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Author Topic: HIV in Saliva Transmission Risk  (Read 22474 times)

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Offline Phoenius10

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HIV in Saliva Transmission Risk
« on: April 21, 2010, 04:08:17 PM »
HIV has been found in saliva.  There is no denying that.  Due to the proteins and enzymes in saliva, it has been found that the virus gets weakened while in the mouth making it harder and very unlikely to be transmitted this way.  However, it is not impossible.

The moderators of these forums are actively telling others in the "Am I Infected" area, that it is IMPOSSIBLE that hiv can be transmitted through saliva and that there have been no documented cases of it.  In my opinion this is inaccurate.  They even restrict others from posting in that area because they obviously know what they are saying is contraversal and putting others lives at risk.

There has been NO STUDY proving that it is IMPOSSIBLE to spread HIV through saliva. Why?  Because we don't know how much blood might be in anyone's saliva at any given time.  So to be going and telling others that you can use saliva as lube all you want and you'll NEVER get infected because in their opinion saliva cannot transmit the virus is clearly wrong and very dangerous.

As for as documented cases, just Google "hiv transmission toothbrush" and read about the documented case of someone getting HIV by sharing a toothbrush.  If that isn't being transmitted by saliva, I don't know what is.

If these moderators think they are right, then show me the studies showing it is impossible.  There are none!!  Even the CDC warns that open-mouth kissing could transmit the virus and recommends against it due to possible blood content.

These moderators should be AT LEAST warn others that there could be a risk of transmission through saliva, although very very low, not that it's IMPOSSIBLE!!

Not even in the content on poz.com do I see anywhere that it says it is impossible for hiv to be transmitted through saliva.

I found it SHOCKING that this forum has such misinformed moderators ESPECIALLY when it comes to the risks involved in transmitting hiv.

Is their definition of "impossible" low risk??!

Lets discuss, debate and put this behind us.  But in their arrogance they will probably just delete this.

Offline Bucko

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Re: HIV in Saliva Transmission Risk
« Reply #1 on: April 21, 2010, 04:17:40 PM »
Saliva is not infectious: period.

Now, where's that popcorn emoticon?  :-\
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 skeebo1969

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Re: HIV in Saliva Transmission Risk
« Reply #2 on: April 21, 2010, 04:20:12 PM »


Welcome to the forums!!
I despise the song Love is in the Air, you should too.

Offline Hellraiser

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Re: HIV in Saliva Transmission Risk
« Reply #3 on: April 21, 2010, 04:22:32 PM »
The moderators are simply operating within the scientific boundaries that no HIV transmission has ever happened orally or through saliva.  You are presenting a dangerous idea for all of us that by simply kissing someone who is negative we could pass along the virus.  Not only do I not like the sound of this, but until proven very clearly in a scientific setting I refuse to give this idea any amount of credibility.

Realize that the moderators won't delete your post unless it violates...

"# We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge."

Offline Matty the Damned

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Re: HIV in Saliva Transmission Risk
« Reply #4 on: April 21, 2010, 04:33:43 PM »
Firstly, I am not a moderator. Nor is Jkinatl2. We have permission from the moderators to answer questions in Am I Infected? forum. Andy Velez is a moderator.

If these moderators think they are right, then show me the studies showing it is impossible.  There are none!!

It not up to us to disprove the assertion, rather the onus is on you to substantiate your claim, something you are yet to do.

HIV has been isolated from saliva, but this does not mean that virus present in saliva is active and capable of mounting an infection.

MtD

Offline Phoenius10

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Re: HIV in Saliva Transmission Risk
« Reply #5 on: April 21, 2010, 05:03:13 PM »
The moderators are simply operating within the scientific boundaries that no HIV transmission has ever happened orally or through saliva.  You are presenting a dangerous idea for all of us that by simply kissing someone who is negative we could pass along the virus.  Not only do I not like the sound of this, but until proven very clearly in a scientific setting I refuse to give this idea any amount of credibility.

I don't like the sound of it either.  But if the virus is there, and blood itself can be present, I don't find it "impossible".

Offline Phoenius10

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Re: HIV in Saliva Transmission Risk
« Reply #6 on: April 21, 2010, 05:09:48 PM »
Firstly, I am not a moderator. Nor is Jkinatl2. We have permission from the moderators to answer questions in Am I Infected? forum. Andy Velez is a moderator.

If these moderators think they are right, then show me the studies showing it is impossible.  There are none!!

It not up to us to disprove the assertion, rather the onus is on you to substantiate your claim, something you are yet to do.

HIV has been isolated from saliva, but this does not mean that virus present in saliva is active and capable of mounting an infection.

MtD

With no other creditable authority states that it is IMPOSSIBLE to spread the virus through saliva, so the onus is on YOU to prove what you are saying.  Where besides these forums does it go to the extreme and say it is IMPOSSIBLE to get hiv through saliva??  Not on the CDC website, not even on the real content on this website.  It's just mis-informed people like you going out on a limb and making this statement only because it is very low risk and you want it to be true.

As for as proof.. hello??  Did you forget about the famous toothbrush case?  Sounds like a documented case to me..  So I ask again, what is your definition of "impossible"?   1 in 1000, 1 in 10000, perhaps 1 in a million??  Just think if you were this unlucky millionth guy who got hiv because some mis-informed moderator (or authorized representative of him) on here stated that it was impossible?
« Last Edit: April 21, 2010, 05:19:15 PM by Phoenius10 »

Offline GSOgymrat

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Re: HIV in Saliva Transmission Risk
« Reply #7 on: April 21, 2010, 05:19:28 PM »
From the CDC website:

Saliva, Tears, and Sweat
HIV has been found in saliva and tears in very low quantities from some AIDS patients. It is important to understand that finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid. HIV has not been recovered from the sweat of HIV-infected persons. Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV.

http://www.cdc.gov/hiv/resources/factsheets/transmission.htm

Phoenius, please show your reference for HIV being transmitted by saliva.

Offline Matty the Damned

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Re: HIV in Saliva Transmission Risk
« Reply #8 on: April 21, 2010, 05:19:45 PM »
With no other creditable authority states that it is IMPOSSIBLE to spread the virus through saliva, so the onus is on YOU to prove what you are saying.  Where besides these forums does it go to the extreme and say it is IMPOSSIBLE to get hiv through saliva??  Not on the CDC website, not even on the real content on this website.  It's just mis-informed people like you going out on a limb and making this statement only because it is very low risk and you want it to be true.

Let's be clear about what's really going on here.

You've got a wasp up your ass about saliva and kissing because somehow you've managed to delude yourself into believing that's how you got HIV. So when you see things which challenge your fragile unreality, you lash out.

Really you're just a rather extreme variation on the ZOMG I GOT TEH AIDZ FROM TEH BLOWJOBZ theme.

That's cool.

Many newly diagnosed types are a bit brittle when it comes to coping with the reality of being HIV positive. I'm pretty sure you've been spending a lot of time trying to see "the bright side" of all this - your high school debating club thread in I just Tested Poz about why you started Atripla being a strong indicator of this.

MtD

Offline Hellraiser

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Re: HIV in Saliva Transmission Risk
« Reply #9 on: April 21, 2010, 05:30:15 PM »
With no other creditable authority states that it is IMPOSSIBLE to spread the virus through saliva, so the onus is on YOU to prove what you are saying.  Where besides these forums does it go to the extreme and say it is IMPOSSIBLE to get hiv through saliva??  Not on the CDC website, not even on the real content on this website.  It's just mis-informed people like you going out on a limb and making this statement only because it is very low risk and you want it to be true.

As for as proof.. hello??  Did you forget about the famous toothbrush case?  Sounds like a documented case to me..  So I ask again, what is your definition of "impossible"?   1 in 1000, 1 in 10000, perhaps 1 in a million??  Just think if you were this unlucky millionth guy who got hiv because some mis-informed moderator (or authorized representative of him) on here stated that it was impossible?

Have you actually read through the "Am I infected?" forum?  Essentially some of these people would be driving themselves absolutely bat shit crazy if you gave them even a shred of proof that their unreasonable >IMPROBABLE< fears had any evidence behind them.  I have absolutely no problem with a 1 in 1,000,000 chance of saliva infectious being ruled out as virtually impossible.

