Wet Petting is risk free?

[sunny]

Hi, I'm Sunny,

and before asking anything, I would like to thank everyone here for helping so many people in distress and thereby creating such a wealth of information! Unfortunately, I cannot access the lessons, the links don't seem to work in Internet Explorer 7.

My question is twofold. One part concerns a possible exposure I had last Friday, the other one is more generally HIV transmission related.

As for the personal part: I am a 30yo sexually inexperienced male, who's been through a HIV scare before (a couple of years ago, I also had a thread in the old forum). I have since accepted that I do have (some sort of) OCD, and that acceptance in itself has made it easier for me to deal with a couple of things, including my HIV fear, which, I now suspect, is to a significant extent responsible for my unfortunate state of sexual inexperience. I am also biting my nails, sometimes to the extent of having small lesions/abrasions at the side of the nail bed.

Having said that, last Friday I decided it was time to at least look at nude female beauty and went to a strip club. But after a while one of the ladies asked if I wanted a private show and I said yes. A couple of minutes later, she offered that I could masturbate myself and she could do the same to her for a couple of Euros.

So far everything was great as no physical contact with any supposedly dangerous fluids or bodyparts had occured. But when I handed her the 20€ bill she touched a finger with a nail-skin biting lesion with the same hand she had used to touch herself just before - there was no bleeding, but the abrasion was rather fresh and thus likely still somehow "open" through wound-fluids. So if vaginal fluids were present, they were also very likely on my finger, and thus possibly, as I masturbated myself with that hand, on my penis (and thus near receptor cells).

If at all present, there wasn't a large quantity - I did not notice any fluids on my finger at the time. And I suppopse it is fair to assume her excitement was not as intense as mine. But I still panicked for a bit after the incident - although I managed to reassure me thereafter that this is likely a "no risk, no testing needed" situation - reading through the archives helped a lot .

Is this correct? Or do you see any risk for HIV transmission in this incident?

As far as the more general part of the question is concerned - I am confused by the differences regarding the "safe sex recommendation" given in the "am I infected" Forum and most (actually: all) other sources I could find on the web, including European and American clinical insitutions as well as HIV prevention foundations and other self-help communities.

If I am reading the "safe sex recommendations" in the forums correctly, it seems to be "There is no risk (and thus no testing needed over a specific contact) for anything sexual that does not involve unprotected anal or vaginal penetration, but get tested once a year anyway".

This is significantly different from the information on actually all other sites I looked at. They are still recommending testing for what they call "low risk activities", including cunnilingus (as opposed to your statements, for example, here: http://forums.poz.com/index.php?topic=7851.0). With respect to mutual masturbation, there seems to be less agreement, but all pages include statements about the infectiousness of vaginal fluids and pre-cum.

I've never read elsewhere that there's a difference between the vaginal lubricant and the fluids protecting the cervix that are obviously closer to the urethra during penetration, but I've read a study conducted among the SF gay community allegedly suggesting that oral infections are more common than normally assumed because they're statistically masked by more risky behavior. Menstrual blood seems also of a much higher concern, and most other pages also mention a very theoretical risk of deep kissing with a single reported case of "bleeding gum to bleeding gum" infection.

So how am I to make sense of such a discrepancy, assuming that you're reading the same medical information? I doubt anyone's lying. So how is this possible? Have there been advances in the statistical and/or microbiological understanding of HIV transmission that you are faster to incorporate into advice than other sites?

Also, if no testing is required in all cases of protected insertive as well as all cases of non-penetrative sex, why do you still recommend an annual HIV test for all sexually active people? I'm assuming the equation "X times zero equals zero" doesn't apply in practice - but why?

I'm truly grateful for your help!

Thanks, Sunny

[RapidRod]

First thing fix you IE7, there is nothing wrong with the links that IE7 won't open. You didn't have a risk in the situation you described. As for why the testing yearly? The CDC suggest that everyone get tested and those sexually active should be tested yearly.

[sunny]

Wow that was truly Rapid, Rod! Thanks a lot for reassuring me about my estimation of the incident!

As for the "yearly testing" question - if you're recommending this because the CDC suggests it, why are your (this site's) recommendations differing from the CDC in other areas (as I recall it)?

And I will look into my IE7... strange that.

Thanks again!

Sunny

[RapidRod]

The testing procedure is a National push for early testing that was just enacted. We support that eveyone should be tested that wants to be test no matter why they are seen in a health setting. As for you other question do you mind explaining it.

