they are unsure of their partner's status but are more comfortable risking oral since it is much safer, and then they get worried after the fact since nothing is 100%. Just a theory.

I think it is important for us to let people know that oral transmission is rare without downplaying any possibility of it. It is a fine line to give people the information without freaking people out about the risks. Educating people about viral loads and treatment, as well as encouraging more people to get tested, will help.

Take care,

Sara





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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #77 on: September 19, 2008, 04:50:50 PM »

Ann-- On another note, think using words like "never" when it comes to transmission issues is tricky. I think saying "to my knowledge" or "as far as we know" is more accurate. When we say "never has somebody tested over giving a blowjob and found they'd been infected" -- it sounds as though that case has never happened. Realistically, with how things go on this particular website, people get attacked for saying that they were infected orally, so it is possible that people just don't want to go through the harassment that often occurs. The moderators lately have been doing a good job of curbing this harassment but I still think it is a deterrent for people to say they were infected orally. Mecch, in this forum, said exactly that-- he believes he was infected via giving a blowjob. So people do say it, although he said it in "living with" not in "am I." I do agree with you that it is interesting that people do seem to worry a lot more over oral -- I'm not sure why that happens but it seems to be the case. Perhaps people abstain from vaginal/anal contact when they are unsure of their partner's status but are more comfortable risking oral since it is much safer, and then they get worried after the fact since nothing is 100%. Just a theory.

I think it is important for us to let people know that oral transmission is rare without downplaying any possibility of it. It is a fine line to give people the information without freaking people out about the risks. Educating people about viral loads and treatment, as well as encouraging more people to get tested, will help.

Take care,

Sara


Sara-

Please re-read what Ann wrote:



I find it rather telling that in all the years I've been working in the Am I forum, never has someone tested over giving a blowjob and found they'd been infected. Conversely, we have had several people (six or so) test over unprotected anal who tested positive. Never oral though, and we see a lot more people worrying over giving blowjobs than we do unprotected anal.


Are you seriously proposing that Ann temper the way she describes her own experience to better fit with your paradigm of what's "possible"?

It's not sufficient that she acknowledge the scientifically theoretical possibility of HIV transmission through oral sex, but now must re-write her experience to the detriment of truth?

When she said "never" (in italics yet!), she meant it. Never in her years of good work counseling people with their fears and assessing real-life risk has one resulted in a positive test result after a "risky" oral-only encounter.

She can expound on various theories, but her actual experience over the years must surely be able to stand for something, no? 
« Last Edit: September 19, 2008, 04:53:02 PM by Bucko »
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Offline srmn98

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #78 on: September 19, 2008, 05:28:43 PM »
Hi Bucko /Ann -

Maybe I misunderstand what Ann wrote --  I was just pointing out that in this very thread there is somebody who says he had oral contact and then tested positive. He just posted a few messages ahead in this very thread. Correct ? So I guess I'm confused by what Ann meant that it had never happened, maybe she can clarify.

I appreciate Ann's commitment to this board, I value Ann's opinions and valuable information -- but perhaps I'm misunderstanding Ann's statement ? 

I do think that educators, doctors, etc walk a difficult line. We do value their individual experiences. But when people we look to for advice come across as definitive (I'm NOT pointing at Ann, this is just a scenario), particularly those whom we look to for advice, we often believe them whole-heartedly. That's why I'm just saying it is tricky when to say something with definitive language when it is not definitive.

When I was making my choices about HIV, I was under the impression that oral was a no risk activity instead of a low risk activity. I wish I had known the true risks, low as they may be. I take full responsibility for my actions, but I still wish I had made the extra effort to get the correct information. Now I want to make it easier for others to at least be informed.

Sara

« Last Edit: September 19, 2008, 05:37:50 PM by srmn98 »

Offline madbrain

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #79 on: September 19, 2008, 05:34:50 PM »

No, there are no specific studies that I'm aware of. I base what I say on the fact that in the three long-term serodiscordant studies, not one of the negative partners became infected despite not using barriers for oral (when condoms were being used consistently for intercourse). Some of the positive partners were on meds and undetectable, but not all; some were not on meds and did have detectable viral loads. However, none of them were newly infected with out-of-control viral loads, either.

It would be difficult to ethically do a study on oral sex in the recently infected with high viral loads. I can't see it ever happening.


Indeed, it would be unethical not to treat someone who is known to have a very high viral load merely for the purpose of those studies. So what that says is that the studies just don't cover the 25% of HIV carriers who aren't aware of their HIV status I believe, let alone of their viral load.

Quote
Please understand that I'm not saying I think this is a common occurrence. However, I do believe there are a few unfortunate souls out there who have given a blowjob to someone who didn't know they were recently infected. Perhaps the blowjob-giver also had tonsils. Maybe those tonsils were slightly inflamed. Maybe they had a small cut in their mouth. Maybe their gums were in a really crappy condition. Maybe, maybe, maybe.

Indeed. And maybe the odds of 1 or more of those events happening is very low, but they could still well be much higher than being hit and killed instantly by a meteor.

Quote
Rather than scare-mongering about oral sex, I think the world's population would be better served by getting people to understand the REAL risks of unprotected intercourse and importantly, get people to TEST REGULARLY. Most new infections are the result of the positive person NOT KNOWING their positive hiv status.

That may very well be true on a global level, not many infections will be prevented even if all oral transmissions were completely stopped. On an individual level however, HIV is still bad news, and I do think people should be better informed about what risks they are taking, because it should be their decision whether or not to take those risks.

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #80 on: September 19, 2008, 06:27:34 PM »
Hi,

The fact that transmission is possible is the main thing I wanted to make clear. People can decide for themselves what risk they are comfortable with. I agree that we all must take responsibility for our actions. I find that easier to do when presented with all of the information.

Absolutely, the more complete and accurate information, the better decisions people can make.

Quote
I do agree with you that it is interesting that people do seem to worry a lot more over oral -- I'm not sure why that happens but it seems to be the case. Perhaps people abstain from vaginal/anal contact when they are unsure of their partner's status but are more comfortable risking oral since it is much safer, and then they get worried after the fact since nothing is 100%. Just a theory.

I can only speak for myself, but in my case I never got very worried after doing unprotected oral with a lot of guys, despite getting other more benign STDs through oral years ago (chlamydia). I thought HIV was a much more fragile virus than that bug based on what I had read about the odds of oral transmission. I only had to re-examine my behavior about oral sex when it was too late, after I had seroconverted, and I started suspecting that I had gotten HIV that way too.