Offline skeebo1969

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Re: HIV in Saliva Transmission Risk
« Reply #10 on: April 21, 2010, 05:33:04 PM »
From the CDC website:

Saliva, Tears, and Sweat
HIV has been found in saliva and tears in very low quantities from some AIDS patients. It is important to understand that finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid. HIV has not been recovered from the sweat of HIV-infected persons. Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV.

http://www.cdc.gov/hiv/resources/factsheets/transmission.htm

Phoenius, please show your reference for HIV being transmitted by saliva.

Hey Phoneyous I thought you said the CDC says nothing about this lie we tell here.....  well wtf is this stuff GSO found... must have been in the fine print on the side of the website or something.
I despise the song Love is in the Air, you should too.

Offline Bucko

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Re: HIV in Saliva Transmission Risk
« Reply #11 on: April 21, 2010, 05:49:41 PM »
Let's be clear about what's really going on here.

You've got a wasp up your ass about saliva and kissing because somehow you've managed to delude yourself into believing that's how you got HIV. So when you see things which challenge your fragile unreality, you lash out.

Really you're just a rather extreme variation on the ZOMG I GOT TEH AIDZ FROM TEH BLOWJOBZ theme.

That's cool.

Many newly diagnosed types are a bit brittle when it comes to coping with the reality of being HIV positive. I'm pretty sure you've been spending a lot of time trying to see "the bright side" of all this - your high school debating club thread in I just Tested Poz about why you started Atripla being a strong indicator of this.

MtD

All the same, these immaculate infection threads never end well  ::)
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 newt

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Re: HIV in Saliva Transmission Risk
« Reply #12 on: April 21, 2010, 05:51:23 PM »
The biomechanics of HIV virus in saliva is against value in a discussion, ie

1. Saliva does carry detectable components of HIV (such as viral RNA and proviral DNA), but these are not infectious on their own. (So, strictly speaking HIV being detected in saliva means bits of HIV).

2. The environment that saliva provides is far too harsh for most infectious particles to remain intact and viable. To start, saliva is hypotonic and tends to disrupt any cells which may be floating around in it. It is designed to do this, it's part of the body's defences.

This combination of factors that mean HIV is almost certainly not transmissible via saliva alone. It is so improbable it's not worth testing. There will never be a study. So all that is left is an unreasonable anxiety.

All risks have boundaries, and one day sommat odd/stupid will happen under specific, one-off circumstances, like for the 2 or so cases of non-sexual household acquired HIV, but this does not mean this constitutes a "normal" or substantive and quantifiable risk worth highlighting.  

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

Offline jkinatl2

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Re: HIV in Saliva Transmission Risk
« Reply #13 on: April 21, 2010, 07:10:21 PM »
Apologies in advance for the volume of posting.

HIV and saliva
An article from "The Molecules of HIV" (c) Dan Stowell
www.mcld.co.uk/hiv
Occasionally I'm asked about whether HIV is present in an HIV-positive person's saliva, and whether it carries a risk of transmission.
The short answer is that saliva virtually never carries any infectious HIV at all.
It does carry detectable "components" of HIV (such as viral RNA and proviral DNA), but these are not infectious on their own. The environment that saliva provides is far too harsh for infectious particles to remain intact and viable.
There are a number of possible mechanisms that have been suggested, which might explain why saliva seems to be so good at destroying HIV. Specific enzymes present in saliva may be important, or the effect of antibodies in saliva. Additionally, the saliva is "hypotonic" and has a tendency to disrupt any cells which may be floating around in it. It's pretty much certain that it's the combination of these factors that mean HIV is not transmitted in saliva.
It may seem strange that such a dangerous virus can't survive in something as "harmless" as saliva. In fact, saliva is a part of the body's natural defences against infection. Additionally, remember that the HIV virus is actually quite fragile.
More information:
.   Shugars DC, Sweet SP, Malamud D, Kazmi S, Page-Shafer K, Challacombe SJ (2002)
.   Saliva and inhibition of HIV-1 infection: molecular mechanisms.
.   Oral Diseases 8: 169-175 Suppl. 2 2002
.   Baron S, Poast J, Cloyd MW (1999)
.   Why is HIV rarely transmitted by oral secretions? Saliva can disrupt orally shed, infected leukocytes.
Archives of Internal Medicine 159 (3): 303-310

Source:

http://www.mcld.co.uk/hiv/?q=HIV%20and%20saliva
"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 jkinatl2

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Re: HIV in Saliva Transmission Risk
« Reply #14 on: April 21, 2010, 07:12:24 PM »


No incident HIV infections among MSM who practice exclusively oral sex.
Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WePpC2072)??Balls JE, Evans JL, Dilley J, Osmond D, Shiboski S, Shiboski C, Klausner J, McFarland W, Greenspan D, Page-Shafer K?University of California, San Francisco, San Francisco, United States

Oral transmission of HIV, reality or fiction? An update
J Campo1, MA Perea1, J del Romero2, J Cano1, V Hernando2, A Bascones1
Oral Diseases (2006) 12, 219–228

AIDS:  Volume 16(17)  22 November 2002  pp 2350-2352
Risk of HIV infection attributable to oral sex among men who have sex with men and in the population of men who have sex with men

Page-Shafer, Kimberlya,b; Shiboski, Caroline Hb; Osmond, Dennis Hc; Dilley, Jamesd; McFarland, Willie; Shiboski, Steve Cc; Klausner, Jeffrey De; Balls, Joycea; Greenspan, Deborahb; Greenspan

Page-Shafer K, Veugelers PJ, Moss AR, Strathdee S, Kaldor JM, van Griensven GJ. Sexual risk behavior and risk factors for HIV-1 seroconversion in homosexual men participating in the Tricontinental Seroconverter Study, 1982-1994 [published erratum appears in Am J Epidemiol 1997 15 Dec; 146(12):1076]. Am J Epidemiol 1997, 146:531-542.

Studies which show the fallacy of relying on anecdotal evidence as opposed to carefully controlled study insofar as HIV transmission risk is concerned:

Jenicek M. "Clinical Case Reporting" in Evidence-Based Medicine. Oxford: Butterworth–Heinemann; 1999:117

Saltzman SP, Stoddard AM, McCusker J, Moon MW, Mayer KH. Reliability of self-reported sexual behavior risk factors for HIV infection in homosexual men. Public Health Rep. 1987 102(6):692–697.Nov–Dec;

Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990 Nov;108(3):339–362.
"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 jkinatl2

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Re: HIV in Saliva Transmission Risk
« Reply #15 on: April 21, 2010, 07:14:47 PM »
What bothers me is that people who claim that these assertions are made without any evidence have failed to perform the most rudimentary search of these forums.

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

http://forums.poz.com/index.php?topic=2511.0

http://forums.poz.com/index.php?topic=2244.0

http://forums.poz.com/index.php?topic=12630.0

http://forums.poz.com/index.php?topic=10457.0


http://forums.poz.com/index.php?topic=1 ... #msg127650


"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 jkinatl2

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Re: HIV in Saliva Transmission Risk
« Reply #16 on: April 21, 2010, 07:15:11 PM »

Mechanism of HIV transmission

The lessons part of this website contains a lot of the information you need. However HIV transmission can be broken down to the following general exposures.

1) Penetrative and receptive anal or vaginal sex
2) Sharing IV drug needles
3) Occupational exposure to blood and concentrated virus in clinical and research labs

Of the above, I will only discuss sexual exposures as this is the topic that is confused on this forum. I will try and give some guidelines for exposure and risk that I use, although one should ALWAYS seek professional medical help and take their advice over anything said on the internet.

Mucosal membranes

It has been incorrectly suggested that HIV transmission occurs via microcracks and lesions on the mucosa of genitalia and the GI tract. This is indeed is not how HIV is transmitted in the majority of cases.

Mucosal membranes are the first line of defense against invading pathogens and line a lot of the areas of our body. It can be generalized to any membrane that contains a layer of mucus on it (wet membranes). These are the nasal passages, mouth, throat, lungs, GI tract and sexual organs. However, HIV transmission can not occur in all of these places. For instance, HIV is NOT an airborne virus and therefore infection via the nasal passages and lungs need not be considered. The eyes and mouth contain many antiviral agents that combat viruses and bacteria and lower the effectiveness of HIV transmission in these areas. This is one of the reasons that oral sex is low on the risk list. These compounds are good at their job and can effectively neutralize viruses prior to infection and a multitude of studies show that. In addition, saliva does not contain active virus, which is why kissing is not a risk. Even if it did then the virus would be neutralized. Ingestion of infected semen therefore does not hold as much risk as one would imagine because of the bodies ability to kill viruses in this area. Small cuts on the teeth and gums might increase the risk slightly, but only very slightly because saliva is so good at its job. Only large areas of bleeding or weeping sores are of any concern but even in these cases, the body does a good job at protecting itself and high and repeated levels of HIV infected material need to be ingested to be of significant risk. Small cuts one gets from flossing and teeth cleaning are therefore of little consequence.