[Ann]

sunny,

One BIG difference between other sites and this site is we do not have a moral agenda to push. We only concern ourselves with the science of hiv - not the myths and not the scare tactics.

The science of hiv dictates that you absolutely did NOT have a risk of infection when you touched the strippers finger. No way. Hiv is very fragile and once it finds itself outside the human body, it quickly becomes damaged and unable to infect.

Ann

[sunny]

OK, so I kept reading the archives - and tried to access the lessons session with three (sic!) different browsers and I could not, believe me, open the any of the links on the main transmission lessons page (http://www.aidsmeds.com/lessons/Transmission1.htm).

Here's the explanation I think you were looking for, rapidrod: First off, some quotes from the CDC -

CDC - Bodily fluids transmitting HIV - Blood, semen, vaginal fluid, breast milk, other body fluids containing blood. HIV has been found in the saliva and tears of some persons living with HIV, but in very low quantities. (Source: http://www.cdc.gov/hiv/resources/qa/qa37.htm)

   

CDC - How is HIV passed from one person to another? - HIV transmission can occur when blood, semen (cum), pre-seminal fluid (pre-cum), vaginal fluid, or breast milk from an infected person enters the body of an uninfected person. HIV can enter the body through a vein (e.g., injection drug use), the lining of the anus or rectum, the lining of the vagina and/or cervix, the opening to the penis, the mouth, other mucous membranes (e.g., eyes or inside of the nose), or cuts and sores. Intact, healthy skin is an excellent barrier against HIV and other viruses and bacteria. (Source: http://www.cdc.gov/hiv/resources/qa/qa16.htm)

Because of this possible risk, the CDC recommends against open-mouth kissing with an infected partner.

CDC - Can I get HIV from oral sex? Yes, it is possible for either partner to become infected with HIV through performing or receiving oral sex. There have been a few cases of HIV transmission from performing oral sex on a person infected with HIV. While no one knows exactly what the degree of risk is, evidence suggests that the risk is less than that of unprotected anal or vaginal sex. (Source: http://www.cdc.gov/hiv/resources/qa/qa19.htm)

CDC - Should I get tested? -The following ... behaviors ... If you answer yes to any of them, you should definitely get an HIV test. If you continue with any of these behaviors, you should be tested every year. ... Have you had unprotected vaginal, anal, or oral sex with men who have sex with men, multiple partners, or anonymous partners? Have you exchanged sex for drugs or money? Have you had unprotected sex with someone who could answer yes to any of the above questions? (Source: http://www.cdc.gov/hiv/topics/testing/resources/qa/be_tested.htm)

As became apparent to me from reading through the archives, your advice quite significantly differs from that on the CDC's website - which I presume is the recommended medical practice in the US. Some illustrative examples:

Ann: All of the studies I've read only talk about the cervico-vaginal fluids being infectious. This is the protective mucus film covering the cervix. The fluid that comes from the vaginal glands aren't really much different than tears or sweat and while these fluids can contain hiv in small quantities, they are by no means infectious. I can't link you to the studies I read because they are on a subscription only NHS (UK medical system) website. The anti-viral properties of saliva also play a very big part.

Fingering is not a risk for hiv infection, regardless of cuts or bitten fingernails. Not one person has ever become infected this way and you will not be the first. (Source: http://forums.poz.com/index.php?topic=8815.0)

Neither getting a blowjob nor fingering are risks for hiv infection. (Source: http://forums.poz.com/index.php?topic=8815.0)

Getting a blowjob is absolutely NOT a risk for hiv infection and it doesn't matter if it was a rough blowjob or that you are uncircumcised. Not one person has ever become infected while getting blown and you will not be the first.  (Source: http://forums.poz.com/index.php?topic=2062.0)

Ann: Going down on a woman is not a risk for hiv infection. It's a combination of the protective properties of saliva and the fact that it's the fluids that are found deep within the vagina, on the cervix, that are infectious, not the lubricating fluids that originate in two glands on either side of the vaginal opening. It is very difficult to become infected with hiv through the mouth. Even taking the ejaculate of an hiv positive man into your mouth is unlikely to result in infection. (Source: http://forums.poz.com/index.php?topic=7851.0)

Andy velez : Is cunnilingus a risk for HIV transmission? Yes, but only theoretically. There have yet to be documented cases in this manner. Given what a common act it is sexually, we would have known long before today if it was more than a theoretical risk. Not only does the giver's saliva create a barrier to HIV transmission, the female fluid most likely to carry HIV, (IF the woman is HIV positive), is in the cervical area. You'd need a very unusually long tongue to penetrate to the cervix to even create a possible risk. (Source: http://forums.poz.com/index.php?topic=7851.0)

