Recent Encounter, low vs high risk?

[Joods84]

Hi, I am hoping you can help to determine my risk of HIV transmission. I recently had an ecounter with an HIV+ male (exact date is Feb 2nd). We did not have sex, including oral. Only kissing was involved and heavy rubbing/touching (including genitals). I am worried because prior to kissing I brushed my teeth. Also, during kissing i playfully bit his bottom lip. I did not notice or taste any blood at that time. Despite this, 11 days later (Feb. 13th), i started to have tingling in my fingers as well as feeling cold/chills; the cold feeling felt like it was all over, but mostly in my hands. Today i do not have tingling buti feel cold/chills constantly and starting to feel “flushed.” I have so much anxiety I’m not sure what to think, it’s constantly on my mind because I thought my activities were safe.  I am not sure if I am making something out of nothing. what is my risk of hiv transmission if I had abrasions or cuts and he as well? Do symptoms occur gradually or all at once? Does oral transmission require copious amounts of blood or the smallest drop? He is also on ART and has been for some time. The last time we discussed his status, I was told he  was undetectable. Please please help by providing any information you can! Thank you!

[Ptrk3]

Nothing in which you engaged, as described in your post, puts you even remotely at risk for potential HIV infection.  Please access this link to read, learn, and understand how the HIV is transmitted:

https://www.poz.com/basics/hiv-basics/hiv-transmission-risks

You had no risk for HIV transmission, in direct answer to your question.

We do not assess symptoms on this forum as indicators or HIV infection, since symptoms, if they occur at all, vary widely, but since you had no risk, it is fair to conclude that your symptoms have nothing whatsoever to do with the HIV (at least from the activities you have described).

If you are ill, see a healthcare provide for appropriate evaluation and treatment, if indicated.

[Joods84]

Thank you so much for your reply! I was reading on another thread and someone mentioned ‘four criteria’ regarding hiv transmission. Can you tell me what these are??

[Jim Allen]

HIV must be present, have an effective route, in sufficient amounts and it must also reach cells which are susceptible to infection.

Now this topic on kissing is really closed now as it simply is not a risk, worse than that it's a myth. Please do not come back about the kissing.

Kissing is not a risk, we know how HIV is and is not transmitted after 40 years. The mouth lacks route and the cells to infect , saliva contains no viable HIV, it's hostile towards HIV even. If you want to believe "what ifs" so theoretical but never actually happened in the real world, than if bleeding it would have to be in large quantity, pure and you would need large activity open bleeding wounds of your own.

So unless your partner was beaten to a bloody pulp before kissing and you had a knife wound or some gaping hole to the mouth you simple had no risk. Not even theoretical. If kissing was a risk in any shape or form we would know about it after 40 years and the entire population would be HIV positive it's not.

6 months ago I was at a 30th national hiv conference with leading experts and we discussed why incorrectly after 4 decades of HIV and 30+ years of advanced research , science and education 25% of people still mistakenly think kissing is a risk.  It's not and it's in part I think people misreading information or reading concerns without context.

Kissing is not how HIV is transmitted, Personally speaking its a topic that should belong to the misguided fears of the past and i am shocked generally saddened whenever it is a topic here, or in surveys

Jim

Here you can read about HIV including how it is transmitted: https://www.poz.com/basics/hiv-basics

On "myths" including kissing here are some threads to read with information. 

Common myths
https://forums.poz.com/index.php?topic=68441.0

https://forums.poz.com/index.php?topic=64850.msg (Dec 2016)
one in five Brits think the HIV virus can be transmitted by kissing

https://forums.poz.com/index.php?topic=67660.0
The knowledge gap is greater under young people under the age of 24 with 20% believing HIV is transmitted from toilet seats and 24% from kissing

Here's what you need to know in order to avoid hiv infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions.

Keep in mind that some sexual practices which may be described as ‘safe’ in terms of HIV transmission might still pose a risk for transmission of other STI's, so please do get fully tested regularly and at least yearly for all STI's including but not limited to HIV and test more frequently if unprotected intercourse occurs

Also note that it is possible to have an STI and show no signs or symptoms and the only way of knowing is by testing.

More information on HIV Basics, PEP, TaSP and Transmission can be found through the links in my signature to our POZ pages, this includes information on HIV Testing

Kind regards

Jim

Please Note.
As a member of the AM I Infected Forum you are required to only post in this one thread no matter how long between visits or the subject matter. You can find this thread by going to your profile and selecting show own post and it will take you here . It helps us to help you when you keep all your thoughts or questions in one thread and it helps other readers to follow the discussion. Any additional threads will be deleted.

Anyone who continues to post excessively, questioning a conclusive negative result or no-risk situation, will be subject to a four week Time Out (a temporary ban from the Forums). If you continue to post excessively after one Time Out, you may be given a second Time Out which will last eight weeks. There is no third Time Out - it is a permanent ban. The purpose of a Time Out is to encourage you to seek the face-to-face help we cannot provide on this forum.
http://forums.poz.com/index.php?topic=220.0

[Joods84]

I appreciate your detailed response! Very informative! Thank you 

[Jim Allen]

You're welcome

[Joods84]

Hi there again. I am back with a couple concerns. Maybe I am not understanding the high vs. low risks of HIV transmission. Or maybe it’s possible that I’m just paranoid. Anyway, I am hoping you can help me to determine if HIV testing is warranted in any of these cases. Last week I engaged in giving in a ‘hand job.’  No oral, just hands only. He ejaculated on my hands and I was wondering if I had any small open cuts or sores that I could possibly contract  the virus this way? Also, he did insert his fingers into my vagina while in the tub. is there any possibility that if he had cuts that it would infect me? We also kissed a lot, which I know it’s really a concern. I’m just a little worried, especially regarding the semen on my hands part.