Offline madbrain

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #81 on: September 19, 2008, 06:49:39 PM »
Hi,

Every current safer sex resource I am aware of is quite clear about the co-factors which are likely to increase the otherwise very low risk of infection through receptive oral sex; but, given that we are dealing in such rare and difficult to observe occurrences, it is next to impossible to put numeric values to the change in risk associated with those co-factors.

I was certainly never aware of the co-factors before my infection. It's not for not having read about STDs. I had gotten material about STDs from my doctor's office, from the periodical newsletter of the SF AIDS foundation to which I donated for many years before I seroconverted. I don't recall seeing the co-factors for HIV oral transmission ever being stated anywhere before I tested positive.

Quote
There just comes a point where it is up to the individual to make some decisions for themselves and just accept responsibility for the fact that nothing fun is without ever risk. If risk is going to freak them out, then they should be using a rubber – not expecting society to give them assurances which they can later use to absolve themselves of any responsibility, when things don't work out the way they would have liked.

I disagree. Individuals cannot make informed decisions if they are given incomplete or inaccurate information about risks of transmission.

And we do get told a lot of fun things are without risk, you only have to read this whole thread - check about masturbation, fingering, etc. I'm not putting any of these into questions, just to be clear, but hypothetically, if any one of them was proven 5 years from now to have more than zero risk, and somebody got infected that way, would someone following that advice have the right be upset and to blame society for giving them the wrong information about the risk they took ? And do you think they might want the corrected risk information to be distributed to others ?

Offline Mike89406

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #82 on: September 20, 2008, 01:22:09 AM »
Sara,

As far as my personal experience goes with this topic I don't know a single person HIV+ personally that has been infected cunnilingus or fellatio. I can say that the research is speculative and since there are no official documented cases of oral sex transmission we may not know for a long time, but what we do know is that in order for there to be any chance for this infection to transmit the virus to a HIV- person some criteria has to come in to play. Cuts inside the mouth, canker sores, brushing and flossing your teeth a couple of hours before oral sex or less will cause cuts or compromise the membrane which could put you at a higher risk. If there aren't any cuts, sores and wounds inside the mouth there is no risk for exposure however what people giving oral sex have to watch out for is other STD's that can be transmitted through the mouth.

My doctor & other HIV specialists have explained to me that there is a minuscule amount of HIV in the saliva from a POZ person but you would have to extract all the HIV out of gallons of saliva and forcibly inject it into someone to infect them.

I'm not a expert on the topic I learned some of my information from 8 almost 9 years being + and surrounded by some of the best ID doctors and research nurses from the NIH in Bethesda and doing my homework.

Sara:
  There are also people who test positive for HIV and claim that unprotected fellatio was their only risky behavior. However, it's virtually impossible to know if these people are always reporting their sexual behavior accurately. (Study volunteers often have a difficult time admitting the truth about potentially embarrassing behavior to healthcare professionals conducting scientific studies.)
Regards Mike
« Last Edit: September 20, 2008, 01:32:47 AM by Mike89406 »

Offline Finnboy

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #83 on: September 20, 2008, 03:39:44 AM »
I was certainly never aware of the co-factors before my infection. It's not for not having read about STDs. I had gotten material about STDs from my doctor's office, from the periodical newsletter of the SF AIDS foundation to which I donated for many years before I seroconverted. I don't recall seeing the co-factors for HIV oral transmission ever being stated anywhere before I tested positive.

OK, well, according to your signature line, you were infected and diagnosed in 2006. The following is typical of the sort of advice that I would have seen long before then (in fact, this is copied word for word from a 2005 Terrence Higgins Trust safer sex leaflet):

Quote
Can HIV be transmitted through oral sex?

The short answer is yes. But the risk is lower than some other sexual activities.

Recent surveys have shown that only a small minority of new cases of HIV that are diagnosed are due to oral sex. Although HIV is present in vaginal fluids, semen and the clear fluid that your penis produces for lubrication before orgasm, it is unlikely these will come into contact with your bloodstream during oral sex. But while it’s unlikely, it’s not impossible.

The risk factor is largely due to your oral hygiene. If you have ulcers, dental bleeding or lacerations then theoretically the infection could reach your bloodstream. However, saliva has enzymes that inhibit transmission and the cells in the mouth aren’t very absorbent, so the chance of transmission is low.

Ways to lower the risk

If you’re performing oral sex on a man then you could:

    * avoid getting semen in your mouth
    * use a condom
    * have oral sex with fewer men.
    * look after your oral hygiene.

Do not have oral sex when you have a throat infection or have bleeding gums.

If you’re performing oral sex on a woman then you could:

    * use a barrier such as cling-film, a dental dam, a Femidom or a sheet cut from a condom
    * have oral sex with fewer women
    * look after your oral hygiene.

You should avoid oral sex when a woman is having her period.

The current leaflet goes even further and talks about not flossing, using mouthwash or brushing your teeth.

I disagree. Individuals cannot make informed decisions if they are given incomplete or inaccurate information about risks of transmission.

If telling people that there is a risk and what they can do to lower the risk - even telling them when they should avoid the activity altogether - really isn't enough; then that most certainly isn't society's problem. It is the individual problem of someone who isn't able to (or doesn't want to) take responsibility for their own actions.

OK, so you could go one step further and say something along the lines of: "Don't give head when you are recovering from oral surgery" - which conveniently covers the high risk factor in the one convincingly documented Australian study case that I am aware of - but there are certain things that come under the heading of plain common-sense.
« Last Edit: September 20, 2008, 04:38:34 AM by Finnboy »

Offline newt

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #84 on: September 20, 2008, 03:52:59 AM »
Yes, but, erm, oral sex with barrier protection is like eating a banana with the skin on
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Offline komnaes

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #85 on: September 20, 2008, 04:34:39 AM »
Quote
I disagree. Individuals cannot make informed decisions if they are given incomplete or inaccurate information about risks of transmission.

Hmmm.. we're talking about an infectious disease with established routes of transmission. But like all infectious diseases this is always a game of chance. You just need that one contact to get infected.

We know there are definitive high risk behaviors (bareback penetrative sex), and there exists a range of low risk to academic/theoretical risk behaviors. That's as accurate a method of risk assessment as one can get, you cannot get more definitive or specific than that because within that range of low/theoretical risk behaviors there are many many variations (e.g. I may have a cut on my finger when I finger her, etc).

Otherwise any education materials will read like a medical journal. I attended many trainings years ago and heard so many questions about those variations (e.g. I just jerk off a guy and with cum still on my hands I rub my eyes, will I get infected; some cum might have landed on a pimple when he cum on my face, will i get infected, ad infinitum, etc). Even at that time it sounded to me those asking were already thinking of possible excuses to tell people when and if they got infected.