Andy Velez: this is one of those incidents which is risky only in theory in the sense that anytime you have sex other than by yourself  there is some risk "theoretically." However, in the real world and despite all kinds of nicks, cuts, abrasions, sores and other bodily issues, there's never been a case of transmission via fingering and you are not about to make history by becoming the first. Getting a blowjob is nil for risk. Whether you ejaculated or not is irrelevant as far as you are concerned although it presents a very low level risk for the person sucking you. So bottom line in all of this is there's no need for further concern on your part nor for testing. Get on with your life. (Source: http://forums.poz.com/index.php?topic=4476.0)

A particularly enlightening exchange -

I ended up having an encounter with a prostitute in Germany (reasonably upscale establishment) where the following happened:
- unprotected oral on me (15 seconds maybe)
- lots of licking/sucking (her nipples, and skin all over, she on my  skin)
- I rubbed her vagina (did not penetrate) with my finger and licked that finger for lubrication twice
I am sorry, I forgot to add that I also had protected vaginal intercourse. But since the condom stayed intact I didn't worry about that...

RapidRod : You didn't have a small risk. You had NO RISK.

NO need for further testing. Just move on (resume sex with my wife most importantly) right??

RapidRod : Yes, move on, have sex with your wife.

jkinatl2 : HIV requires contact with very specific CD4 cells in order to infect. These exist in the urethra on a male.

I never knew that. so it's only at the tip/opening of the penis? So basically I could have a fresh cut on my skin that slightly bleeds- rub HIV vaginal fluid on it and be ok?[/i]

Anm : Yes, that's absolutely correct. Successful hiv transmission occurs INSIDE the human body as in unprotected anal or vaginal intercourse. As Jonathan pointed out, hiv needs to bump into (it cannot move and therefore cannot seek out) specific cells such as the ones found in the lining of the urethra.
Hiv is a very fragile virus as well. It has "plugs" that must find specific receptors on specific cells. The membrane of the virus as well as the plugs quickly become damaged when outside the human body through even minute changes in temperature, pH levels and moisture levels.

And some attempted explanations -

1. There is a difference between "reported" cases and "documented" cases. In a documented case, the mode of transmission has been proven. In the cases you talk about, there were other factors in each one that came to light afterwards that discounted the claims of the patient to be infected through cunnilingus.
2. The whole menstrual blood thing is theoretical. Menstrual blood isn't quite the same as fresh blood from a cut. You would be very unlikely to be infected this way.
3. There aren't all that many cases of transmission from giving a blowjob that have been proven. There may be many reported cases, but often times people will not or cannot (because of memory loss due to drink/drugs intake) admit to more risky behaviours. In the cases where it has been proven beyond a shadow of a doubt, there are usually mitigating factors such as terrible oral health.

There have been long-term studies of couples where one is positive and one is negative. 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. This shows us two things. One, condoms are very effective for the prevention of hiv transmission. Two, oral sex (giving a blowjob) is much lower risk than previously believed. We now have the evidence that oral sex is a very, VERY low risk activity where hiv transmission is concerned. (Source: http://forums.poz.com/index.php?topic=7851.0)

I personally disagree with the LESSONS section regarding theoretical risks such as insertive oral. I tend to trust first tier peer-reviewed quantifiable scientific data, and I believe it was an unfortunate concession to the CDC and perhaps even POZ.com that caused insertive oral to be listed as even a theoretical risk.

The three serodiscordant studies are extraordinarily compelling, and I am far more inclined to trust that quantifiable data than any unquantified theories or the notoriously unreliable patient self-report.

I am not at all a fan of theoretical risk. I find it to be a way of saying "there is no data to support this conclusion" without admitting such. It is speculation, and has no place in hard science. At 25 years into the pandemic, the vectors of HIV transmission have seriously narrowed, and the science has grown from the anecdotal to the quantifiable.

My HIV risk assessment is based on tangible data. However, intangible data is still used to a degree in many HIV sites. This site seems to rely on it the least, which is why I am here.

I am confident that as more data materializes, the LESSONS section will reflect this. We are, after all, a dynamic site and not a static one.

You do not get HIV from insertive oral. I am sorry that this site did not sufficiently allay that unfounded fear. Saliva is not infectious. Other STDs? Yes. HIV? No.

