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HIV and Oral Sex

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ianmx:
I am newly diagnosed and was recently having a conversation with my advocate where the topic of oral sex came up. When I talk about oral sex I talk with the assumption that there is precum or full ejaculation in the mouth... he was adamant that oral sex was not without risk, however whenever i see the question in the forums here, mostly 'am i infected' the standard response is oral is a 0% risk factor. or at least played off as no reason to be tested, only anal and vaginal unprotected sex is a risk.

I googled and i cannot find any site, including the cdc, that says oral is a 0% risk factor but all agree the risks are greatly reduced. i see many sites refer to 'some studies' but i cannot find those studies. some say that because most sexual encounters would include other activities other than oral it is hard to determine the transmission. meaning at best oral is inconclusive but not risk free.

where is the thought process and policy of this site that oral is 0% risk taken from? of course anyone who feels they need to post in 'am i infected' should be encouraged to be tested 100% of the time, but that's another story.

i put this in prevention because knowledge is prevention and i wasn't sure where else the question would fit.  :D

ian

Jeff G:
We do not comment on what other sites say about oral transmission and rely on the latest peer reviewed science instead . We always tell people to test risk or not .

There have been no fewer than three separate serodiscordant couples studies (where one person is HIV positive, the other negative.) These couples were tracked for three. five and ten years. The couples used condoms for penetrative vaginal and anal sex, but NO BARRIER at all for oral sex. Any kind of oral sex.

These studies yielded NO infections.

http://journals.lww.com/aidsonline/Fulltext/2002/06140/Evaluating_the_risk_of_HIV_transmission_through.17.aspx#P38

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.

ianmx:
Thank you for the link :)

I have actually seen that study before. I found it interesting that they only tested heterosexuals and out of the infected 135 people, only 25 were male. The mix isn't even close to real life HIV statistics.

Even this study mentions other studies where M2M oral might have resulted in 'probable' infections.

"A recent work found eight cases of probable orogenital transmission among 102 recently infected men who had had sex with men"

The CDC isn't a website, it is the government policy on infectious diseases in which the medical community bases their own information, and they report that there is a low risk with oral sex and much of that risk depends on the oral care of participants.

The study linked to here mentions no oral care or if the people in the study had been examined by dentists for gingivitis, cavities, or sores in the mouth. All things that the CDC points to as being a risk factor. The CDC also recommends not having oral within 25 minutes of brushing your teeth.

This study linked to actually concludes that transmission through oral is a low probability when other risks are excluded... is one of those risks oral health? This study does not give a 0% risk factor, they don't even suggest that is their conclusion, they were dealing with a controlled group and maybe oral health was considered as part of the controlled group. That isn't real life experience, we don't 'hook up' and take a trip to the dentist first.

These tests are not done by saying 'hey, we think you might get HIV if you give this HIV guy a blow job, wanna try?'... They eliminate everything they consider to be a risk and reject people who might meet those risk factors, maybe people with a cold sore in their mouth? That isn't real world sex and we don't send our oral partners for an oral exam before hand. The goal of the test is to eliminate all risks first because they don't really want to infect someone, so they go in confident they have covered their bases.

I must admit there is a lot on contradicting information about HIV. I hear the reason HIV cannot be passed by oral is because the virus cannot live in the mouth, but yet we have oral HIV tests. We hear the virus cannot live outside the host body because just exposure to the air kills the virus, yet we accept shared needles as a means of transmission. Maybe we know less than we think we know.  ;) ... or speaking for myself. hahah

Well, still an interesting read to say the least. Thanks for the link!

ian

leatherman:

--- Quote from: ianmx on August 19, 2015, 03:37:04 pm ---I hear the reason HIV cannot be passed by oral is because the virus cannot live in the mouth, but yet we have oral HIV tests.

--- End quote ---
When you seroconvert your immune system produces antibodies to fight off a virus. those tests looks for antibodies that have developed to HIV, not HIV itself. A viral load measures the actual HIV.


--- Quote from: ianmx on August 19, 2015, 03:37:04 pm ---We hear the virus cannot live outside the host body because just exposure to the air kills the virus, yet we accept shared needles as a means of transmission.

--- End quote ---
shared injection needles can hold hiv-filled blood and literally inject it into the blood system of someone else. air doesn't have time to breakdown the hiv and the hiv is forced into another person (a wound bleeds outward and that's why hiv blood splattered onto the wound of another person is not enough to transmit hiv)

ianmx:

--- Quote from: leatherman on August 19, 2015, 09:03:50 pm ---When you seroconvert your immune system produces antibodies to fight off a virus. those tests looks for antibodies that have developed to HIV, not HIV itself.

--- End quote ---

Thanks Leatherman! that i did not know about the oral tests. Learn something new every day  :D

ian

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