It is possible to be infected via the mouth and the eyes but these cases have been limited to high concentrations and volumes of HIV infected blood splashed into the eyes and/or mouth during occupational accidents. Blood contains the highest concentration of HIV of all the body fluids.


Making up a very small percentage of the mucosal membranes are cells of the immune system. It is these cells that are susceptible to HIV infection and it is these patrolling cells that are thought to be the targets for initial infection. However, they lie under the layer of secretions of the mucosal membrane that is hard to penetrate. In addition, HIV is not very transmissible and even if a virus came into contact with a susceptible cell, infection remains an unlikely event. Not all HIV particles are infectious. Estimates put the particle:infectivity ratio as low as one virus per 100. So, even if unprotected sex occurs, the likelihood that transmission will occur is low.

There are a multitude of other factors that can influence HIV infection the most important of which is surface area of the exposed tissue, length of time of exposure and concentration of virus within the infected material. In males the surface area is remarkably small, limited mainly to the urethra. In addition vaginal fluids contain low amounts of HIV, so low in fact that transmission is made more unlikely.

So how, you might ask, do men get HIV in the background of such factors that prevent HIV infection? In Africa the answer lies with the high incidence of other STDs. STDs cause an influx of immune cells to the sites of STD infection and these increases the number of potential targets for infection. The risk might double. One should not confuse STDs with abrasions and small cuts on the penis. While these break the skin or chap it, it reduces the skin to the level of a mucus membrane and thus doesn’t increase the risk much past what it is with unprotected sex, due to the insignificant increase of the surface area. If there is a large bleeding wound, then yes that would increase the chances of infection because the skin is compromised, but nobody has sex with a bleeding penis.

For women, the mucus membrane is larger and semen contains more infectious material. Therefore the chances of infection are slightly higher. However, one should not lose sight of the fact that the numbers are still remarkably low. Estimates put the risk from a single unprotected event as low as 1:1000. This is how effective the mucus membrane is at protecting your body. Infection can occur, but it remains an unlikely event.

In anal sex there are a few more things to consider. By design the human rectum is mainly an exit only device. The mucus membranes are therefore prone to a little damage from repeated thrusting from a penis or sexual device. In the case of anal sex, therefore, HIV transmission can occur through the breakage of the anal and rectal mucosal membranes. Again, although it might seem like HIV transmission would be a likely event, it remains lower than most viral transmissions. Hemorrhoids make HIV infection more likely.

So what does a worry well do with this sort of information? Well, don’t panic for starters. Although I have described how HIV is transmitted, don’t forget that of all viruses, HIV remains a hard one to get. Let’s compare it quickly with other viruses. Influenza virus infects cells of the respiratory tract, which are present at high concentration. Therefore inhalation of infected droplets will likely lead to infection (if someone producing virus sneezes on you). The concentration of Influenza is also higher than that of HIV and the particle:infectivity ratio is also high. So, you are likely to get the flu if you are exposed to it. The opposite is true for HIV. If you are exposed to HIV, the mere presence of the virus does not lead to transmission because of difficulty in finding a target cell, the presence of mucus and the rather rubbish ability of HIV particles to complete an infectious cycle. Indeed, in most cases it doesn’t. On the rare occasion that HIV can even get to the cells it wants to infect, it remains unable to do so due to a low particle:infectivity ratio.

So what steps can you take to protect yourself? The answer is use condoms. This will prevent HIV infected material from contacting mucus membranes and that will be enough. What if a condom bursts? Well, the condom will still protect you or your partner. As they don’t break immediately they are used, they still offer some protection. As I said, one of the factors is duration of exposure, so if the condom breaks and you keep banging away happily for another two or three minutes, the level of risk doesn’t increase to that of unprotected sex but rather still remains lower.

What about cuts and scratches? As I have said, an open cut is an area that can lead to transmission. However, it has to be bleeding. Semi-healed cuts retain some of that barrier and are not as great a risk as people imagine. Don’t forget that the presence of virus on these areas does not mean infection takes place. Furthermore when the virus is outside the warm and wet environment of the body, it starts to dry and this leads to further inactivation of the virus and the still lowering of the particle to infectivity ratio. Don’t forget about the size of the cut either. A small cut or dermatitis isn’t going to increase your risk significantly so if you had sex with shaving scars on your genitals, these are not of much concern.

People often make the mistake of thinking that HIV is like other viruses and mere exposure leads to infection. I can’t stress strongly enough how low the transmission rate is compared to other viruses. For all the reasons above, HIV is not easy to get and the use of condoms prevents HIV transmission. If you got HIV infected semen or vaginal fluids on your skin that is no risk at all. If you got it into a cut then this is only a marginal risk, made lower if the cut is small (such as a hangnail). One thing to watch for is exposure of cuts to blood. The only reason to be concerned there is because the concentration of HIV is higher in blood.

Hope that clears things up a bit…
"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 jkinatl2

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Re: HIV in Saliva Transmission Risk
« Reply #17 on: April 21, 2010, 07:16:11 PM »
AIDS:  Volume 16(17)  22 November 2002  pp 2350-2352
Risk of HIV infection attributable to oral sex among men who have sex with men and in the population of men who have sex with men

Page-Shafer, Kimberlya,b; Shiboski, Caroline Hb; Osmond, Dennis Hc; Dilley, Jamesd; McFarland, Willie; Shiboski, Steve Cc; Klausner, Jeffrey De; Balls, Joycea; Greenspan, Deborahb; Greenspan, John Sb

aCenter for AIDS Prevention Studies, Department of Medicine, bDepartment of Stomatology, School of Dentistry, and cDepartment of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA; dAIDS Health Project, San Francisco, CA, USA; and eSan Francisco Department of Public Health, San Francisco, CA, USA.

Sponsorship: This work was supported by a grant from NIDCR (1 R01 DE12911-01) and was presented in part at the 2nd National HIV Prevention Conference, Atlanta, GA, 14 August 2001.

Received: 3 January 2002; revised: 6 June 2002; accepted: 20 June 2002.

We examined HIV infection and estimated the population-attributable risk percentage (PAR%) for HIV associated with fellatio among men who have sex with men (MSM). Among 239 MSM who practised exclusively fellatio in the past 6 months, 50% had three partners, 98% unprotected; and 28% had an HIV-positive partner; no HIV was detected. PAR%, based on the number of fellatio partners, ranges from 0.10% for one partner to 0.31% for three partners. The risk of HIV attributable to fellatio is extremely low.

Since HIV was identified as being sexually transmitted, there has been considerable interest in the risk associated with performing fellatio. Although early studies found no independent risk for fellatio, the high correlation among multiple sexual practices raised the possibility that risk existed but could not be detected. Subsequently, case reports accumulated, largely among men who denied other risk behaviors [1]. Researchers acknowledged that fellatio, although not an efficient route of infection, nonetheless appeared to carry a small risk. Two studies provided quantitative estimates of the low risk among men who have sex with men (MSM) [2,3]. One [3] estimated the per-contact risk of unprotected fellatio with an HIV-positive or unknown HIV status partner [4/10 000; 95% confidence interval (CI) 0.01%, 0.17%] to be lower than the per-contact risk of acquiring HIV from protected receptive anal intercourse (RAI) (0.18%; 95% CI 0.10%, 0.28%).

Current 'safe sex' guidelines specify that unprotected orogenital sex is unsafe but low risk. A recent study of primary infection in San Francisco [4] reported that 8% of HIV-positive participants acquired HIV from fellatio. This finding has been widely interpreted that as many as 8% of HIV infections among MSM are attributable to fellatio [5]. It is understandable, given these conflicting messages, that individuals continue to ask for greater clarity regarding this risk. The population-attributable risk percentage (PAR%) is of special interest, because even a low-risk exposure could result in a substantial proportion of infections.