(Source: http://forums.poz.com/index.php?topic=458.0)

I collected more. But I think this selection already demonstrates clearly that you are - how to put this - more likely to say "no risk" than, say, the CDC, despite looking at the same data. If I am reading the above quote about "mitigating" factors in the cases of oral infection correctly, that's just another way of saying that it can happen, but only if you're someone who's having oral sex with a partner who's gums are bleeding visibly.

On the other hand, even this Australian site mentioned in one of the threads that states that dental dams aren't needed for Cunnilingus states a couple of lines below that fellatio does carry a small risk even for the insertive partner, as opposed to your statements above (http://www.afao.org.au/view_articles.asp?pxs=84&pxa=ve&id=413&pxc=sec_clo)

However, it's not that another different interpretation is going to help assumed worried wells like me - neither after nor before a possible sexual encounter. I'd truly like to believe that you're the only ones reading the data correctly, or, possibly the only ones saying what other should be saying but aren't based on institutional concerns - but then, even if the institutional policy bias seems to be evident in some of the CDC's statements quoted above - what difference would it make for the virus if sex has been given freely or in exchange for money or whatever - this argument would probably not hold for all official disease control agencies around the world - is there any evidence of differences between them regarding the current state of affairs in "safe sex"?

If it is indeed true, as quoted above, that "[a]t 25 years into the pandemic, the vectors of HIV transmission have seriously narrowed, and the science has grown from the anecdotal to the quantifiable" how can differences persist?

As a sexually inexperienced person scared of HIV I want to know... I need to know, if my interpretation of your stance, that everything excluding unprotected penetration is riskfree in the real world, is right. Strangely, I can accept the one case of blood-to-blood infection through deep kissing. One in 3 billion women, that's apparently fine with me. But the rest - the "rubbing her vaginal juices into a fresh cut on my index finger is risk free because infection only occurs inside a body"-part? I have read some  encouraging results of sero-discordant couple studies. But also some that suggest that statistical masking may cut in both directions with respect to oral infections - people may lie about having had more risky encouters, sure. But maybe the infection did not take place during the more risky encounter but is still attributed to it thus statistically lowering the former's infectiousness and increasing the latters (which, in turn, will even increase the probability of said attribution in the next round of counting).

This is all very confusing... hope you can help. Thanks a lot!

Sunny

PS - one more thing: Regarding some official HIV statistics I looked at - male sex workers may be covered by the men-who-have-sex-with-men high-risk categroy, but there is no category for female sex workers (who aren't included in other groups, such as origin in high prevalence countries). Thus, I am wondering if female sex work as such can not be classified as a high risk behavior since infection and prevalence among those pursuing this activity aren't statistically different from the rest of the population. Then, on the other hand, given the assumed higher frequency of sexual contacts and regular HIV testing of sex workers compared to the general public, wouldn't this actually indicate that, statistically, the per act risk of unsafe sex with an unknown female sex worker is statistically safer than the per act risk of unsafe sex with an unknown non sex-working woman?

[sunny]

OOPS. No idea how this ended up as a new thread... I pressed reply in my "confused" thread... Sorry for that.

[RapidRod]

What a waste of time. Keep all your thoughts and questions in your orginal thread. Seems like your OCD has the best of you and this is NOT an OCD website. You were never at risk.

[RapidRod]

http://www.dph.sf.ca.us/sfcityclinic/drk/stdprevention16.asp

VAGINAL FLUIDS DURING HAND JOB
QUESTION
I am petrified over a possible exposure to an STD. I stupidly went to a massage parlor and got a hand job from a woman who used lotion from a bottle. I don't know if she touched herself during the act, as at some point, I took over masturbating. She gave me a second hand job later. I'm worried she may have had her own vaginal fluids on her hand at this point. Am I at risk?

ANSWER
You can stop worrying -- what you described poses very little risk. Just so you know, kissing, masturbation, mutual masturbation, and frottage (dry humping) are considered safer sex activities with very little to no risk of HIV transmission. Rarely, STDs like the virus that causes warts can be transmitted from genitals-to-hands-to-genitals, but most STDs and HIV are not transmitted this way. For more information on what sexual activities can put you at risk for which STDs, click here.

To your health,
Dr. K

Now I do believe we give the same information as others, including doctors.

[Andy Velez]

Sunny, are you just trying to score points here or do you have a specific question you would like to ask?

Keep it simple, please.

[Ann]

Sunny,

I've merged your new thread into your original thread - where you should post all your additional thoughts or questions. It helps us to help you when you keep all your additional thoughts or questions in one thread.