Well, who knows, it could have been that one time I stepped on some cum in a sauna while I had this cut on my toe.
Aug 07 Diagnosed
Oct 07 CD4=446(19%) Feb 08 CD4=421(19%)
Jun 08 CD4=325(22%) Jul 08 CD4=301(18%)
Sep 08 CD4=257/VL=75,000 Oct 08 CD4=347(16%)
Dec 08 CD4=270(16%)
Jan 09 CD4=246(13%)/VL=10,000
Feb 09 CD4=233(15%)/VL=13,000
Started meds Sustiva/Epzicom
May 09 CD4=333(24%)/VL=650
Aug 09 CD4=346(24%)/VL=UD
Nov 09 CD4=437(26%)/VL=UD
Feb 10 CD4=471(31%)/VL=UD
June 10 CD4=517 (28%)/VL=UD
Sept 10 CD4=687 (31%)/VL=UD
Jan 11 CD4=557 (30%)/VL=UD
April 11 CD4=569 (32%)/VL=UD
Switched to Epizcom, Reyataz and Norvir
(Interrupted for 2 months with only Epizcom & Reyataz)
July 11 CD=520 (28%)/VL=UD
Oct 11 CD=771 (31%)/VL=UD(<30)
April 12 CD=609 (28%)/VL=UD(<20)
Aug 12 CD=657 (29%)/VL=UD(<20)
Dec 12 CD=532 (31%)/VL=UD(<20)
May 13 CD=567 (31%)/VL=UD(<20)
Jan 14 CD=521 (21%)/VL=UD(<50)

Offline Ann

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #86 on: September 20, 2008, 07:32:30 AM »
quote from Sara: Maybe I misunderstand what Ann wrote --  I was just pointing out that in this very thread there is somebody who says he had oral contact and then tested positive. He just posted a few messages ahead in this very thread. Correct ? So I guess I'm confused by what Ann meant that it had never happened, maybe she can clarify.

what I said: I find it rather telling that in all the years I've been working in the Am I forum, never has someone tested over giving a blowjob and found they'd been infected. Conversely, we have had several people (six or so) test over unprotected anal who tested positive. Never oral though, and we see a lot more people worrying over giving blowjobs than we do unprotected anal.

I was speaking strictly of my experiences in the Am I Infected forum of this website - not the other forums. I would have thought it was rather obvious.

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Offline LordBerners

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #87 on: September 20, 2008, 02:10:05 PM »
This bears repeating:

accept responsibility for the fact that nothing fun is without ever risk.

I'd like to chime in, hopefully without offending anyone.  Of course what is 'fun' is rather subjective, but for me masturbation is more fun than 'safe sex', and certainly is devoid of risk.
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Offline mecch

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #88 on: September 20, 2008, 03:00:32 PM »
Is this thread still quite active?  Well some people kindly wrote to me privately to thank me for sharing my "transmission" experience. 
The title of this thread - nobody likes to talk about it.   The title was not lets prove there is or is not oral hiv transmission. 
Someone mentioned that there won't be studies of high viral load active partners (e.g. recent seroconvertors or althernatively those poz people somewhere close to or in AIDS diagnosis) because it would be unethical to not treat those people known to have high viral loads.
In fact, in my country, it was only one or two years in around 2005 that many people were treated at seroconversion - in acute HIV that is.  Now it is back to the viral load and CD4 test.  So everyone known to be seroconverting is ADVISED by the medical community to avoid sex if possible until the viral load goes down, and if no possible to avoid, to absolutely practice strict safe sex, not "safer sex". 
Unfortunately many people DO NOT know they are seroconverting!  (That was the case of the guy who trasmitted to me.  And, as I said, the contact was verified by subsequent genotype testing)

I hear the pendulum is swinging back, after AIDS mexico 2008, to treatment at Acute/Seroconversion stage. To my knowledge, there is only one doctor in my part of the country who seems to get away with perscribing the treatment and having insurance companies not object! 

What a mess, really!

I shared my experience NOT to instill fear in those who get hung up over giving blowjobs.  Rather to show that, yes, special circumstances combined with oral sex, can be an HIV transmission risk.

If all you naysayers want to object, so be it.  How many of you would be willing to risk your sureness on this  issue by giving oral sex to a group of seroconverters with high viral loads!   Not me.

I for one, also believe in superinfection - and nobody wants to talk about that either because the science is so scant and the evidence is so few cases around the world.

But the science evolves EVERY year. Who knows what we will discover eventually.

I also believe that I ONLY became infected after 25 years of the same "safer sex" practices - oral and deep throating but no cum in the mouth - because as it happened I was very sad and stressed for a few months when I did get infected, and I believe my natural killer cells and thymic functions were reduced!  Combined with poppers. Combined with a particularly big dick, which reached into my throat (dedric cells). Combined with the guy having a high viral loads.  Combined with him having used injection to treat his impotence.

But there was no unprotected anal sex. And no sperm exchange. 

Its exhausting and sad to think about all those special conditions.  Mind boggles.

Life goes on.  I am on HAART since August.  I know its working to radically reduce my viral load, which was 5,000,000 in August.   I get more results next week.

I hope it leads to undectable by Christmas and I have many healthy years ahead of me.

Less stigma, less shame, more acceptance on however people get HIV (hardly ANYONE wants to get it, afterll) more understanding of the benefits and advances in treatment circa 2008, will lead to more TESTING, and hopefully more treated poz people, and less transmission.   

When i was seroconverting in early May, a very reputable clinique surveyed my practices and didn't recommend HIV testing precisely because I always used condoms. 

“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline mecch

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #89 on: September 20, 2008, 04:01:05 PM »
You know, I learned something contributing to this thread:

It seems that some people accuse people who say they got HIV through oral sex of being in denial about an alternative route of transmission - I'm not saying anyone in this thread did that, but just generally.

Related to that theory about the orally-infected-poz-person (oipp?) is the unspoken assumption that the oipp must feel shame about the supposed non-oral but true transmission act. 

But actually, one could turn that argument around. What if most people have a hierachy of shame and guilt attached to HIV transmission. Maybe those who deny oral transmission think oral transmission is less shameful!  And maybe they don't want someone to have a "less shameful" story about it.  As in, (for us gays at least) "come on, you were an irresponsible barebacker so just admit it".   

Oral transmission is rare, but it happens.