We present preliminary results from an ongoing study investigating orally acquired HIV infection demonstrating: (i) that such infection is rare; and (ii) conduct analyses using previously published data to show that the PAR% of HIV attributable to fellatio is also extremely low.

From December 1999 to 2001, individuals seeking HIV testing at an anonymous testing site in San Francisco were screened to identify those who in the past 6 months reported no anal or vaginal sex, had not injected drugs, and had performed fellatio on at least one male partner. Eligible participants completed a pre-HIV test survey, measuring a 6-month history of sexual practices. Post-interview HIV serology was conducted to determine participants' HIV serology using using enzyme immunoassays, Western blot confirmation, and a sensitive/less sensitive enzyme immunoassay strategy [6] to identify recently acquired infection. PAR% was estimated using Levin's formula: (p S(RR - 1)/(p(RR - 1) - 1) * 100), where p is the population exposure prevalence, and RR is relative risk [7]. An estimate of RR from previously published data was used [2], and the prevalence p of fellatio partners was obtained from data collected in a population-based study of MSM [8]. We estimated the prevalence p from data collected in baseline interviews in which participants were asked how many fellatio (receptive oral sex) partners they had had in the previous year. Analyses have shown that the prevalence of fellatio [9] and fellatio partners (unpublished data) has not changed significantly since that study was initiated. As the median number of reported fellatio partners in the previous year reported by participants in this study was three (range 0-400), we estimated the PAR% for one, two, and three fellatio partners.

Of 10 283 anonymous testing site clients, 413 (4%) were eligible, and 243 (2.3%) participated. Of those, 239 (98%) were men, whose median age was 39 years, and all were MSM. Four women were dropped from the analysis. No recently acquired HIV infections were detected and the estimated probability of orally acquired HIV was 0 (95% CI 0, 1.5%). The median number of fellatio partners in the past 6 months was three (interquartile range 1-6), almost all (98%) were unprotected. One third (35%) reported getting semen in their mouth, and of those, 70% swallowed it. Fellatio on a known HIV-positive partner was reported by 28%; of those, 81% did not use a condom, and 39% had swallowed ejaculate.

The PAR% rises as the number of partners increases: PAR% for one fellatio partner (p = 18%, RR = 1.01) was estimated at 0.18%, for two fellatio partners (p = 12%, RR = 1.02) at 0.25% and for three fellatio partners (p = 10%, RR = 1.03) as 0.31%. The cumulative PAR% for one to three fellatio partners could thus be 0.74%.

The absence of HIV infections detected in this sample confirms previous research that orally acquired HIV infection is rare. HIV prevalence and incidence among MSM who tested at the same anonymous testing sites in San Francisco during a similar time period (December 1999 to February 2001) were appreciably higher. The overall prevalence of HIV infection was 3.3% (95% CI 2.9-3.9), and among repeat testers the incidence was 1.9/100 person-years (95% CI 1.6-2.3). Among those who reported unprotected RAI, HIV prevalence and incidence were 5.1% (95% CI, 4.1-6.3) and 3.5/100 person-years (95% CI, 2.7-4.5), respectively. Among those who reported protected RAI, HIV prevalence and incidence was 2.3% (95% CI, 1.7-3.1) and 1.7/100 person-years (95%CI 1.2-2.3), respectively (T. Kellogg, San Francisco Department of Public Health, personal communication). These figures reveal the striking difference in the risk of HIV between those who report exclusively fellatio and those who report higher-risk sexual behaviors.

A strength of this study is that participants were queried about behaviors before HIV testing. Consistently, studies that rely on individuals identifying 'how they got infected', report a higher proportion of orally acquired infections than can be reliably established [4,5]. HIV-positive MSM may inaccurately report higher-risk exposures for reasons including social desirability and recall. Men may also report having only oral sex as a risk behavior because that is the only 'unprotected' sexual behavior they engage in, not acknowledging anal sex when a condom was used. Vittinghoff et al. [3] hypothesized that condom breakage or slippage could account for the higher per-act infectivity of protected anal sex compared with unprotected fellatio.

Our results are based on a modest sample size; therefore, we cannot rule out the possibility that the probability of infection is indeed greater than zero. Our data and those of others (D. Osmond, San Francisco Young Men's Health Study: ≤ 3%, unpublished data) show that the proportion of individuals who engage exclusively in fellatio is very low, thus obtaining precise and reliable estimates of the per-partner and per-contact risks of acquiring HIV from fellatio will be difficult. The likely importance of heterogeneity of susceptibility and infectiousness add further uncertainty to quantifying risk.

Our calculations showing very low PAR% are consistent with the findings of extremely low individual risk. In addition, if one considers that only a fraction of those who report fellatio are actually exposed to semen (35%), the PAR% will be considerably lower.

These data confirm that the risk of HIV infection attributable to fellatio among MSM and in the MSM population is especially low. It is important that health professionals, including HIV counsellors have valid information to impart to their sexually active clients. If individuals believe that the risk of HIV from fellatio is high or on a par with well-documented high-risk exposures such as anogenital sex, they may not feel that sexual behavior choices make a difference. Acquiring HIV through fellatio is significantly less risky than from anal sex, and therefore one's choice of sexual practices do matter.
Acknowledgements

The authors would like to acknowledge help from the following organizations and people who contributed to this project: Tim Kellogg at the San Francisco Department of Public Health; Dr Ron Stall, who contributed greatly to the inception and realization of the study; the Counseling and Testing Staff at the AIDS Health Project, especially Shannon Casey, Daniel Tracy, Barbara Adler and Joanna Rinaldi; Yvonne de Souza, Behnahz Cheikh, Mariza Labao, and staff from the Oral AIDS Center at UCSF; Henry Raymond at the Center for AIDS Prevention Studies, UCSF; Dr Robert Bolan at the Los Angeles Gay and Lesbian Project.
References
1.Rothenberg RB, Scarlett M, del Rio C, Reznik D, O'Daniels C. Oral transmission of HIV. AIDS 1998, 12:2095-2105.
[Medline Link] [Fulltext Link] [CrossRef] [Context Link]
2.Page-Shafer K, Veugelers PJ, Moss AR, Strathdee S, Kaldor JM, van Griensven GJ. Sexual risk behavior and risk factors for HIV-1 seroconversion in homosexual men participating in the Tricontinental Seroconverter Study, 1982-1994 [published erratum appears in Am J Epidemiol 1997 15 Dec; 146(12):1076]. Am J Epidemiol 1997, 146:531-542.
[Medline Link] [Context Link]
3.Vittinghoff E, Douglas J, Judson F, McKirnan D, MacQueen K, Buchbinder SP. Per-contact risk of human immunodeficiency virus transmission between male sexual partners. Am J Epidemiol 1999, 150:306-311.
[Medline Link] [Context Link]
4.Dillon B, Hecht F, Swanson M, et al. Primary HIV infections associated with oral transmission. In: 7th Conference on Retroviruses and Opportunistic Infections. San Francisco, 2000 [Abstract 473].
[Context Link]
5.Hawkins D. Oral sex and HIV transmission. Sex Transm Infect 2001, 77:307-308.
[Medline Link] [CrossRef] [Context Link]
6.Janssen RS, Satten GA, Stramer SL, et al. New testing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes [published erratum appears in JAMA 1999 26 May; 281(20):1893]. JAMA 1998, 280:42-48.
[Medline Link] [Context Link]
7.Kelsey JL, Thompson WD, Evans AS. Methods in observational epidemiology. New York, NY: Oxford University Press, Inc.; 1986.
[Context Link]
8.Osmond DH, Page K, Wiley J, et al. HIV infection in homosexual and bisexual men 18 to 29 years of age: the San Francisco Young Men's Health Study. Am J Public Health 1994, 84:1933-1937.
[Medline Link] [Context Link]
9.Osmond DH, Buchbinder S, Cheng A, et al. Prevalence of Kaposi sarcoma-associated herpesvirus infection in homosexual men at beginning of and during the HIV epidemic. JAMA 2002, 287:221-225.
[Context Link]
© 2002 Lippincott Williams & Wilkins, Inc
"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

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Offline Rev. Moon

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Re: HIV in Saliva Transmission Risk
« Reply #18 on: April 21, 2010, 07:18:44 PM »
This qualifies as one of the dumbest, most ignorant, and most dangerously inaccurate threads ever created.  Seeing this kind of bullshit makes me seriously angry.