If you need help finding your thread when you come here, click on the "Show own posts" link under your name in the left-hand column of any forum page.

Please also read through the Welcome Thread so you can familiarize yourself with our Forum Posting Guidelines. Thank you for your cooperation.

There is NO WAY you would have become infected through the incident you describe in your first post. You have already been told that. Copy and paste all you want, our answer isn't going to change.

Ann

[sunny]

Ann, thanks for merging the thread - I did not intend to start another thread, actually, as I said I clicked the reply button in the "confused" thread.

Ann, Andy, RapidRod,

thanks a lot for your replies -

Sunny,

... There is NO WAY you would have become infected through the incident you describe in your first post. You have already been told that. Copy and paste all you want, our answer isn't going to change.

Ann

I do understand that. I cannot say that I'm no longer thinking about the incident, but I am no longer overly concerned about it. Thank you very much for your help with respect to my personal problem.

What a waste of time. Keep all your thoughts and questions in your orginal thread. Seems like your OCD has the best of you and this is NOT an OCD website. You were never at risk.

It may be a waste of time to anyone else, but it wasn't to me. I know that OCD is much more of a problem for me than HIV. In fact, knowing this is already helping. As far as the posts on this site are concerned, my question as well as that of many other worried wells seem to indicate to me that, while you are not an OCD website, you are indirectly dealing with OCD to a non-trivial degree. I was hoping that my asking a more general question would help clarify things for other people with OCD as well - they will also browse the archives and collect and compare snippets of your wisdom.

Sunny, are you just trying to score points here or do you have a specific question you would like to ask?

I have indeed. But, as you may have guessed already, I'm also writing to clarify things for myself.

You know, dealing with risk in a rational manner is something rather difficult for those of us who are experiencing fear, in general, but particularly with respect to HIV. In this state of mind reading "no risk" is significantly different from reading "in the real world, this doesn't happen", or, far worse, fom "little to no risk." I suppose that all three statements are referring to the same statistical reality - some people giving advice may be slower than others when it comes to updating their advice (a recent study among doctors in Europe indicated that it takes serveral years for new scientific results to trickle down to every general practitioner - this wasn't HIV related, but still) or they may have institutional or political reasons to do so. But how are scared worried wells like me supposed to know? If we're lucky, we get your advice - say, no risk - we feel better until we find another site that says "very little to no risk", like in the page RapidRod quoted above. Then the "what if" thing starts...

I guess what I am looking for is an explanation for the tiny differences in emphasis. You know, to avoid to mentally fall in between the cracks of "the truth, the whole truth, and nothing but the truth" and finally be able to get a (sex) life without being afraid and actually enjoy doing more than kissing. That's why Ann's statement about rubbing HIV+ vaginal juices onto a fresh cut would be a "NO risk" activity was like a ray of light - as it, while no one would actually do it, illustrates the difficulty of transmitting the HIV in a very drastic and compresenhible way. Now, if other people's "little to no risk" would in this situation refer to mitigating theoretical circumstances such as the possibilty getting infected after literally washing his hands in extensive amounts of HIV+ vaginal juices for a couple of hours, then I (and other worried wells) would understand where the difference comes from and thus benefit much more from your truly amazing effort to help us.

Thanks again!

Sunny

[RapidRod]

Then you need to know the definition of Theoretical vers. Documented.

[sunny]

RapidRod,

that may well be so. I was hoping you and the other experts might be able to enlighten me and other worried wells about these differences (if only with a link or so).

Yesterday, I read of a 1/20,000 per act risk for insertive oral (fellatio) on thebody.com (safer sex forum). Low(est) risk? No risk at all because even 1/20,000 is a statistical extrapolation based on an a theoretical risk, not a real one? Could the margin of error in that number be high (people not telling the trueth about riskier incidents, or rinfections being falsely attributed to riskier incidents simply because they're riskier).  How did that number come about? How do such numbers in general come about? What per act numbers constitute  "no", "theorietical", "extremely low", "minimal", "low", or "high" risk?

Thanks,
sunny

[Ann]

Sunny,

If you'd bothered to read the Transmission Lesson on THIS site, you'd know that the numbers which came out of the study The Body cites have been discredited. They basically pulled the numbers out of thin air.

If you cannot bring yourself to believe that you had no risk, then test and collect your negative result.

Ann

[sunny]

Ann, thanks for the quick reply!

If you'd bothered to read the Transmission Lesson on THIS site, you'd know that the numbers which came out of the study The Body cites have been discredited. They basically pulled the numbers out of thin air.