I don't care how anyone gets HIV, actually. Because I believe that almost noone wants to get infected. If people are reckless, it could be for million different reasons and it could be just once or all the time. Who is to judge. If people are unlucky, then they are just unlucky - everyone gets bad deals a few times in life!

Its a virus. Hard to transmit often, often quite avoidable, but not always.

How about this: happens all the time: Your run into your friend at a party and she/he says "I'd kiss you hello but maybe not, cause I've got/I'm getting the flu."   

If someone knew they had a high viral load, it would be nice to avoid ANY risk, no? I would not KNOWINGLY give oral to a person with a 1,000,000 viral load. 

I do believe there are more details to "safer sex" that could be profitably shared with the public, but perhaps not all the public will be clever enough to manage it.  Someone above mentioned the opposite idea - as in we can't possible warn people of all the "common sense" wisdom of unwise hiv risk actions...(Do not walk in a busy sexclub steam room with cuts on your feet, etc...."  This is sort of insulting.

The Swiss announcement about a new "safer sex" rule - treated and undectable means nontransmissable in faithful, closely monitored hetero couples -- is dangerous when it justifies poz guys in my gay world saying they are non-transmissable because undetectable, so they can bareback whomever they please. BUT THAT doesn't mean the Swiss announcement is completely indefensible.  Maybe it's erring to the benefit of intelligent people.

As I said, only after one seroconverts in my country do doctors warn poz people about dangers of high viral loads - e.g "protect other people".  And they don't give HAART, normally.  But they know the number of seroconversions go in fits and starts over the year, grouped into mini-waves.

I'm not glad I have HIV, I'm surprised how i got it, I'm surprised to discover that I would have been a hyper fast "progressor" were not for effective treatment, so actually I'm glad I got tested and I'm glad I am now treated so fast (in "acute phase") precisely because I can soon resume my sex practices knowing that I'm not radioactive with high viral loads - greatly lessoning my own and my partners hesitation about sucking dick again without condoms.







Best regards,
Mecch
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline RapidRod

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #90 on: September 20, 2008, 05:00:25 PM »
Mecch, I read your thread on MedHelp. You don't know if you contracted HIV from oral sex or not. You said it was possible that you had a condom failure.

Offline bocker3

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #91 on: September 20, 2008, 05:26:50 PM »
I'm been following this thread and tried to stay out because each time the topic comes up people get so ugly, but.........

It's one thing to state an opinion on whether or not you think oral transmission is possible, probable or what not -- it's an entirely different thing to start spouting whether or not YOU think someone got infected one way or another.  Unless you were there at the time of infection, you really have no say in it.  It's none of your business.
I think Ann has been doing a great job at trying to keep this thread informative and civil -- but it is probably hopeless.  The personal attacks and downright meanness is just unnecessary. 

And... before someone starts throwing out the old, "I'm just thinking of all the worried well in Am I Infected", spare me.  Unless it's a crazy thing like "I got HIV from sharing someone's lipstick", we aren't going to be sparing them any worries by bashing someone else.  The moderators and members do a pretty good job of talking sensibly to the WW.  In this particular topic, it's simply an excuse to demean and be mean to others.

OK -- I got it off my chest.  Now back to regular programming, already in progress.

Mike
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Offline Bucko

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #92 on: September 20, 2008, 05:40:25 PM »
Mecch, I read your thread on MedHelp. You don't know if you contracted HIV from oral sex or not. You said it was possible that you had a condom failure.

Link, please, Rod?
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Offline BT65

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #93 on: September 20, 2008, 09:50:35 PM »
I just have to chime in and say a bit from my personal experience (and believe me, it runs deep and goes back a few miles).  I've given more head than Andy Warhol, all "unprotected," and have never, ever gotten any kind of disease or dis-ease from said act. And I've had many, many unsightly johns. I have gotten many STD's from unprotected vaginal and anal sex. 

My take is that people aren't getting honest, plain and simple (or are in denial).
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Offline Mike89406

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #94 on: September 21, 2008, 02:57:26 AM »
No one can say for certain that mecch did or didn't become POZ by oral transmission. I certainly won't argue the point simply because I'm not a medical expert, I do believe I'm highly educated in my status as I have been schooled by my various doctors, nurses, and HIV researchers enough to know what safe sex is or isn't and various routes of transmission and to practice universal precautions. Having said that the only sure way of preventing transmission is abstinence if you want to get down to brass taxes because the fact remains anal sex as we all know is the easiest route of transmission and oral sex while very low is probable but not certain in most cases.

Just because a person uses a condom every time during anal sex does not prevent you from transmission, truth be told all it takes is a little semen leaking out any place on the condom or the base of the condom rolling and a little semen comes in contact in the anus passage.

What does this all mean? You can be the safest person with a condom check the expiration dates and think your being careful using the condom even though a condom doesn't rip or you can't see leakage  doesn't mean the receptive person is safe I think the condom effective rate is 90 something percent but still a higher infection rate than oral transmission.

Does this mean people like mecch is lying or denying anything? Certainly not maybe he is sure of or strongly believes that this is how he received HIV and if that's the way it happened or what he believes so be it. Who am I to judge.

Last thing though there are HIV+  persons out there that will deny the real way they were infected to avoid embarrassment or that's just they're nature. That's the point I was trying to make.

Mike

Offline komnaes

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #95 on: September 21, 2008, 03:31:18 AM »
If we want to go as far as abstinence except when one is in a committed relationship, we might as well not to have sex at all. Think about all the cases of folks getting infected by their partners in relationships they thought were monogamous. That's why I always think abstinence is a moral position, not a practical position, in educational and public awareness campaigns.

I tend not to believe in claims of oral transmission, and you don't really need to be a medical scientist to have an opinion, because I have been living with HIV for many years even before my diagnosis and I have seen enough cases to have an educated opinion. If a friend or someone I know is to tell me that s/he got it through oral sex, I won't go on to argue or insist that s/he must have done more than that to get infected, or that s/he is lying. It's done deal, so, except from a medical research perspective, it really doesn't matter at all now as s/he is HIV positive.

And for the folks that are still negative - the more sensible approach, for me at least, is to tell them that there exists an academic risk of transmission via oral sex, then they can decide what they'd like to do with the information. You just cannot get more definitive in term of risk assessment by also adding that one should regularly check for STDs and HIV if one has an active sex life.
« Last Edit: September 21, 2008, 03:33:42 AM by komnaes »
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Offline Mike89406

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #96 on: September 21, 2008, 05:07:15 AM »
I won't go on to argue or insist that s/he must have done more than that to get infected, or that s/he is lying. It's done deal, so, except from a medical research perspective, it really doesn't matter at all now as s/he is HIV positive.

