Confused, worried and all other emotions thrown in

[billynomates]

First and foremost I just want to thank the moderators for the good job they do. I
Have read through thousands of responses and you never seem to lose your cool even when some of the enquiries out out right silly. It must be frustrating but yet you never come across that it is...

However I do have an enquiry regarding unprotected oral sex. There have been thousands of replies to people who have worries about putting themselves into situations- me included and we always given the same response the 12 virus fighting enzymes, the numerous study of couples where one partner is positive and the other one remaining negative, receptive oral sex only being a theoretic risk etc...

As much as I did this helpful and comforting. I am sure there are people who have caught HIV from oral sex. I just wonder how many people who have got it but don't bother getting tested  as they think oral sex isn't a risk. Why do other organisations say it is a risk if it's not?

I don't want to be argumentative or put down the work you do as you provide an excellent service and offer comfort to those who diagnosed. I just find it very confusing as there are people on the recently diagnosed board who genuinely believe they were infected from receptive oral sex. It's not for us to ask why, but why would they lie? Then they are told by others not to think or get angry as to how the acquired it and if anyone posts onto the just diagnosed board who is concerned they are removed. There never seems to be a real discussion about HIV from oral sex. If it's not a real risk why are people so concerned and why can we not discuss it? If I HIV positive it will be from giving oral sex. Yet I am lead to believe that's virtually impossible. Please advise

[RapidRod]

HIV is transmitted by;
Unprotected penetrative anal and/or vaginal sex
Sharing works with other IV drug abusers
Mother to child

[billynomates]

Just as I expected, no real discussion but that's fine. I will let you know my results when I am mentally ready to go get tested. I know that if I am positive, will be from Oral sex as I never have anal sex and have never done drugs at all in my life. I pray you're right and of course i don't want to prove you wrong. Just not entirely convinced but thank you

[RapidRod]

Just as I expected, no real discussion but that's fine. I will let you know my results when I am mentally ready to go get tested. I know that if I am positive, will be from Oral sex as I never have anal sex and have never done drugs at all in my life. I pray you're right and of course i don't want to prove you wrong. Just not entirely convinced but thank you

And your test will be negative. Simple as that.

[billynomates]

Well thank you for your positivity. That has given some comfort. Like i said, I pray you're right and my concern turns out to be a trivial one compared to what some poor people are going through. Can I make a suggestion though, the hiv information page is somewhat contradicting to what you're saying. Deepthroating, sores in the mouth, ulcers etc... Are listed as risk factors where you're saying that they're not. I think this is where it is misleading. It is either a risk or it is not. Not on some pages of information then not I'm the answers you give. See my point?

[RapidRod]

Well thank you for your positivity. That has given some comfort. Like i said, I pray you're right and my concern turns out to be a trivial one compared to what some poor people are going through. Can I make a suggestion though, the hiv information page is somewhat contradicting to what you're saying. Deepthroating, sores in the mouth, ulcers etc... Are listed as risk factors where you're saying that they're not. I think this is where it is misleading. It is either a risk or it is not. Not on some pages of information then not I'm the answers you give. See my point?

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.

[billynomates]

Thank you for the wealth of information, I will have a good read through all of it though my question was aimed at the information on this site. Having read the transmission information again it quite clearly states

"There have been three case reports and a few studies suggesting that some people have been infected with HIV as a result of unprotected oral sex. However, these case reports and studies all involved MSM – men who were the receptive partners (the person doing the "sucking") during unprotected oral sex with another HIV-positive man"

So there is a risk, however low. In all your responses you state that there isn't. I just think we need to be educating people more. Yes the risk is low but that doesn't mean it doesn't/won't happen. My concern is that if you do only perform unprotected receptive oral sex as a gay man, if you do test positive then you must be a liar and really had unprotected anal sex at some point or got drunk and didn't know what you were doing??? I rest my case as you have more important things to be answering, but I hope that you take this into account when advising worried people. 

[RapidRod]

There are no VERIFIED DOCUMENTED CASES. There also has been several long term suro couples studies one positive and one negative where they used protection for anal and vaginal sex and no one used protection for oral and not one person, not one person contracted HIV. Now if you feel uncomfortable getting a bj or giving one then use a condom that is your prerogative.

[jkinatl2]

Do you genuinely think we haven't taken all that into account? Do you really think we have not spent the last TEN YEARS doing risk assessment here and elsewhere, reading the latest reports, without taking these things into consideration?

You either think quite highly of yourself, quite little of us, or both.

I've been doing HIV/AIDS prevention outreach since 1994. Andy has done it longer than that. We would NEVER make the assessments we make unless we seriously thought we were absolutely correct.

So long as patient report post-infection remains the ONLY method by which oral infection is reported, and so long as sero-discordant couples' studies consistently refute that means of infection, I will not be compelled to chance my assessment here.

