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Author Topic: Transmission Question  (Read 1394 times)

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Offline odyssey

  • Member
  • Posts: 765
  • One Crazy Mofo!
Transmission Question
« on: November 10, 2010, 03:08:07 PM »
Okay, so I know I should probably know the answer to this, and I think I do, but I just want to get some confirmation. I'm a transguy who hasn't had lower surgery, and I'm also HIV poz. I have however had a radical hysterectomy, so I don't have a uterus or cervix or anything. My question is, what are the risk of transmitting HIV to a partner if they perform oral sex on me?

I'm pretty sure from what I've learned that this is a very low to no risk activity, but I would just like some answers from the Am I Infected experts to either confirm what I think is true or to set me straight (in the sense of correcting me, not making me heterosexual, because that certainly isn't going to happen).

Thanks in advance!

odyssey
01/09/09- diagnosed HIV+
01/16/09   CD4-425    22%  VL- 32,415
11/09- started Reyetaz/Norvir/Truvada
03/10- stopped R/N/T
10/18/11   CD4- 328   20%  VL- 84,000
10/25/11   CD4- 386   22%
10/28/11- start Truvada/Reyetaz/Norvir
12/30/11  CD4- 523  29%
03/08/12  CD4- 503  31%  VL 57
07/02/12  CD4- 897  43%
08/31/12  CD4- 745  39%
12/27/12  CD4- 884  40%
03/28/13  CD4- 819  39%
07/19/13  CD4- 739  40%
10/17/13  CD4- 535  36%
01/16/14  CD4- 743  43%

02/14- switched from R/N/T to Tivicay/Epzicom because of CKD 3 suspected from tenofovir.

03/14- switched back to R/N/T due to severe nausea and inability to eat on T/E.
 
04/01/14 CD4- 898  42%   VL-

Offline GSOgymrat

  • Member
  • Posts: 5,002
  • HIV+ since 1993. INTJ
Re: Transmission Question
« Reply #1 on: November 10, 2010, 03:25:36 PM »
I have no idea, but that is an interesting question.

Offline Matty the Damned

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  • Posts: 12,198
  • Ninja Please
Re: Transmission Question
« Reply #2 on: November 10, 2010, 04:10:07 PM »
Odyssey,

There is no risk of you transmitting HIV to a sexual partner who performs unprotected oral sex on you, radical hysterectomy or otherwise.

Nor would the risk exist if you'd had bottom surgery in any form (ie metoidoplasty, phalloplasty etc) either.

There would be some risk if you had unprotected vaginal sex with a male but that risk would be greatly reduced following the removal of your cervix. It cannot be considered zero, however.

I should add that I'm not suggesting that you do or do not have vaginal sex of any sort. I appreciate that some transguys are averse to this practice, whilst others are not.

MtD

Offline odyssey

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  • Posts: 765
  • One Crazy Mofo!
Re: Transmission Question
« Reply #3 on: November 10, 2010, 04:16:39 PM »
Wow, so are you saying having had my cervix removed actually makes sex safer? Hmm, I never would have guessed that. I'm actually trying to work on not having unprotected sex anymore. I know its a lot of fun, but I really don't need to be getting myself any more germs. That, and I'd feel really awful if I got someone else sick I think.

odyssey
01/09/09- diagnosed HIV+
01/16/09   CD4-425    22%  VL- 32,415
11/09- started Reyetaz/Norvir/Truvada
03/10- stopped R/N/T
10/18/11   CD4- 328   20%  VL- 84,000
10/25/11   CD4- 386   22%
10/28/11- start Truvada/Reyetaz/Norvir
12/30/11  CD4- 523  29%
03/08/12  CD4- 503  31%  VL 57
07/02/12  CD4- 897  43%
08/31/12  CD4- 745  39%
12/27/12  CD4- 884  40%
03/28/13  CD4- 819  39%
07/19/13  CD4- 739  40%
10/17/13  CD4- 535  36%
01/16/14  CD4- 743  43%

02/14- switched from R/N/T to Tivicay/Epzicom because of CKD 3 suspected from tenofovir.

03/14- switched back to R/N/T due to severe nausea and inability to eat on T/E.
 