I wont argue it either because all that really matters is the last sentence because you can debate how or how you didn't receive it. What matters now is that the person has the virus. 

Offline mecch

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #97 on: September 21, 2008, 06:52:14 AM »
I agree with Komnaes and Mike.
If someone gets HIV its a done deal. I agree that we can be suspicious of frequent reports of oral transmission and certainly be informative when people have fears about oral transmission.
My post to MedHelp was before I had genotype matching to the source of my infection so there were about five likely partners and sex acts (late march or April) that could have let to the infection.  I spoke to the source of my HIV and we reviewed our sex acts and I can only go on faith theirfore to believe him that there was no condom failure. I didn't see condom failure with any of the five, actually. I said on MedHelp it was a theory.  Just as I say here that oral transmission is a theory for me.  (I believe it is likely and my seroconversion symptoms concur.) 
Someone above then starts to talk about sperm leaking out the edge of a condom during anal sex and so then we start of the same track of strange circumstances that can turn "safer sex" into unsafe sex. Just like the list of unlikely circumstances that may have led to oral transmission in my case - the fact that the source was seroconverting and had high viral load (and didnt know, which he confirmed subseqently) for example or that he.... blah blah blah I've already discussed this list above....

Strange that those who are really not interesting in allowing for possible oral transmission -- (and aren't we really talking about THROAT transmission if we are talking about deepthroaters enjoying large penises - try to find that in printed safer sex guidelines, by the way) --  would now go down a hershey highway of special circumstances in which protected anal sex (or vagainal sex, for that matter) could lead to transmission.

I believe I opened this conversation sufficiently that EVERYONE involved could benefit from examining their own values and prejudices they bring to such a conversation, in addition to the epidemiological science about the low risk of oral transmission.  Its not just the OIPP (potentially... orally infected positive person) who needs to examine their "beliefs" and acts.

For me, its cool to read this, no personal offense taken. I don't know any of you so say whatever you want.


“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline mecch

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #98 on: September 21, 2008, 07:38:30 AM »
I just have to chime in and say a bit from my personal experience (and believe me, it runs deep and goes back a few miles).  I've given more head than Andy Warhol, all "unprotected," and have never, ever gotten any kind of disease or dis-ease from said act. And I've had many, many unsightly johns. I have gotten many STD's from unprotected vaginal and anal sex. 

My take is that people aren't getting honest, plain and simple (or are in denial).

Bettytacy, I don't follow the logic of your post.  You would have say which STDs you go through unprotected vaginal and anal sex and how you know transmission was only through that and not through a blow job. For instance the viruses that cause anal or vaginal warts can be transmitted orally. 

On the other hand, I do agree with the general gist of your comment. I think you are representing the "experiential evidence" contingent regarding the low risk of HIV transmission. I gave tons of head for 25 years and did NOT seroconvert.  By the way I was not a sperm taker - only happened a couple of times when the active didn't ask.  On that count, I know oral sperm pigs who have never seroconverted. 

This "experiential evidence" also proves the rarity of oral transmission and general sureness of safer sex guidelines about oral risk and HIV.

I believe that a few in this thread are making the point that perhaps "safer sex" education could (for certain ages, population, perhaps) use an overall about to match the evolving science.  That was my point in bringing up the new Swiss guidelines about transmissability of HIV in unprotected vaginal sex.

A LONG LONG time ago, when I lived in the USA... William F. Buckley at the beginning of the epidemic recommended that HIV poz gay guys be tatooed on the ass.  EVERYONE was scandalized by this, rightly so. But I had a mixed reaction to it at the time. I thought, thats not the worst idea from a transmission standpoint.  I mean, if in the 80's with all the fear and unknowns then, if you knew that someone was POZ you could make decisions based on that for your own either 1) protection or 2) peace of mind.

I thought it was REALLY strange that my specialist made such a point of telling me about my high transmissability when I had viral load of millions during seroconversion this summer.  I mean I agreed with him and followed his guidelines - but where is that info beforehand.

Yes it wouldn't do much good for personal choice in choosing your sex acts if the other person doesn't know their POZ status, let alone their viral load. 

But it seemed to me my doc - who also does NOT think oral sex is much of a risk for anyone - was hypocritical because then when I was radioactive he was telling me not to have ANY sex because suddenly oral sex was a risk. 

So in a nut shell - keeping this thread on ORAL TRANSMISSION - it seems many of us are looking forward to a day when much more of the population is regularly tested for HIV with the hope that knowing you are POZ is going to lead to honesty and also choices to prevent risk acts with other people.  Also lower the stigma of being POZ, of having the dreaded HIV virus.  The effective treatment helps here too.

This knowledge in the POZ community and this info coming form science to the POZ community (the obligation to be vigilant to protect negative people) doesn't match what negative people commonly know about risk. 

So wouldn't it be extra nice in the future if POZ people 1) knew they were poz and 2) knew how much virus they had so as to 3) were told the advantages and risks of early HAART and offerred the choice of very load viral loads if they choose to go on HAART - which would be paid for by insurance companies upon the patients and doctors choices - not some antiquated C4/viral load guideline and 5) share some of that info with their partners.  (As in - "you should know before you deep throat my beautiful big penis that I have a high viral load and a lot of precum".)  Hahaha - I go pretty far I know.  But you are all clever enough to see my point.

So aren't we coming around to an evolved knowledge somewhat related to Buckley's original, provocative and vulgar proposition!



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Offline atlq

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #99 on: September 21, 2008, 09:45:26 AM »
I really did not want to come here and post. But I guess my inner stupid is overwhelming me now. I hold no animus toward people who believe they become positive through oral sex . But I do have a problem with this idea that there is a "conspiracy of silence" on this subject or that those of us who are questioning on this issue are seeking to stifle discussion.

 
You know, I learned something contributing to this thread:

It seems that some people accuse people who say they got HIV through oral sex of being in denial about an alternative route of transmission - I'm not saying anyone in this thread did that, but just generally.

Related to that theory about the orally-infected-poz-person (oipp?) is the unspoken assumption that the oipp must feel shame about the supposed non-oral but true transmission act. 

But actually, one could turn that argument around. What if most people have a hierachy of shame and guilt attached to HIV transmission. Maybe those who deny oral transmission think oral transmission is less shameful!  And maybe they don't want someone to have a "less shameful" story about it.  As in, (for us gays at least) "come on, you were an irresponsible barebacker so just admit it".   

 



?????..Yeah...I lie in bed at night, tossing and thinking "If only I had become positive by sucking dick instead of having intercourse....I would feel so much...cleaner....."