Do your damned homework before you say anything like this.

I'm sure that you have a name for your virus: Jesus. You probably blame the Holy Spirit for your positive status.
« Last Edit: April 21, 2010, 08:56:17 PM by Rev. Moon »
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Offline jkinatl2

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Re: HIV in Saliva Transmission Risk
« Reply #19 on: April 21, 2010, 07:58:10 PM »
Let's be clear about what's really going on here.

You've got a wasp up your ass about saliva and kissing because somehow you've managed to delude yourself into believing that's how you got HIV. So when you see things which challenge your fragile unreality, you lash out.

Really you're just a rather extreme variation on the ZOMG I GOT TEH AIDZ FROM TEH BLOWJOBZ theme.

That's cool.

Many newly diagnosed types are a bit brittle when it comes to coping with the reality of being HIV positive. I'm pretty sure you've been spending a lot of time trying to see "the bright side" of all this - your high school debating club thread in I just Tested Poz about why you started Atripla being a strong indicator of this.

MtD

I am always dismayed when I hear efforts to claim that the assertions on AM I (and in the Transmission section) are made without merit and without substantiation.

Thing is, I rarely wade into posts in the Recently Infected forum, or even here, when someone claims an unlikely source of transmission. I understand that the psychology of HIV infection is complex, and that people are often brittle and fragile when they enter a forum, or walk through the world in which they have HIV.

HIV is a tough weight to carry, and for some people, they need denial, and anger, and the absolute assurance that they did "all the right things" and still somehow got this virus.

The stigma of being infected remains a strong one. And even in the HIV community, there is a hierarchy of the infected. Those who are born with it, of course, being on the highest tier. Those who shared IV drug needles are commonly on the lower tiers of that hierarchy.

Not that this matters to a virus. A virus wants what it wants, and once it is inside the body, it wants to reproduce. We let this stigma bleed into our lives when we insist that only promiscuous people get HIV, or those who practice receptive anal sex, or share needles. When we try to assert a moral component to what is essentially a chemical process.

I notice that, after a few years of infection, a lot of that anger, that denial, that need to somehow be absolved for the sin of our sexuality, dissipates. Simply put, I don't think it possible to sustain that level of anxiety beyond a certain point. Well, not without veering dangerously close to some of the bat-shit craziness that has graced these forums on more than one occasion.

We are made to live in linear time. It is the very definition of insanity to exist in a single moment (our infection) and resist moving through that, past that. I think that best purpose of these forums could be providing the support necessary for that process to begin, and then to sustain it through the journey.

So it's hard to come down on someone who is recently diagnosed, and I normally do not debate science with someone who is not at a point where they can participate in what is often painfully critical thinking. 

But in the AM I INFECTED forum, I do not see those rules as having application. There, a far harder scientific foundation is necessary, with far less regard for the sensibilities of the persons involved. In the years since I became a member of AIDSMEDS, I think there have been maybe a dozen, perhaps two dozen, of the people who have tested positive after posting in the AM I forum. And almost all of those people had a scientifically verifiable risky exposure to HIV.

I am deeply sorry if I come across as insensitive sometimes. It is not my intention. My own way of coping with HIV is hardly a model for others. But one of the most important things to me has been the science behind HIV. Imprecise though it is, and subject to corruption as the pharma companies are, it is still the closest to the Socratic method as I am going to find on the subject.

"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

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Offline jkinatl2

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Re: HIV in Saliva Transmission Risk
« Reply #20 on: April 21, 2010, 08:09:49 PM »
Lets discuss, debate and put this behind us.  But in their arrogance they will probably just delete this.

Having read the entirety of your missive, I now regret putting the effort into once again posting the science I did. It appears that your intent is to disrupt, and not to discuss.

There is indeed a vetting process for those allowed to participate in the AM I INFECTED forum. Trust me, playing party politics is not one of them. I caused quite a stir in the early years, with my own dogged insistence on first-tiered peer-reviewed science as the foundation for transmission theory as expressed in AIDSMEDS.

It is my opinion that we must substantiate as much as can be substantiated without the reliance on anecdotal data and patient report -which is a notoriously unreliable form of scientific inquiry. And yes, I have the source for that opinion as well :)

I am sorry, however, to have spent substantial time on the conversation that is not, in retrospect, really a conversation at all, but an accusation.



"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

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Offline jkinatl2

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Re: HIV in Saliva Transmission Risk
« Reply #21 on: April 21, 2010, 08:17:09 PM »

HIV has been isolated from saliva, but this does not mean that virus present in saliva is active and capable of mounting an infection.

MtD

To that point, HIV has been isolated in tears and sweat as well. I do not look forward to the newly infected person who claims to have gotten HIV through the gym, or a hot tub, or through the tears of a friend. And I see accepting a sliding scale of scientific credibility to be a road that goes straight there.
"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

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Offline RapidRod

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Re: HIV in Saliva Transmission Risk
« Reply #22 on: April 21, 2010, 08:46:01 PM »
http://www.aegis.com/news/pr/1998/pr980105.html

Study Shows Component of Saliva is Very Effective in Blocking AIDS Virus Potential for Use in Preventing Sexual Transmission of HIV

PR Newswire; Wednesday January 7, 6:42 pm EST


NEW YORK, Jan. 7 /PRNewswire/ -- Research conducted at The New York Hospital-Cornell University Medical College has found that a natural component of human saliva has a very powerful effect in blocking the growth of laboratory strains of HIV as well as AIDS viruses taken directly from patients. This finding could lead to the development of natural inhibitors to HIV transmission.
In a study published in the January 5 issue of the Journal of Experimental Medicine, Dr. Jeffrey Laurence, Director of the Laboratory for AIDS Virus Research; Dr. Ralph Nachman, Chairman of the Department of Medicine; Dr. Roy L. Silverstein, Chief of the Division of Hematology-Oncology; and a team of biomedical scientists describe how they have identified a natural sugar-protein, concentrated in saliva, known as TSP (thrombospondin), and discovered its remarkable ability to block the growth of the AIDS virus.

Recognizing that over the past years several labs have found a variety of substances in human saliva that partially inhibit the growth of HIV, Dr. Laurence and his research team delved further into this phenomenon.

Dr. Laurence said, "We began by exploring why there is so little HIV virus in saliva, while large amounts of the virus are found in other body fluids; and why human saliva is so effective at blocking the growth of the AIDS virus in the test tube. This led us to the discovery of TSP."

According to Dr. Laurence, "We made the observation that thrombospondin type 1 (TSP-1) can block HIV-1 infection of primary human cells and transform human cell lines of T lymphocyte and monocyte lineages. TSP is effective against both laboratory-adapted strains of HIV-1 and HIV-1 patient isolates. It is active at physiologic concentrations. Saliva experiments indicate that TSP-1 is a major component of the natural HIV inhibitory capacity of saliva."

TSP is of particular interest as a natural inhibitor, as others have shown that it may promote wound healing, and suppression of some bacterial infections. Higher levels of TSP in the saliva of some male, as opposed to female, animals may relate to the more frequent wounding of male animals. Wound licking, with application of saliva molecules that could inhibit infection, would then be very beneficial.

Speaking of the application of this research, Dr. Nachman said, "This is an exciting finding that is another step forward in our research efforts aimed at preventing AIDS transmission. TSP derivatives could potentially be used vaginally, rectally and orally in condoms, foams, suppositories, mouthwashes and toothpastes to inhibit transmission of the AIDS virus."

While TSP is a very large molecule that would be unwieldy to use directly in patients, the Cornell research team also investigated the mechanism of action of TSP. They found that peptides -- small pieces of the larger TSP -- could block binding of the AIDS virus to its receptor on immune cells. This offers the potential for direct use of these smaller molecules to prevent sexual transmission of HIV.

Funding for this work was provided by the Dental, Heart/Lung/Blood, and Allergy/Immunology Institutes of the NIH.

SOURCE: The New York Hospital - Cornell Medical Center

Offline xman

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Re: HIV in Saliva Transmission Risk
« Reply #23 on: April 21, 2010, 08:50:30 PM »
If you want a life with no risk zip up your mouth and get in an antiradiation suit. Doing so you'll die anyway some day.
sign the petition launched by the aids policy project addressed to the nih aimed to increase the money needed to find the cure:

http://www.aidspolicyproject.org/petition_for_the_nih

we can make a difference and we need to fight. please support them! it doesn't cost you anything. they need it now more than ever!