Believe me, please, that I am not able to open the lessons URLs indicated in the welcome thread.

http://www.aidsmeds.com/lessons/HIVtests1.htm
http://www.aidsmeds.com/lessons/Transmission1.htm

I don't know if other people are able to read them, I tried with IE7, IE6, and Firefox 2 and could not open the documents in any of them.

I will keep trying to read them, of course. I try to open them whenever I check this site, just in case it's a coding error that has been fixed.

If you cannot bring yourself to believe that you had no risk, then test and collect your negative result.

I do believe you, as far as my recent thumb-touching incident is concerned. My continued questioning is a result of my attempt to understand better - in general - and therefore develop a healthier relation to sex in general, which I consider crucial to my personal physical as well as psychological health.

So, if you have any information besides the lessons that you think might be able to increase my understanding in a useful way, I'd be grateful for that info.

Thanks again,
Sunny

[RapidRod]

I don't have any trouble opening up in links to anything here or elsewhere. Get your computer fixed.

[ACinKC]

Me either.  In IE 7 Try holding the control button down when you click on the link.  You may have a pop up blocker in effect.

[Ann]

Sunny,

Here is the Transmission Lesson. It took two posts to post the whole thing, so make sure you read both.

Introduction

Human immunodeficiency virus (HIV) was established to be the cause of the acquired immunodeficiency syndrome (AIDS) in 1983. Ever since then, a lot of research has been conducted and a great deal of information has been generated regarding the ways HIV can be transmitted from one person to another.

The problem with much of the information about HIV transmission, especially on the World Wide Web, is that it speaks in very general terms. All too often, there is a lot of conflicting information as well. For example, some sources refer to oral sex as "risky," whereas others say "low risk" or "no risk." This can be very frustrating and it also leads to the spread of misinformation about the transmission of HIV.

HIV infection – and HIV testing – is a medical issue. We have developed this lesson to provide straightforward and accurate information regarding HIV transmission. However, it is important to stress that this lesson – and other sources of HIV information on the World Wide Web – should not be consulted as an alternative to medical care and testing. If you fear that you have been exposed to HIV – regardless of how low the perceived risk and no matter how much information you find on the World Wide Web – you need to get in touch with your healthcare provider or an HIV testing center.

How is HIV Transmitted?

HIV enters the body through open cuts, sores, or breaks in the skin; through mucous membranes, such as those inside the anus or vagina; or through direct injection. There are several ways by which this can happen:

 Sexual contact with an infected person. This is the primary focus of this lesson and is reviewed in greater detail in the following sections.
   
 Sharing needles, syringes, or other injection equipment with someone who is infected.
   
 Mother-to-child transmission. Babies born to HIV-positive women can be infected with the virus before or during birth, or through breastfeeding after birth. More information about HIV and pregnancy can be found in this lesson.
   
 Transmission in healthcare settings. Healthcare professionals have been infected with HIV in the workplace, usually after being stuck with needles or sharp objects containing HIV-infected blood. As for HIV-positive healthcare providers infecting their patients, there have only been six documented cases, all involving the same HIV-positive dentist in the 1980s.
 
 Transmission via donated blood or blood clotting factors. However, this is now very rare in countries where blood is screened for HIV antibodies, including in the United States.

Since the beginning of the HIV/AIDS epidemic, new or potentially unknown routes of transmission have been thoroughly investigated by state and local health departments, in collaboration with the U.S. Centers for Disease Control and Prevention (CDC). To date, no additional routes of transmission have been recorded, despite a national system designed to detect unusual cases.

Sexual Transmission of HIV

In the United States, sexual contact is the most common route of HIV transmission. As of December 2004, 44% of AIDS cases reported to the CDC were among men who contracted HIV through sex with other men (MSM). The term MSM is important – and used quite a bit in this lesson – because many men who have sex with men do not necessarily identify themselves as "gay" or even "bisexual." HIV transmitted through sexual activity among heterosexuals accounted for 13% of all AIDS cases reported to the CDC, with most of these cases among women infected by men. Only a small percentage (less than 5%) of AIDS cases in the United States involves men who were infected with HIV through sexual activity with HIV-positive women.

Heterosexual intercourse is the most common mode of HIV transmission in poor countries. In Africa slightly more than 80% of infections are acquired heterosexually, while mother-to-child transmission and transfusions of contaminated blood account for the remaining infections. In Latin America, most infections are acquired through MSM and through misuse of injected drugs, but heterosexual transmission is rising. Heterosexual contact and injection of drugs are the main modes of HIV transmission in South and South East Asia.