[billynomates]

I think if you read my posts that the only people I think highly of are yourselves for the dedication and comfort you give to others. I don't think highly of myself at all, quite the opposite.I do not believe for once that you make assumptions based on fiction nor do look at work you've both done for many years in research as anything less than amazing. I do however have concerns about the contradicting information on this site. I happily believe what you say and want yo believe it 100% (I can't imagine anyone actually wanting to aqquire HIV to prove you wrong) but I was pointing out to the information listed in the transmission site. Maybe as someone scared, I am mis understanding the information but to me unless I read there is 100% no risk at all, that means there are risks. That's all I was merely pointing out. And like I said you have given me a wealth of information written by people much more educated and knowledgable than me. I will read it all when I have a chance. Unfortunately other HIV/aids organisations do not promote the same
Thoughts of you. Yes they're mist probably wrong, but if we're all to be educated on such an important issue, then everyone should Benin the same page. That's my thinking of course and who am I? Apologies if you find my musings to be disrespectful as they're nit meant to be at all. I
Will keep my thoughts to myself from now on and let you guys get back tp your important work. Thanks for listening

[RapidRod]

I think if you read my posts that the only people I think highly of are yourselves for the dedication and comfort you give to others. I don't think highly of myself at all, quite the opposite.I do not believe for once that you make assumptions based on fiction nor do look at work you've both done for many years in research as anything less than amazing. I do however have concerns about the contradicting information on this site. I happily believe what you say and want yo believe it 100% (I can't imagine anyone actually wanting to aqquire HIV to prove you wrong) but I was pointing out to the information listed in the transmission site. Maybe as someone scared, I am mis understanding the information but to me unless I read there is 100% no risk at all, that means there are risks. That's all I was merely pointing out. And like I said you have given me a wealth of information written by people much more educated and knowledgable than me. I will read it all when I have a chance. Unfortunately other HIV/aids organisations do not promote the same
Thoughts of you. Yes they're mist probably wrong, but if we're all to be educated on such an important issue, then everyone should Benin the same page. That's my thinking of course and who am I? Apologies if you find my musings to be disrespectful as they're nit meant to be at all. I
Will keep my thoughts to myself from now on and let you guys get back tp your important work. Thanks for listening

We can't be responsible for what other websites say or do not say.

[billynomates]

Of coure not but you can control what's on THIS site and that was what my original comment was about. But game over. I will write to you and prove you right (God willing) when  tested. Thank you

[jkinatl2]

We actually spent months reconfiguring this area of the forum a couple of years ago. Granted, we are responsible only for aidsmeds.com and not poz.com which is a separate entity. HIV transmission theory has evolved greatly since the inception of HAART therapy, which has transformed HIV into a manageable illness. I believe the CDC still (wrongly) cautions against open-mouthed kissing. Because our site is not as beurocratic as others we have fortunately been able to keep abreast of scientific evolution.

Regardless, I have absolutely no confidence that any information we offer you will change your opinion. By all means, test at the three month period.

Best of luck to you.

[billynomates]

Thank you. That was the answer I was looking for. And I apologise if I seemed ungrateful and mistrusting of your advice. You have cleared up my initial question and that's enough for me to move on. I shall bother you no more and can say again, thank you for your hard work and
Dedication. Yours truly, Bill

[Ann]

"There have been three case reports and a few studies suggesting that some people have been infected with HIV as a result of unprotected oral sex. However, these case reports and studies all involved MSM – men who were the receptive partners (the person doing the "sucking") during unprotected oral sex with another HIV-positive man"
 

Billy,

The implication of the portion of your post that I quoted is this. There have never been reports of women claiming to have been infected through giving blowjobs. MSM are the only people to have reported this - and that is likely to be because of the stigma attached to anal intercourse. While there is also stigma attached to MSM oral sex, it is far stronger when it comes to anal intercourse.

The case reports and studies referenced in the above quote all involved what's called "patient report" and patient report is notoriously unreliable. The studies that we can give credence to are the three where serodiscordant couples were followed - in one study, up to ten years. Some of the positive partners were on treatment, some were not. In the couples who used condoms for anal or vaginal intercourse, but no barrier for oral activities, not one of the negative partners became infected with hiv. Not one.

These hiv negative people were not new to the world of hiv and worried about what others may think about how they got hiv. These studies followed negative people before their seroconversion; they were regularly questioned about their sexual activities with their positive partners. These people went into the study knowing that they weren't being judged. They knew they were contributing to our knowledge concerning hiv transmission. They had no motivation to lie about how they got infected - or how they stayed hiv negative, for that matter.

I hope that sheds more light on the subject.

Ann

[billynomates]

Ann that really does shed a great deal of light.

I've read through so many of the responses on here to the thousands of queries regarding worries attributed to oral sex and never really got a confident explanation as most of the answers were the same. I Understand you have so many people to respond to, you don't have the time to give written essays to each and everyone one of us but for someone who likes to know the ins and outs of a ducks a** the facts you have just given have given me comfort.

I didn't want to be someone who challenges people such as yourself and Rod and others who have dedicated your life to helping others with a wealth of information and support but I couldn't help being honest with my ignorance in Not quite understanding the facts. Fear does play a big part.

I appreciate you writing to me, thank you

[Ann]

Billy,

You're welcome.

Although it sounds like you've probably read my usual prevention spiel before now, here it is again:

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

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

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

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

Anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

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

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv.

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

BTW, I noticed you were posting in someone else's thread and I temporarily locked that thread so you couldn't. You need to know you are not permitted to post outside your own thread - I saved you being told off.

Please make sure you read and abide by our rules found in the Welcome Thread. Thank you for your cooperation.



Ann