Offline Hellraiser

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Re: HIV in Saliva Transmission Risk
« Reply #24 on: April 21, 2010, 08:53:26 PM »
So, Phoenius, I don't want this parade of posts to scare you away from the forums.  You seem like a very bright guy and I for one value your input along with everyone else's.  However, advocating the HIV infection is capable through saliva is just not a winner.

Offline xman

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Re: HIV in Saliva Transmission Risk
« Reply #25 on: April 21, 2010, 08:58:56 PM »

LOL

Courtesy of Paramount Pictures
sign the petition launched by the aids policy project addressed to the nih aimed to increase the money needed to find the cure:

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we can make a difference and we need to fight. please support them! it doesn't cost you anything. they need it now more than ever!

Offline tednlou2

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Re: HIV in Saliva Transmission Risk
« Reply #26 on: April 22, 2010, 12:36:09 AM »
HIV is a very hard virus to transmit.  It does make me think we all just had to be very unlucky and would have had a better chance of winning the lottery--or so it would seem.  I also wonder how many poz people, both male and female, I had sex with but escaped the virus those times.  It obviously eventually caught up to me.  We all could have had sex with several HIVers, but just didn't get infected those times, because the virus is actually hard to transmit.

I've wondered before how many on here know exactly how they contracted the virus--any who only performed oral and got it that way (doubt any at all), total tops, and bottoms.  I believe I contracted the virus due to not having much receptive anal sex.  Then, my friend tried using a toy on me causing trauma to the anal area, then he (well endowed) performed insertive anal sex on me causing further trauma, then he took the condom off without me knowing and reinserted until I realized he took the condom off.  I often wonder how much him trying to use that large toy on me created the perfect storm.  I can wonder until the cows come home.  I do know that I wouldn't have gotten it from kissing, from his sweat, and very, very unlikely from oral.  It was taking it up the rear and not making damn sure that condom stayed on.

Offline Phoenius10

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Re: HIV in Saliva Transmission Risk
« Reply #27 on: April 22, 2010, 01:51:11 AM »
From the CDC website:

Saliva, Tears, and Sweat
HIV has been found in saliva and tears in very low quantities from some AIDS patients. It is important to understand that finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid. HIV has not been recovered from the sweat of HIV-infected persons. Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV.

http://www.cdc.gov/hiv/resources/factsheets/transmission.htm

Phoenius, please show your reference for HIV being transmitted by saliva.

Please show me the word "impossible to spread" in that statement about saliva.  It only says that HIV was not found in sweat, NOT saliva.  So one can perhaps imply hiv cannot be spread through sweat since it is not present.  But nowhere in that paragraph does it say or can be implied that saliva is not a transmission source.  It leaves it up to the reader to make their own judgement since it can't really be proven or disproved due to the low chance.  So how people can say it's IMPOSSIBLE given the facts is plain foolish.

Offline Phoenius10

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Re: HIV in Saliva Transmission Risk
« Reply #28 on: April 22, 2010, 02:11:27 AM »
I found that these forums are VERY biased because most who post here are HIV+.  Of course HIV+ people would like to believe a very low chance means IMPOSSIBLE.  Who would want to use a condom for everything?  I sure wouldn't.  But it's time to be realistic.  Low probability is not IMPOSSIBLE!  The chances of getting hiv from any one sex act with a pos person was determined to be low probablility.. something like 0.05%.  If it wasn't, a lot more people would have hiv right now.  So we all are here because of a very low probability chance.  So its disturbing to me that all of you can't appreciate what a low chance even means, being as you yourselves are only here because you were that one unlucky person already.

There can be fresh blood anyone's saliva and whether the saliva itself can kill the virus is even meaningless when that happens.  We don't know how long it can last in blood mixed with saliva.. do you??  It's something you have to consider when saliva is used as lube especially.

And I say again, no website of authority, not even this one, states its impossible to spread hiv through saliva.  And there's good reason for that.  Only the misguided people on these forums with their wishful opinions are telling people these false lies.   The word impossible should not be used.  "Very low risk" should be used along with explaining the factors that could make it possible, ie blood in the saliva and an open wound.   This isn't rocket science here.

What bothers me is that people who claim that these assertions are made without any evidence have failed to perform the most rudimentary search of these forums.

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

http://forums.poz.com/index.php?topic=2511.0

http://forums.poz.com/index.php?topic=2244.0

http://forums.poz.com/index.php?topic=12630.0

http://forums.poz.com/index.php?topic=10457.0


http://forums.poz.com/index.php?topic=1 ... #msg127650




Offline Alain

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Re: HIV in Saliva Transmission Risk
« Reply #29 on: April 22, 2010, 02:22:38 AM »
Hi Phoenius10,

If you don't mind me asking, are you defining yourself as a gay men or Bisexual?

Offline Bucko

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Re: HIV in Saliva Transmission Risk
« Reply #30 on: April 22, 2010, 02:54:01 AM »
So you're saying that you've never been penetrated, not once (never), anally?
Blessed with brains, talent and gorgeous tits.

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Offline tednlou2

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Re: HIV in Saliva Transmission Risk
« Reply #31 on: April 22, 2010, 03:13:01 AM »
I found that these forums are VERY biased because most who post here are HIV+.  Of course HIV+ people would like to believe a very low chance means IMPOSSIBLE.  Who would want to use a condom for everything?  I sure wouldn't.  But it's time to be realistic.  Low probability is not IMPOSSIBLE!  The chances of getting hiv from any one sex act with a pos person was determined to be low probablility.. something like 0.05%.  If it wasn't, a lot more people would have hiv right now.  So we all are here because of a very low probability chance.  So its disturbing to me that all of you can't appreciate what a low chance even means, being as you yourselves are only here because you were that one unlucky person already.

There can be fresh blood anyone's saliva and whether the saliva itself can kill the virus is even meaningless when that happens.  We don't know how long it can last in blood mixed with saliva.. do you??  It's something you have to consider when saliva is used as lube especially.

And I say again, no website of authority, not even this one, states its impossible to spread hiv through saliva.  And there's good reason for that.  Only the misguided people on these forums with their wishful opinions are telling people these false lies.   The word impossible should not be used.  "Very low risk" should be used along with explaining the factors that could make it possible, ie blood in the saliva and an open wound.   This isn't rocket science here.


I understand your argument.  There is a lot of misinformation and things we just don't know.  I think most of us have heard people say HIV is killed as soon as it hits the air.  I've heard so many say that.  Well, is all of it killed immediately?  I understand what you're saying.  There is a big debate about super-infections as well.  Many think they are very real and happen at any stage of the disease.  Most think it doesn't happen or only happens when you're first infected.

Your argument is that people should say it has never been documented that saliva transmitted HIV instead of saying it is impossible?  I think the evidence shows it is not transmitted via tears or saliva.  If there is blood in the saliva, then the transmission would come from the blood and not the saliva.  Since all the data shows it isn't transmitted through saliva and tears, I think it would be irresponsible to go around saying you can get it from kissing.  Too many people have worked so hard to reduce the stigma and fears.  I will admit that some keep this going by saying to avoid deep throat kissing. 

Offline azprince

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Re: HIV in Saliva Transmission Risk
« Reply #32 on: April 22, 2010, 07:29:33 AM »
If I am understanding correctly, I think the first thread was about HOW the information is presented , while I dont want to get into the issue of Saliva  through kissing, I do agree that the forum of am I infected is getting too unfriendly for information seekers!
Andy Velez who is running the forum of am I infected like a dictator is quite insensitive to guys who are panicking and seeking information , I think he is trying to be firm with them to calm them down , but he ignores the simple fact that  when someone is in a panic and shock , the last thing he needs is such an aggressive old man answering him in the most rude way....
I remember a year ago when I was passing through the same difficult time, Andy was very rude when answering my questions , he only made me more depressed and angry, a year passed and I cant get over it...
I wonder what is the point of having a rude moderator on a website that is supposed to promote support and understating to people with a chronic illness??  if Andy Velvez was on a website that deals with victims of cancer and he answered their questions in the same rude  way, he would have been sued !