The reason why sexual activity is a risk for HIV transmission is because it allows for the exchange of body fluids. Researchers have consistently found that HIV can be transmitted via blood, semen, and vaginal secretions. It is also true that HIV has been detected in saliva, tears, and urine. However, HIV in these fluids is only found in extremely low concentrations. What's more, there hasn't been a single case of HIV transmission through these fluids reported to the CDC.

Specific Sexual Practices: What are the Risks?

Studies have repeatedly demonstrated that certain sexual practices are associated with a higher risk of HIV transmission than others.

Vaginal Intercourse:

Unprotected vaginal intercourse is the most common mode of HIV infection worldwide. In the United States and many other developed nations, it is the second most common mode of sexual HIV transmission (after anal intercourse among MSM).

At least five European and American studies have consistently demonstrated that male-to-female HIV transmission during vaginal intercourse is significantly more likely than female-to-male HIV transmission. In other words, HIV-positive men are much more likely to transmit the virus to HIV-negative women through vaginal intercourse than HIV-positive women are to HIV-negative men.

There are a few reasons for this. First, there are more men than women in the United States infected with HIV, meaning that it's much more likely for a female to have sex with an HIV-positive male than for a male to have sex with an HIV-positive female. Second, women have a much larger surface area of mucosal tissue – the lining of the vagina and cervix that can chafe easily and are rich in immune system cells that can be infected by HIV – than men. For men, HIV must enter through a cut or abrasion on the penis, through the lining of the urethra inside the penis.

There has been some research suggesting that men who are uncircumcised have a higher risk of becoming infected with HIV or transmitting the virus if they are already HIV positive. However, it is important to stress that men who are circumcised can still be infected (or transmit the virus) if condoms are not used for vaginal sex.

Men or women who have ulcerative sexually transmitted infections (STIs), such as genital herpes or syphilis, are more likely to spread the virus if they are HIV positive or to become infected with the virus if they are HIV negative.

Anal Intercourse:

Being the receptive partner – the "bottom" – during unprotected anal intercourse is linked to a high risk of HIV infection. The reason for this is that HIV-infected semen can come into contact with mucosal tissues in the anus that can be damaged easily during anal intercourse. And the risk of HIV transmission isn't necessarily reduced if the "top" pulls out before ejaculation – studies have demonstrated that pre-ejaculate (pre-cum) can contain high amounts of HIV and can result in transmission during anal intercourse.

It's important to note that both MSM and heterosexuals have anal intercourse. Many heterosexuals report that it is a pleasurable form of intimacy that eliminates the risk of pregnancy. However, it is still associated with a high risk of HIV infection, if condoms are not used and the insertive partner's HIV status is either positive or not known.

Is the insertive partner (the "top") also at risk during unprotected anal intercourse? At least eight studies conducted over the years were unable to demonstrate a clear link between insertive anal sex and a risk for HIV infection among MSM. However, these studies should not be interpreted to mean that being the top during anal intercourse – and not using a condom – is without risk. We know that men can be infected with HIV through vaginal intercourse – an activity in which they are the insertive partner. Based on this knowledge, it is also believed that the insertive partner during unprotected anal intercourse can also be infected with HIV. Studies, using mathematical estimates, suggest that unprotected insertive anal sex is roughly four to 14 times less risky than unprotected receptive anal sex. However, experts still believe that the risk for transmission is noteworthy.

Penile-Oral Sex

Of the different sex acts, the one that often causes the greatest amount of confusion in terms of risk – and raises the greatest number of questions – is penile-oral sex. The fact is, most experts agree that fellatio, sometimes referred to as "blow jobs," is not an efficient route of HIV transmission. However, this does not mean that it cannot happen.

Research attempting to evaluate the risk of fellatio has often faced important limitations. For starters, very few people participating in studies only engaged in penile-oral sex. Many people also had unprotected vaginal or anal intercourse, making it very difficult to determine if unprotected fellatio is an "independent factor" associated with HIV transmission. There are also people who test positive for HIV and claim that unprotected fellatio was their only risky behavior. However, it's virtually impossible to know if these people are always reporting their sexual behavior accurately. (Study volunteers often have a difficult time admitting the truth about potentially embarrassing behavior to healthcare professionals conducting scientific studies.)