Additional questions:
1. Can HIV live on inanimate objects (ie sheets, towels, etc) and still spread the virus?
2. I’ve read here in several places that an undetectable status means untransmittable. Is this theoretical? Meaning if you use protection? I’ve read a few cases where an undetectable status resulted in passing on of the infection?

[Jim Allen]

The encounter was not a HIV risk. 

Nobody has ever been infected through fingering despite day to day cuts, bumps or boo boo's. Same can be said about giving a handjob and contact with fluids, its not a route and its exposed to the environment.

We also kissed a lot, which I know it’s really a concern

We have been over this before, its not a HIV concern. Please don't bring up kissing again. If you keep having such fears than you should consider talking to a therapist to help you cope with your thoughts.

To answer your questions:

1.
No. HIV transmission is always a biological event and this lacks all the conditions required.

2.

Why the questions on U-U?

I’ve read here in several places that an undetectable status means untransmittable. Is this theoretical? Meaning if you use protection?

By protection i presume you mean a condom.

No, U=U means that people living with HIV who are taking their treatment can suppress the virus so that even during condomless intercourse they can not pass on the virus. 

I’ve read a few cases where an undetectable status resulted in passing on of the infection?

Either you have misread or you have been reading dated shit. Look you are entitled to your doubts & fears but not your own facts. We are all here to support, however let me be clear on this point for you and other members who may have similar doubts reading this thread.

To start with the lowest ever recorded threshold of sexual transmission occurred in the early 2000 at a suspected viral load of 362 copies/ml, the key point was the individual was not on ART above 200 copies/ml in blood and the VL (viral load) in other uncontrolled transmissible fluids could have been even higher. (1)

Its simple there is nearly 22+ years of evidence on TaSP (Treatment as prevention) both through observational data and controlled studies, that consistently has proven its effectiveness confirming the Swiss statement and later the refined consensus statement, although the news/media act as if its something new.

There have been 0 sexual transmission recorded when someone living with HIV was and remained adherent to treatment for 6+ months and virally suppressed defined as lower than 200 copies . There have been transmission when people did not meet that statement/criteria . (2)

Hence based on records & studies at the time the Swiss statement was made  more than a decade ago (3) and, since then more large scale studies continued to confirm this and allowed the refinement of the statement leading to empowering the U=U movement & supported consensus statement today.

A person living with HIV (PLHIV), who is on Antiretroviral Therapy (ART) and has achieved an undetectable viral load in their blood for at least 6 months, can not sexually transmit HIV.

This is also known as Undetectable = Untransmittable (U=U)

There is plenty of information on U=U through this sticky topic. https://forums.poz.com/index.php?topic=71864.0 . Overall the U=U message has been endorsed by over 850 organizations from nearly 100 countries

Best, Jim.


(1)
Castilla J et al. Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV. J Acquir Immune Defic Syndr 40: 96-101, 2005

(2)
http://i-base.info/htb/32308

(3)
Vernazza P et al. Bulletin des médecins suisses 89 (5), 30 January 2008

[Joods84]

Jim, thanks for the response.However, please don’t mistake my not being educated on this topic as ignorance. By no means am I here to refute any information provided. I just want to understand. I thought this was supposed to be a platform for me to voice my questions and concerns. In any case, thanks for your time.

[Jim Allen]

Hiya,

We covered the kissing and its a closed topic. You had questions and they had been answered. Asking or expressing repeatedly the same concerns is simply excessive posting. Its just a risk assessment service.

Regarding the rest of your assessment, about U=U etc, as said you are entitled to your doubts & fears but not your own facts. I've provided the information on this but still don't know why its a concern or question though?

Jim

[Joods84]

There’s no question/concern regarding the U=U. I have received the references and appreciate them. I understand this is a risk assessment service, however, your delivery is aggressive. Never once did I use profanity towards you. You shouldn’t make someone feel small for things you know and they don’t. Again, thank you for your time and resources. Thanks you for alleviating some fears. I will be sure educate myself on what you provided.

[Jim Allen]

You're welcome.

I see you want to be a tad more personal fine, but i get the last word 

You have to understand the issue I have with you is not about what you don't know. I have no issue educating people I do it here, and face to face. I have lived long enough with this virus that I have heard just about everything and I don't judge.

In risk assessment I asses the facts not the feeling or fears you have, but my issue with you and what i have explained to you is that your fears, does not mean we will accept you coming onto a HIV community platform and lying and/or making up facts about HIV.  Its harmful to the community, and requires a swift and definitive reply and so I called you out on this.

You might find that aggressive or not like it, well tough. As mentioned I personally find your claims & conduct harmful to the wider community, that is my bigger concern.

Either you have misread or you have been reading dated shit. Look you are entitled to your doubts & fears but not your own facts. We are all here to support, however let me be clear on this point for you and other members who may have similar doubts reading this thread.

Now this is a risk assessment service and I have provided you a risk assessment including additional information on U=U.  You keep coming back with the same and I have given you additional space as I understand that its fear driving your postings, however this topic really is closed now.

Any additional postings on questions already answered will result in a ban from the forum.

I really do wish you well because having fears in life is not fun at all, however if you keep having irrational fears than you should consider speaking to someone face to face, it can't be easy living with fears but its simply outside of my scope to assist you in learning how to cope with that.

Best. Jim

Anyone who continues to post excessively, questioning a conclusive negative result or no-risk situation, will be subject to a four week Time Out (a temporary ban from the Forums). If you continue to post excessively after one Time Out, you may be given a second Time Out which will last eight weeks. There is no third Time Out - it is a permanent ban. The purpose of a Time Out is to encourage you to seek the face-to-face help we cannot provide on this forum.
http://forums.poz.com/index.php?topic=220.0