04/01/14 CD4- 898  42%   VL-

Offline Matty the Damned

  • Member
  • Posts: 12,198
  • Ninja Please
Re: Transmission Question
« Reply #4 on: November 10, 2010, 04:27:32 PM »
Wow, so are you saying having had my cervix removed actually makes sex safer? Hmm, I never would have guessed that. I'm actually trying to work on not having unprotected sex anymore. I know its a lot of fun, but I really don't need to be getting myself any more germs. That, and I'd feel really awful if I got someone else sick I think.

odyssey

Yup. In biological females HIV finds a handy lair in the cervix and it is the fluids produced by and around the cells of the cervix (columnar epithelium etc) that contain relatively high concentrations of the virus.

The fluids produced in and by other parts of the vagina and surrounds (notably Bartholin's Glands) are not particularly infectious if at all.

So it follows that removal of the cervix removes this particular locus of infection. But, nothing is guaranteed so it's still important that you have protected sex (anal or vaginal).

But infecting other people with HIV is not the best reason for you to have protected anal or vaginal sex. You should be thinking about the possibility of someone infecting you with an STD such as syphilis.

Syphilis is a problem because it's relatively common in homosexual male populations and it probably the nastiest STD a poz bod can contract. HIV positive people who contract syphilis face more complicated treatment regimens and are much more likely to progress to the tertiary phase of the disease than HIV negative people. Moreover this progression can happen much more quickly in HIV positive people.

Believe me, tertiary syphilis (especially neurosyphilis) is something you want to avoid. It's a dreadful disease which can have really catastrophic consequences.

MtD

Offline odyssey

  • Member
  • Posts: 765
  • One Crazy Mofo!
Re: Transmission Question
« Reply #5 on: November 10, 2010, 04:32:17 PM »
Thanks for the info Matty!
01/09/09- diagnosed HIV+
01/16/09   CD4-425    22%  VL- 32,415
11/09- started Reyetaz/Norvir/Truvada
03/10- stopped R/N/T
10/18/11   CD4- 328   20%  VL- 84,000
10/25/11   CD4- 386   22%
10/28/11- start Truvada/Reyetaz/Norvir
12/30/11  CD4- 523  29%
03/08/12  CD4- 503  31%  VL 57
07/02/12  CD4- 897  43%
08/31/12  CD4- 745  39%
12/27/12  CD4- 884  40%
03/28/13  CD4- 819  39%
07/19/13  CD4- 739  40%
10/17/13  CD4- 535  36%
01/16/14  CD4- 743  43%

02/14- switched from R/N/T to Tivicay/Epzicom because of CKD 3 suspected from tenofovir.

03/14- switched back to R/N/T due to severe nausea and inability to eat on T/E.
 
04/01/14 CD4- 898  42%   VL-

Offline Matty the Damned

  • Member
  • Posts: 12,198
  • Ninja Please
Re: Transmission Question
« Reply #6 on: November 10, 2010, 04:33:10 PM »
Thanks for the info Matty!

Anytime babe. :-*

MtD

Offline jkinatl2

  • Member
  • Posts: 6,007
  • Doo. Dah. Dipp-ity.
Re: Transmission Question
« Reply #7 on: November 10, 2010, 06:55:19 PM »
Not that he needs my validation, but every work Matty says is scientifically verifiable. Vaginal fluids situated in the cervical  area are the only ones which have been reported to contain sufficient amounts of infectious fluid to facilitate transmission and overpower the naturally occurring anti-HIV elements found in human saliva.

The fluids expressed by the Bartholin's Glands are closer to the fluids found in sweat or tears. They present little if any risk for HIV infection, and the latest decade or so of HIV study has more than borne that out.

Syphilis, like Matty said, is a serious problem with HIV positive folks. Also, antibiotic-resistant strains of Chlamydia and Gonorrhea tend to cycle, usually one step ahead of the latest medical breakthrough (thankfully no more than that thus far, as we have managed to contain and control them - barely - up till now).

Sadly though, syphilis and chlamydia and gonorrhea are FAR hardier than HIV, and can be transmitted even in the absence of intercourse. That's why, IMHO, any sexually active person with partner(s) of unknown status ought to get a full STD screening every six months. Syphilis remains one of the FEW STD's which requires a three month window period.