I find this talk from some the OP's (meaning Oral Pozzies) about the lack of medical advice on oral sex to be ....unconvincing?

I remember having conversations (many in fact) with my then partner (who is negative) about sexual boundaries that made us both comfortable. And I distinctly remember having discussions about oral sex, theoretical versus documented risk, etc... . This was in the mid nineties.



 
 
A LONG LONG time ago, when I lived in the USA... William F. Buckley at the beginning of the epidemic recommended that HIV poz gay guys be tatooed on the ass.  EVERYONE was scandalized by this, rightly so. But I had a mixed reaction to it at the time. I thought, thats not the worst idea from a transmission standpoint.  I mean, if in the 80's with all the fear and unknowns then, if you knew that someone was POZ you could make decisions based on that for your own either 1) protection or 2) peace of mind.

 

 

 

Good God....

I guess we could all be forceably  tattooed....or  maybe each person who has sex could , oh I don't know, just read some basic information on HIV transmission and take prudent and reasonable precautions....


I always disclose to my sexual partners. It just works better for me. And yeah, I think disclosure is good and healthy. But universal disclosure (barring Buckley's mass branding) is not going to occur. Therefore, it is up each of us to use prudent precautions when having sex... I really don't see it as being significantly more complicated then that.

If you are uncomfortable having oral sex because of theoretical risk, slap a condom on the thing (gag!)....


Submitted with all due respect,

 :)







« Last Edit: September 21, 2008, 09:51:15 AM by atlq »
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Offline komnaes

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #100 on: September 21, 2008, 10:08:16 AM »
I don't think we arrange on much of anything Mecch, in particularly after reading your last two posts..

This thread starts again with a proposition that we don't talk about oral transmission, as if it's a skeleton in the closet, which is not true to start with. And then there are folks making claims that people who think they were infected via oral sex are lying because some of us have prejudices and are making value judgments.

What we are just saying is that whatever one said about how s/he was infected here is just an anecdote. Nothing more. If one is so sure that s/he was infected via oral sex, s/he should talk to her/his health providers and doctors, who will then investigate and report the case as part of the overall statistics gathered regularly. If there are enough cases with overwhelming evidences suggesting that oral transmission is very real or even common (i.e. the risk is less than academic), then the data and evidences will be reviewed and confirmed, which will then be adopted for the drafting and amending of safer sex guidelines.

And we're just saying that those reviewed guidelines should be what we relay on to tell negative folks to assess their risks. Is there any prejudice or value judgment in relaying on this process that we need to be mindful of?
Aug 07 Diagnosed
Oct 07 CD4=446(19%) Feb 08 CD4=421(19%)
Jun 08 CD4=325(22%) Jul 08 CD4=301(18%)
Sep 08 CD4=257/VL=75,000 Oct 08 CD4=347(16%)
Dec 08 CD4=270(16%)
Jan 09 CD4=246(13%)/VL=10,000
Feb 09 CD4=233(15%)/VL=13,000
Started meds Sustiva/Epzicom
May 09 CD4=333(24%)/VL=650
Aug 09 CD4=346(24%)/VL=UD
Nov 09 CD4=437(26%)/VL=UD
Feb 10 CD4=471(31%)/VL=UD
June 10 CD4=517 (28%)/VL=UD
Sept 10 CD4=687 (31%)/VL=UD
Jan 11 CD4=557 (30%)/VL=UD
April 11 CD4=569 (32%)/VL=UD
Switched to Epizcom, Reyataz and Norvir
(Interrupted for 2 months with only Epizcom & Reyataz)
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April 12 CD=609 (28%)/VL=UD(<20)
Aug 12 CD=657 (29%)/VL=UD(<20)
Dec 12 CD=532 (31%)/VL=UD(<20)
May 13 CD=567 (31%)/VL=UD(<20)
Jan 14 CD=521 (21%)/VL=UD(<50)

Offline Bucko

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #101 on: September 21, 2008, 12:24:09 PM »
If we want to go as far as abstinence except when one is in a committed relationship, we might as well not to have sex at all.

Bingo, Shawna-

You hit the nail on the head. It's where this discussion always seems to lead, which is why "nobody likes to talk about it".

Much as it's been strenuously denied, there is a deep vein of sexual prohibitionism that runs through many of the posts here. When I find it similarly expressed by AIDSphobes in other places on the web, I go full-throttle attack. Here, for the most part, I've bitten my tongue.
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Offline Peter Staley

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #102 on: September 21, 2008, 12:48:56 PM »
No one can say for certain that mecch did or didn't become POZ by oral transmission. I certainly won't argue the point simply because I'm not a medical expert, I do believe I'm highly educated in my status as I have been schooled by my various doctors, nurses, and HIV researchers enough to know what safe sex is or isn't and various routes of transmission and to practice universal precautions. Having said that the only sure way of preventing transmission is abstinence if you want to get down to brass taxes because the fact remains anal sex as we all know is the easiest route of transmission and oral sex while very low is probable but not certain in most cases.

Just because a person uses a condom every time during anal sex does not prevent you from transmission, truth be told all it takes is a little semen leaking out any place on the condom or the base of the condom rolling and a little semen comes in contact in the anus passage.

What does this all mean? You can be the safest person with a condom check the expiration dates and think your being careful using the condom even though a condom doesn't rip or you can't see leakage  doesn't mean the receptive person is safe I think the condom effective rate is 90 something percent but still a higher infection rate than oral transmission.

Does this mean people like mecch is lying or denying anything? Certainly not maybe he is sure of or strongly believes that this is how he received HIV and if that's the way it happened or what he believes so be it. Who am I to judge.

Last thing though there are HIV+  persons out there that will deny the real way they were infected to avoid embarrassment or that's just they're nature. That's the point I was trying to make.

Mike

Interesting thread, everyone.  And for the most part, respectful.

I haven't read every word, so if someone else said this, I'm sorry for the big ditto...

For me, the big unmentionable thus far is this:  THERE IS NO SUCH THING AS "NO RISK," IN ALL HUMAN ACTIVITIES.  Everything we do in life carries with it some small level of risk, including risk of death -- everything.

Thousands of people die each night in their sleep, so each night, when we fall asleep, we're entering a state of risk..  of death.

Thousands of people die each day in car accidents, so each time we enter a motor vehicle, we enter a state of risk.. of death.  Same goes for every mode of transportation available to us.

Thousands of people are seriously injured or die each day in their homes (most often in their showers or bathtubs).  

You get my point.  Each and every second of the day carries a theoretical risk of death, which rises and lowers depending on what we're doing at that moment in time.  