I hope he reconsiders his attitude with those young kids who are already scared .
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

Offline RapidRod

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Re: HIV in Saliva Transmission Risk
« Reply #33 on: April 22, 2010, 07:40:42 AM »
If I am understanding correctly, I think the first thread was about HOW the information is presented , while I dont want to get into the issue of Saliva  through kissing, I do agree that the forum of am I infected is getting too unfriendly for information seekers!
Andy Velez who is running the forum of am I infected like a dictator is quite insensitive to guys who are panicking and seeking information , I think he is trying to be firm with them to calm them down , but he ignores the simple fact that  when someone is in a panic and shock , the last thing he needs is such an aggressive old man answering him in the most rude way....
I remember a year ago when I was passing through the same difficult time, Andy was very rude when answering my questions , he only made me more depressed and angry, a year passed and I cant get over it...
I wonder what is the point of having a rude moderator on a website that is supposed to promote support and understating to people with a chronic illness??  if Andy Velvez was on a website that deals with victims of cancer and he answered their questions in the same rude  way, he would have been sued !

I hope he reconsiders his attitude with those young kids who are already scared .

No one asked you.

Offline Matty the Damned

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Re: HIV in Saliva Transmission Risk
« Reply #34 on: April 22, 2010, 07:50:39 AM »
If I am understanding correctly, I think the first thread was about HOW the information is presented , while I dont want to get into the issue of Saliva  through kissing, I do agree that the forum of am I infected is getting too unfriendly for information seekers!
Andy Velez who is running the forum of am I infected like a dictator is quite insensitive to guys who are panicking and seeking information , I think he is trying to be firm with them to calm them down , but he ignores the simple fact that  when someone is in a panic and shock , the last thing he needs is such an aggressive old man answering him in the most rude way....
I remember a year ago when I was passing through the same difficult time, Andy was very rude when answering my questions , he only made me more depressed and angry, a year passed and I cant get over it...
I wonder what is the point of having a rude moderator on a website that is supposed to promote support and understating to people with a chronic illness??  if Andy Velvez was on a website that deals with victims of cancer and he answered their questions in the same rude  way, he would have been sued !

I hope he reconsiders his attitude with those young kids who are already scared .


OK this is utter fucking crap. I've known Andy for 5 years and we've never gotten along very well but that's largely because I'm an arrogant douchebag.

Andy Velez may be many things, but he's not rude, insensitive or aggressive.

AMI is run the way it is for a reason. You don't do those people any favours by indulging them with well intentioned hand holding and coddling. That just enables their bad behaviour.

Andy may be firm, but I'm yet to see him be rude to a WW. On the contrary, he's an exemplar of the civil, no nonsense and highly professional attitude which typifies our work in AMI and frankly, AZ, you do him an enormous disservice with this ill considered attack.

MtD

Online bocker3

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Re: HIV in Saliva Transmission Risk
« Reply #35 on: April 22, 2010, 07:52:10 AM »
the last thing he needs is such an aggressive old man answering him in the most rude way....

So you are saying that it would be OK if it were an aggressive "young man"???  
Probably not -- I guess it's just you being rude to someone on this website.

As to the topic of this thread -- you can NEVER scientifically prove that something is impossible.  All you can do is look at the data and come up with how likely something is to happen.  So, while you are likely to never see a scientific journal say that something absolutely can not happen -- when you see comments like "no documented cases have been seen", or something similar -- there is pretty strong evidence that it is unlikely to happen (assuming it has been extensively looked into, of course).

You are looking for a word "impossible" that you will never see -- however, lack of "impossible" does not mean the evidence points to it being possible -- it simply means that it can't be SCIENTIFICALLY disproved.

My advice -- move on -- get over this obsession.  If you want to use this site as support, stop picking a fight that you will not win, this site is filled with caring, supportive people.  If you joined this site simply to "fight" about this topic -- then please move on somewhere else.

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
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Offline azprince

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Re: HIV in Saliva Transmission Risk
« Reply #36 on: April 22, 2010, 08:07:24 AM »
Mike,
I hope it was clear that I was referring to the fact that he is aggressive and rude regardless of age( I am amazed that you picked the od man out of the phrase  :D, him being an old man would only make me think he should be nicer and more compassionate with the kids who are freaking out about their status...
And yes there are many supportive guys here, but its too bad that a moderator is acting rudely ...

As I said . I am not getting into the saliva thing, things  can prove to be  facts then change within 10 years
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

Offline Dachshund

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Re: HIV in Saliva Transmission Risk
« Reply #37 on: April 22, 2010, 08:09:14 AM »
If I am understanding correctly, I think the first thread was about HOW the information is presented , while I dont want to get into the issue of Saliva  through kissing, I do agree that the forum of am I infected is getting too unfriendly for information seekers!
Andy Velez who is running the forum of am I infected like a dictator is quite insensitive to guys who are panicking and seeking information , I think he is trying to be firm with them to calm them down , but he ignores the simple fact that  when someone is in a panic and shock , the last thing he needs is such an aggressive old man answering him in the most rude way....
I remember a year ago when I was passing through the same difficult time, Andy was very rude when answering my questions , he only made me more depressed and angry, a year passed and I cant get over it...
I wonder what is the point of having a rude moderator on a website that is supposed to promote support and understating to people with a chronic illness??  if Andy Velvez was on a website that deals with victims of cancer and he answered their questions in the same rude  way, he would have been sued !

I hope he reconsiders his attitude with those young kids who are already scared .


There is one thing Andy isn't, and that is rude. If anything he is way too accommodating to knuckleheads.

Offline loop78

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Re: HIV in Saliva Transmission Risk
« Reply #38 on: April 22, 2010, 08:20:49 AM »
Andy Velez who is running the forum of am I infected like a dictator is quite insensitive to guys who are panicking and seeking information , I think he is trying to be firm with them to calm them down , but he ignores the simple fact that  when someone is in a panic and shock , the last thing he needs is such an aggressive old man answering him in the most rude way....
I remember a year ago when I was passing through the same difficult time, Andy was very rude when answering my questions , he only made me more depressed and angry, a year passed and I cant get over it...
I wonder what is the point of having a rude moderator on a website that is supposed to promote support and understating to people with a chronic illness??  if Andy Velvez was on a website that deals with victims of cancer and he answered their questions in the same rude  way, he would have been sued !

I hope he reconsiders his attitude with those young kids who are already scared.

I wanted to stay away from this thread as I was convinced whatever reasons I were able to provide to the OP about his irrational fears about saliva would fall on deaf ears, as the whole question stinks of argument from ignorance.

Anyway, this comment about Andy made me come out of the proverbial closet just to say he, as well as Matty, Ann and the rest, were extremely helpful and sensitive when I went through the hard time of testing +, and I believe being categorical in their answers is a service to the community as otherwise they would promote unnecessary worrying and unwarranted fear.

Edit: What bocker just beat me to write :-)
« Last Edit: April 22, 2010, 08:24:35 AM by loop78 »

Offline Assurbanipal

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Re: HIV in Saliva Transmission Risk
« Reply #39 on: April 22, 2010, 08:42:41 AM »
AZ

I went back and read your initial thread in "Am I Infected?"  It's probably still very difficult for you to do that, because learning you have become infected is very traumatizing.  It wouldn't be surprising for you to have some emotional scars from that experience

But, if you can, I'd encourage you to reread it.  I think if you do so you  will see that Andy was doing what he could to answer both your explicit and implied questions in a way that (looked at objectively) is not at all aggressive.  And that may help you now, after having had time to adjust to the diagnosis, to understand yourself better.  It's a pretty unique opportunity to reconcile memory and emotion.

Assurbanipal
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Assurbanipal

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Re: HIV in Saliva Transmission Risk
« Reply #40 on: April 22, 2010, 08:46:26 AM »
Phoenius

Just as an observation, you seem to be conflating information about blood with information about saliva.

They are different. 

Sure, you can mix them, since they are both fluids.

But there is no evidence of transmission of HIV in saliva.

A
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline GSOgymrat

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Re: HIV in Saliva Transmission Risk
« Reply #41 on: April 22, 2010, 09:00:00 AM »
I found that these forums are VERY biased because most who post here are HIV+.  ...

And I say again, no website of authority, not even this one, states its impossible to spread hiv through saliva.  And there's good reason for that.  Only the misguided people on these forums with their wishful opinions are telling people these false lies.   The word impossible should not be used.  "Very low risk" should be used along with explaining the factors that could make it possible, ie blood in the saliva and an open wound.   This isn't rocket science here.