In short, listen to Matty and Newt - and to this site (AIDSMEDS) when it comes to protecting itself. Heresay and anecdote is simply that, and often agenda driven.
"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 odyssey

  • Member
  • Posts: 765
  • One Crazy Mofo!
Re: Transmission Question
« Reply #8 on: November 10, 2010, 06:59:57 PM »
Yet another great reason I got a hysterectomy (even though I didn't know it at the time). So I could have less infectious bodily fluids. Now I wonder if my insurance company would have bought that as a reason? But yes, I do need to worry about other STDs, probably a lot more so than I have. I guess I've always thought, oh, they're curable, so no need to worry. I'm starting to seriously reconsider that premise after reading your responses.
01/09/09- diagnosed HIV+
01/16/09   CD4-425    22%  VL- 32,415
11/09- started Reyetaz/Norvir/Truvada
03/10- stopped R/N/T
10/18/11   CD4- 328   20%  VL- 84,000
10/25/11   CD4- 386   22%
10/28/11- start Truvada/Reyetaz/Norvir
12/30/11  CD4- 523  29%
03/08/12  CD4- 503  31%  VL 57
07/02/12  CD4- 897  43%
08/31/12  CD4- 745  39%
12/27/12  CD4- 884  40%
03/28/13  CD4- 819  39%
07/19/13  CD4- 739  40%
10/17/13  CD4- 535  36%
01/16/14  CD4- 743  43%

02/14- switched from R/N/T to Tivicay/Epzicom because of CKD 3 suspected from tenofovir.

03/14- switched back to R/N/T due to severe nausea and inability to eat on T/E.
 
04/01/14 CD4- 898  42%   VL-

Offline Matty the Damned

  • Member
  • Posts: 12,198
  • Ninja Please
Re: Transmission Question
« Reply #9 on: November 10, 2010, 07:07:00 PM »
Yet another great reason I got a hysterectomy (even though I didn't know it at the time). So I could have less infectious bodily fluids. Now I wonder if my insurance company would have bought that as a reason? But yes, I do need to worry about other STDs, probably a lot more so than I have. I guess I've always thought, oh, they're curable, so no need to worry. I'm starting to seriously reconsider that premise after reading your responses.

Hysterectomy also protects transmen against uterine and cervical cancers. If you don't have 'em you can't get cancer in 'em. T (ie testosterone therapy) is implicated in increasing the risk of uterine and ovarian cancers, so there is good reason for this procedure and possibly an oophectomy (removal of the ovaries) as well. I'm not sure if oophectomy was part of your hysterectomy. It is in some places but not in others.

Chlamydia and gonorrhoea are indeed curable but can have nasty long term consequences if left untreated. Given that they can be asymptomatic it's wise to be tested for them. Urine PCR testing would be indicated in your case as cervical swabbing is not an option.

Other STDs of note include Heptatitis A & B, both of which are vaccine preventable.

MtD

Offline odyssey

  • Member
  • Posts: 765
  • One Crazy Mofo!
Re: Transmission Question
« Reply #10 on: November 10, 2010, 07:13:15 PM »
Oh yeah Matty, that was one of the main reason I opted for the surgery, other than just not wanting those damn organs in there anymore. Fortunately for me, I had previously battled with endometriosis, so my Medicaid paid the 14 or so thousand dollars for the removal of my cervix, uterus, fallopian tubes, and ovaries.

So yes, everything that can become cancerous is out. I mean, unless I'm unlucky enough to get vaginal cancer. But I'm hoping down the road to have a metoidioplasty with urethral lengthening, at which point they get rid of that too. So hopefully I'll be all set.

Another note... I've been vaccinated against Hep A and Hep B, as well as HPV. I got my Medicaid to pay for that before I had my sex legally changed to male while they were still only giving it to girls. I guess that was a plus of being considered a girl, lol. Now I'm legally male.

odyssey
01/09/09- diagnosed HIV+
01/16/09   CD4-425    22%  VL- 32,415
11/09- started Reyetaz/Norvir/Truvada
03/10- stopped R/N/T
10/18/11   CD4- 328   20%  VL- 84,000
10/25/11   CD4- 386   22%
10/28/11- start Truvada/Reyetaz/Norvir
12/30/11  CD4- 523  29%
03/08/12  CD4- 503  31%  VL 57
07/02/12  CD4- 897  43%
08/31/12  CD4- 745  39%
12/27/12  CD4- 884  40%
03/28/13  CD4- 819  39%
07/19/13  CD4- 739  40%
10/17/13  CD4- 535  36%
01/16/14  CD4- 743  43%

02/14- switched from R/N/T to Tivicay/Epzicom because of CKD 3 suspected from tenofovir.

03/14- switched back to R/N/T due to severe nausea and inability to eat on T/E.
 
04/01/14 CD4- 898  42%   VL-

 


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