There is no moment in our day when the risk falls to zero -- it never happens.

So it's all about relative risk, and choosing our levels of risk.  The frustration I and others feel about the above quote (and similar quotes by others in this thread) is that there are many people who are choosing and even championing the avoidance of remarkably small sexual risks, while choosing to take far higher risks with other activities, often on a daily basis.

For instance, are those that choose sexual abstinence due to a fear of oral sex or sex with condoms also choosing abstinence from motor vehicles?  If not, then they are being illogical.  There are approximately 36,000 motor vehicle deaths in the U.S. each year, or put another way, 1 in 7,700 Americans die each year in a car accident.  If blowjobs caused anywhere near that number of HIV infections, we'd have data to show it.

So Mike and Mecch -- do you avoid cars as well?  Do you leave your homes each day (all sorts of risks outside the home!)?  Have you stopped taking showers (a leading cause of falls leading to disability)?

Sure, there are people in this world who are general risk avoiders -- who don't go outside, and take all possible precautions in their homes.  I think they aren't living, but at least they're consistant.

But I've never heard from those sad souls in these forums.  Instead, our "Am I Infected?" forum is filled with folks worried about blow jobs and leaking condoms who drive to work on busy highways each day.  Why are they freaked out about a hard-to-measure risk, but have seemingly no problem with well-defined risks?

I think the answer is related to stigma in some way.  Then again, I can't read your minds.

My two cents.

Offline mecch

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #103 on: September 21, 2008, 01:42:00 PM »
Well many people are misreading me. I fully support the science that says that the risk of HIV transmission via oral sex is very low.
I also took the title of this forum to mean that someone wanted to talk about this whole issue anyway.
I also shared my own experience that perhaps I am one of those one in several million meteor hits - meaning my serocoversion is linked to a evening with one man, several sexs acts, and no unprotected anal intercourse. We have gone through all the "special rare circumstances" that might explain how the virus was transmitted either orally or anally and I participated in all those discussions with an open mind.
I never suggested that I had a fear of oral sex, past, present or future, in fact the contrary.
I also pointed out the contradictory recommendations of one of the noted HIV specialists in my country, who is also my doctor - in that oral transmission is considered not likely but then the recommendation that ALL SEX stop until astronomical viral loads were eliminated - and the rationale was to err on the side of caution because in those circumstances, (very high viral load) oral sex might -- REPEAT MIGHT -- be more risky, and no doctor is going to say otherwise.
Every country and many AIDS organisations take a slightly different stance on this ORAL TRANSMISSION issue regarding their safer sex guidelines.
People who don't want to read all the thread can conviently dump on me as being in denial or advocating for fear but I deny nothing and don't wish to make anyone afraid of oral sex!

Best to all

“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline bocker3

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #104 on: September 21, 2008, 01:47:30 PM »
Peter -- thanks for your excellent post.  While I think that everyone has a right to choose their risk taking comfort without ridicule -- championing the same is a different story (whether that be no sex or anything else).
In the end it seems we can sum it up as:

Life is terminal -- enjoy what you have while it is here.

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline Mike89406

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #105 on: September 21, 2008, 03:51:21 PM »
Interesting thread, everyone.  And for the most part, respectful.

I haven't read every word, so if someone else said this, I'm sorry for the big ditto...

For me, the big unmentionable thus far is this:  THERE IS NO SUCH THING AS "NO RISK," IN ALL HUMAN ACTIVITIES.  Everything we do in life carries with it some small level of risk, including risk of death -- everything.

Thousands of people die each night in their sleep, so each night, when we fall asleep, we're entering a state of risk..  of death.

Thousands of people die each day in car accidents, so each time we enter a motor vehicle, we enter a state of risk.. of death.  Same goes for every mode of transportation available to us.

Thousands of people are seriously injured or die each day in their homes (most often in their showers or bathtubs).  

You get my point.  Each and every second of the day carries a theoretical risk of death, which rises and lowers depending on what we're doing at that moment in time.  

There is no moment in our day when the risk falls to zero -- it never happens.

So it's all about relative risk, and choosing our levels of risk.  The frustration I and others feel about the above quote (and similar quotes by others in this thread) is that there are many people who are choosing and even championing the avoidance of remarkably small sexual risks, while choosing to take far higher risks with other activities, often on a daily basis.

For instance, are those that choose sexual abstinence due to a fear of oral sex or sex with condoms also choosing abstinence from motor vehicles?  If not, then they are being illogical.  There are approximately 36,000 motor vehicle deaths in the U.S. each year, or put another way, 1 in 7,700 Americans die each year in a car accident.  If blowjobs caused anywhere near that number of HIV infections, we'd have data to show it.

So Mike and Mecch -- do you avoid cars as well?  Do you leave your homes each day (all sorts of risks outside the home!)?  Have you stopped taking showers (a leading cause of falls leading to disability)?

Sure, there are people in this world who are general risk avoiders -- who don't go outside, and take all possible precautions in their homes.  I think they aren't living, but at least they're consistant.

But I've never heard from those sad souls in these forums.  Instead, our "Am I Infected?" forum is filled with folks worried about blow jobs and leaking condoms who drive to work on busy highways each day.  Why are they freaked out about a hard-to-measure risk, but have seemingly no problem with well-defined risks?

I think the answer is related to stigma in some way.  Then again, I can't read your minds.

My two cents.

I think I was misunderstood and perhaps I should have elaborated more I said the only safe way to avoid infection is abstinence and this was directed to 2 persons in particular that are worried about oral transmission and the risk. I don't share the same concerns and my life has been filled with risk. I am married to a wife who has been negative and been with me even before I was infected but I still enjoy my sex life in fact if I did practice abstinence truth be told I'd be a single man right now. The point is If anyone is scared of giving a BJ or cunnilingus then I don't know what to tell you.

I did mentioned earlier that it doesn't matter how you were infected but that no matter what you still have the virus.

Hope this helps.

Mike

Offline Peter Staley

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #106 on: September 21, 2008, 04:42:15 PM »
Mike & Mecch -- thanks for the clarifications.

I guess the thread title and subject matter still irks me a little, so I vented.   Instead of "nobody likes to talk about oral sex and HIV transmission," wouldn't "most folks don't feel the need to talk about.." be more apt, given its apparent rarity?

The original post from Sarah asked us to stop using the phrase "no risk" to describe an act (like ALL acts -- see my post above) that carries a theoretical risk.