Since you are presumably HIV+ I suppose your comments are biased as well.

I understand your problem with the word "impossible" being used but saying something is "very low risk" when there is no documented evidence that it has ever happened is equally inaccurate.

Offline veritas

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Re: HIV in Saliva Transmission Risk
« Reply #42 on: April 22, 2010, 09:24:19 AM »

Phoenius,

Although I believe your warning is meant well, I have to agree with those posting that saliva, in and of itself, is not a factor in hiv transmission. Your toothbrush analogy really refers to blood transmission rather than saliva transmission. A toothbrush is a good blood transmitter, thus the risk, as inferred by other posters. I believe if you follow the guidelines in the following link, you can put your fears to rest:

http://www.sfaf.org/aids101/transmission.html#

Aidsmeds is not the only sight that fosters this opinion. Also, the medical community has not found any such transmission  as others have stated (I've looked for such transmissions myself).

v

Offline WillyWump

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Re: HIV in Saliva Transmission Risk
« Reply #43 on: April 22, 2010, 11:30:35 AM »
Andy Velez who is running the forum of am I infected like a dictator is quite insensitive to guys who are panicking and seeking information , I hope he reconsiders his attitude with those young kids who are already scared .


WHAT? LOL! Andy is the least abrasive of the bunch over there (no offense to the others). Sounds like sour grapes are fermenting in you.

-Will
POZ since '08

Last Labs-
6/3/14 CD4- 736, UD 34%
6/25/13 CD4- 1036, UD,
2/4/13, CD4 - 489, UD, 28%

Current Meds: Prezista/Epzicom/ Norvir
.

Offline leese43

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Re: HIV in Saliva Transmission Risk
« Reply #44 on: April 22, 2010, 01:57:06 PM »
I remember a year ago when I was passing through the same difficult time, Andy was very rude when answering my questions , he only made me more depressed and angry, a year passed and I cant get over it...


I don't think you remember at all, perhaps you should go back and read your thread in am i infected.
Oct 04 - Neg
Aug 05 - infected
Oct 05 - cd4 780, vl 60k
Apr 08 - cd4 430, vl 243
Jul 08 - cd4 550, vl 896
Nov 08 - cd4 730, vl 1.8k
May 09 - cd4 590, vl 1.5k
Sep 09 - cd4 460 vl 34k
Dec 09 - cd4 470 vl 42k
April 10 - cd4 430 vl 88.5k
July 10 - cd4 330 vl 118k
Aug 10 - started reyataz/truvada/norvir
Aug 10 - cd4 380 vl 4k (12 days after starting meds :))
Sep 10 - cd4 520 vl 1.5k
Oct 10 - cd4 590 vl 44
Jan 11 -cd4 610 vl <40 cd4% 50
May 11 - cd4 780 vl UD

Offline azprince

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Re: HIV in Saliva Transmission Risk
« Reply #45 on: April 22, 2010, 03:05:17 PM »
Ok, its my opinion and I respect all different opinions, my thoughts are that those who are still in the process of getting the information of being infected need extra care  in how to not turn their trauma into a worse one, most of them need huge amount of support in such a difficult time... and they need a careful way of addressing them, so that they feel they are welcomed to ask, and others are here to listen and show support! this si what this website is about , right ?
I might be wrong in my opinion , I have been wrong many times before, but still when I see newly diagnosed people, the first thing I say: I understand why are you scared! then I try to make their concerns seem ok and not stupid  :P
and one note for the guy who called those newly infected and freaking out with questions as nucklheads ....maybe you need to rethink about your comment ! because its so impolite and arrogant and honestly , it shows a great amount of ignorance or insensitivity  ..... reading few books from worldwide writers now and then will help  on your way to eat steak    ;D
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

Offline azprince

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Re: HIV in Saliva Transmission Risk
« Reply #46 on: April 22, 2010, 03:11:54 PM »
AZ

I went back and read your initial thread in "Am I Infected?"  It's probably still very difficult for you to do that, because learning you have become infected is very traumatizing.  It wouldn't be surprising for you to have some emotional scars from that experience

But, if you can, I'd encourage you to reread it.  I think if you do so you  will see that Andy was doing what he could to answer both your explicit and implied questions in a way that (looked at objectively) is not at all aggressive.  And that may help you now, after having had time to adjust to the diagnosis, to understand yourself better.  It's a pretty unique opportunity to reconcile memory and emotion.

Assurbanipal

Thanks , and I understand that it has been long time, maybe I will re-read them one time, but I also exchanged PMs with Andy, and nothing of what I am saying is directed against him its generally speaking of the importance of being extra careful when dealing with newly traumatized people whether HIV+ or not, Andy is specialized in psychology as I read, and now from my education, I know this is the alphabet of helping others emotionally get over their traumas, to be very patient and understanding to why they are questioning what might seem to us, stupid questions !
Once again thanks for the comment and sorry if it sounded like a personal issue, its not !
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

Offline Moffie65

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Re: HIV in Saliva Transmission Risk
« Reply #47 on: April 22, 2010, 03:26:00 PM »
I just want to thank all of you who actually placed some time into your responses, and gave the science as the foundation of your answers.  Notably, jkinatl (Jonathan), Matty, and others I might have missed.  It is refreshing to see Jonathan back again and posting real science; as it has been very lacking here lately, and I am not good at finding it.  I have found that speaking with personal experience here lately is a total waste of time, because when I do it, I am lambasted with no "internet" references. 

Imagine that, I must now back up my personal experience of living with this shit for 27 years, with some website that doesn't even know me or my experience.  But sure enough, those that populate this place lately, surely don't want my experience at all anymore.  Yes, I find that so alarming, I just don't do it anymore.  Guess they really don't want to know the truth, like getting HIV from saliva is truly a myth.  Just doesn't happen, never ever.  Just isn't scientifically possible, and if so, everyone on the planet would have HIV by now. 
The Bible contains 6 admonishments to homosexuals,
and 362 to heterosexuals.
This doesn't mean that God doesn't love heterosexuals,
It's just that they need more supervision.
Lynn Lavne

Offline Dachshund

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Re: HIV in Saliva Transmission Risk
« Reply #48 on: April 22, 2010, 03:37:53 PM »
Ok, its my opinion and I respect all different opinions, my thoughts are that those who are still in the process of getting the information of being infected need extra care  in how to not turn their trauma into a worse one, most of them need huge amount of support in such a difficult time... and they need a careful way of addressing them, so that they feel they are welcomed to ask, and others are here to listen and show support! this si what this website is about , right ?
I might be wrong in my opinion , I have been wrong many times before, but still when I see newly diagnosed people, the first thing I say: I understand why are you scared! then I try to make their concerns seem ok and not stupid  :P
and one note for the guy who called those newly infected and freaking out with questions as nucklheads ....maybe you need to rethink about your comment ! because its so impolite and arrogant and honestly , it shows a great amount of ignorance or insensitivity  ..... reading few books from worldwide writers now and then will help  on your way to eat steak    ;D


I wasn't directing it towards the newly infected. Oh and Mr. Wordsmith, knucklehead is spelled with a k. ;)

Offline skeebo1969

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Re: HIV in Saliva Transmission Risk
« Reply #49 on: April 22, 2010, 04:04:42 PM »
Ok, its my opinion and I respect all different opinions, my thoughts are that those who are still in the process of getting the information of being infected need extra care  in how to not turn their trauma into a worse one, most of them need huge amount of support in such a difficult time... and they need a careful way of addressing them, so that they feel they are welcomed to ask, and others are here to listen and show support! this si what this website is about , right ?
I might be wrong in my opinion , I have been wrong many times before, but still when I see newly diagnosed people, the first thing I say: I understand why are you scared! then I try to make their concerns seem ok and not stupid  :P
and one note for the guy who called those newly infected and freaking out with questions as nucklheads ....maybe you need to rethink about your comment ! because its so impolite and arrogant and honestly , it shows a great amount of ignorance or insensitivity  ..... reading few books from worldwide writers now and then will help  on your way to eat steak    ;D

A lot of this could have easily been avoided by just wearing a condom....  but I guess that's Andy's fault as well..

I despise the song Love is in the Air, you should too.

 


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