I don't have a problem telling someone with unwarranted fears about that blowjob they gave last night that it was "no risk."  Similarly, I would have no problem telling a parent that is considering NOT immunizing their child because of unwarranted fears of causing autism that there is actually "no risk" that one will cause the other -- even though a theoretical risk remains (since it's almost impossible to prove a negative relationship).

For someone suffering from unwarranted fears, the phrase "theoretical risk" is wide enough to drive their biggest fears through, and a ticket to all their doomsday scenarios.  You may as well say "you're right -- you are going to die!"


Offline Mike89406

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #107 on: September 21, 2008, 05:44:03 PM »
Mike & Mecch -- thanks for the clarifications.

I guess the thread title and subject matter still irks me a little, so I vented.   Instead of "nobody likes to talk about oral sex and HIV transmission," wouldn't "most folks don't feel the need to talk about.." be more apt, given its apparent rarity?

The original post from Sarah asked us to stop using the phrase "no risk" to describe an act (like ALL acts -- see my post above) that carries a theoretical risk.

I guess i too felt that there was a feeling that people were worrying more about oral sex & not so much anal sex. But I understand where Sara is coming from.

Mike

Offline ColtbearNJ

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #108 on: September 24, 2008, 06:47:18 PM »
First let me give a shout out to Ann, Peter, Andy, Tim, Jonathan, Alan, Rod, and many, many  others whom I have known since I became poz in 2001 (started meds 2 years later), who got me through it here - I love and appreciate all of you every bit as much now as I did then (if not more), and have always valued your opinions and posts.  Not only that, but your patience, compassion and caring (uh, did I mention patience?),   ;)  continues to amaze me to this day.  Now, I'd like to say hello to the many "new" and not so new members whose intelligent, controversial, timely, funny, but above all, caring posts and threads I have read.  This one being a prime example of exactly why I have always thought of this site as family and home - especially when I've needed specific and accurate information, as many are seeking here, there is a reason why I specifically posted to this thread.

Though I'll never know for sure, and have stopped beating myself over the head over my status years ago, there will always be a tiny part of me that also wonders if I became positive through someone going down on me who happened to be poz, and either didn't know or chose not to tell me.  I have always taken safety precautions when playing with sex buddies whom I didn't know, to the point of using "munchkin rubbers" (finger cots), for any cracks on my fingers due to dry skin because of my type 2 diabetes.  As Mecch said in one of his posts above, I can't help but wonder, being well-endowed and hitting the back of my partner's throat roughly and repeatedly with my cock - if he happened to have a high viral load, could it have been possible that I contracted the virus through my urethra?

Countless feelings also come into play here, as with each of us, especially regarding how each of us became positive - which is a deeply personal matter, not always shared readily with others (and rightly so), but we owe it to ourselves to be honest with ourselves as well.  And I would be lying to myself if I said that was the only risk factor that could have contributed to my own uh, "positivity" back then.  There was the isolated incident (during that same time period), when, (even though I knew better), I went down on this incredibly handsome and well-endowed guy and took his load, not once, but twice. And, in a rare moment during another time (also during the same time period), when I actually let someone fuck me - with a condom, of course, but when he came, there was the terrifying realization that the condom had slipped off somewhat while he was fucking me, because when he pulled out, I noticed there was cum that I could feel on my skin back there, as well as some inside the condom.

So, here I am today, thankfully undetectable since I started taking the Sustiva and Trizivir five years ago, but still with that tiny shred of wonder about if I became poz due to oral transmission... and also with the realization that, if I truly believed that, I would have the moral responsibility (as well as a possible legal one), of telling each and every sex buddy that I go down on of my status, and that is how I believe I became positive. 

Do I?  Absolutely not.  Though the "no-fault of mine" train-of-thought would love me to believe that oral transmission was the case (and absolves me of any self-responsibility for my status), I don't believe that to be the case for one second.  There were too many other variables, and I truly believe that the condom slippage was, in fact, the true cause.  The one time I let an unknown sex partner do that to me (well, ok, we had seen each other twice before, but had only engaged in oral sex), was the one time too many.  And, above all and most importantly, purely accidental.  I am now one who believes that the lower (or undetectable) a person's VL is, the risk factor is commensurately lower, and never having any pre-cum, as long as there are no bodily fluids exchanged, do not feel the need to disclose.  Which brings me to the following.

I have been single for many years now, and at 53, am finding I need (rather, want), more than casual sex at this point in my life.  I met a great guy about 6 months ago, and when things were becoming serious, I told him my status.  I thought the best way to do that was to show him my lab test results, and pointed to the blank space where my VL was supposed to be, and the phrase below, "cannot be measured due to the non-numeric value...", but also told him, "there's a difference between virtually no risk and absolutely no risk, and you need to be aware of that."  As have all of the "being hit by a bolt of lightning, a meteor, a bus or train" threads above have (justifiably) mentioned.  I also told Tom that, "There's a difference between having a healthy concern about the virus and being paranoid about it to the point of being frozen and not willing (or being unable) to get past that.  Which, for people who want the latest information and wish to stay informed will always be found on this site and the few others like it.  But I'm beginning to wonder if Tom falls in the latter category and if he'll truly be able to get past this, despite everything I've said and how honest I've been.

Well, I think I've said more than enough for now.  If what I've said can help someone in any way, for that I'm truly grateful.  And if anyone has any suggestions as to how I might be able to help get Tom past this, your input and suggestions are more than welcome (you can PM me.)

Thanks to everyone on the site for making (and keeping) it the true force of human nature that it is and always has been since its inception, and

Wishing everyone love, blessings, and the best of health always (and bear hugs),
Steve


Offline mecch

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Re: Nobody likes to talk about it ... oral sex and HIV transmission.
« Reply #109 on: September 25, 2008, 08:22:02 AM »
And I would be lying to myself if I said that was the only risk factor that could have contributed to my own uh, "positivity" back then.  There was the isolated incident (during that same time period), when, (even though I knew better), I went down on this incredibly handsome and well-endowed guy and took his load, not once, but twice. And, in a rare moment during another time (also during the same time period), when I actually let someone fuck me - with a condom, of course, but when he came, there was the terrifying realization that the condom had slipped off somewhat while he was fucking me, because when he pulled out, I noticed there was cum that I could feel on my skin back there, as well as some inside the condom.


Ummm, you mentioned three possible transmission routes - two unconvincing and one kind of mysterious ("cum on my skin back there").  Back where, man?

Wait, anyway, don't answer!  I'm coming round to the idea that it was the best advice - those who told me to stop pondering unsolved mysteries..

Hope your partner deals with his fears. If not, bid a sad adieu and find someone affirmative.


« Last Edit: September 25, 2008, 08:28:01 AM by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

 


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