Because unprotected fellatio can mean that body fluids from one person can (and do) come into contact with the mucosal tissues or open cuts, sores, or breaks in the skin of another person, there is a "theoretical risk" of HIV transmission. "Theoretical risk" means that passing an infection from one person to another is considered possible, even though there haven't been any (or only a few) documented cases. This term can be used to differentiate from documented risks. Having unprotected receptive anal or vaginal intercourse with an HIV-positive partner is a documented risk, as they have been shown in numerous studies to be an independent risk factor for HIV infection. Having unprotected oral sex is a theoretical risk, as it is considered possible, but has never been shown to be an independent risk factor for HIV infection.

Here's a good way to think about theoretical risk: In theory, it is possible that while walking down the street, a meteor will fall on your head and kill you instantly. This is because meteors do occasionally fall to earth. People live their lives above ground, so there is a theoretical risk of being hit be a meteor. In fact, there have been reports of a few people being hit by meteors. But because the risk is so small, given that few meteors fall to earth and the large number of inhabitants of this planet, the risk is purely theoretical. The same principle holds true with oral sex – millions of people all over the world are believed to engage in unprotected oral sex and there have only been a handful of documented cases of HIV transmission. In turn, fellatio, and other types of oral sex (see below), remains a theoretical risk for HIV infection.

There have been a number of studies that have closely followed MSM and heterosexual couples, in which one partner was HIV positive and the other partner was HIV negative. In all of the studies, couples that used condoms consistently and correctly during every experience of vaginal or anal sex – but didn't use condoms during oral sex – did not see HIV spread from the HIV positive partner to the HIV negative partner.

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. There haven't been any case reports or studies documenting HIV infection among female receptive partners during unprotected oral sex. Even more importantly, there hasn't been a single documented case of HIV transmission to an insertive partner (the person being "sucked") during unprotected oral sex, either among MSM or heterosexuals.

Is insertive oral sex a possible route of HIV transmission? Yes. But is it a documented risk? Absolutely not.

Continued next post

[Ann]

Continuation of Transmission Lesson:

Oral-Vaginal Sex

Like the study of fellatio, evaluating the risk of unprotected oral-vaginal sex (cunnilingus) is difficult, given that most people surveyed in studies did not avoid other types of unsafe sexual activity. However, there have been case reports highlighting one case of female-to-female transmission of HIV via cunnilingus and another case of female-to-male transmission of HIV via cunnilingus. Both of these cases involved transmission from receptive partner (the one receiving oral sex) to the insertive partner (the one performing oral sex). There haven't been any documented cases of HIV transmission from the insertive partner to the receptive partner.

Oral-Anal Sex

Oral-anal sex is often referred to as analingus. Analingus, or "rimming," is not considered to be an independent risk factor for HIV. However, it has been shown to be a route of transmission for hepatitis A and B, as well as parasitic infections like giardiasis and amebiasis.

Digital-Anal or Digital-Vaginal Sex

Digital-anal or digital-vaginal sex is the clinical term for "fingering" either the anus or the female genitals (including the vagina). While it is theoretically possible that someone who has an open cut or fresh abrasion on his or her finger or hand can be infected with HIV if coming into contact with blood in the anus or vagina or vaginal secretions, there has never been a documented case of HIV transmission via fingering.

What about the "per-act risk" numbers?

Epidemiologists – scientists who study the transmission and control of epidemic diseases – are fond of using mathematical models to calculate the risks of certain infections spreading (like HIV) from person to person. These calculations are usually written as the "per-act" or "per-contact" risk. For example, one study conducted by the CDC – and frequently cited by many sources of HIV transmission information – suggested that a person has a 1 in 200 chance of becoming infected with HIV if he is the receptive partner during unprotected anal intercourse with someone known to be HIV positive. On the other end of the spectrum is the risk calculated for insertive oral sex: 1 in 20,000 if condoms are not used and the receptive partner is known to be HIV positive.

Making personal decisions about unprotected sexual activity using these numbers is not recommended. For starters, these numbers are based on assumptions and guesses, not actual evidence of HIV transmission. Second, even if the researchers are right – that there is a 1 in 20,000 chance of being infected with HIV via unprotected insertive oral sex with someone known to be positive – many experts argue that this number is close enough to zero as to not be concerned about it at all.

Just as these numbers can unnecessarily scare people, they can also give some people a false sense of security. For example, the 1 in 200 risk associated with receptive anal sex with someone known to be HIV positive doesn't mean that you can have unprotected anal sex 199 times before becoming infected. It's very possible to become infected with HIV after just one incident of unprotected receptive anal intercourse.

It's also important to stress that there are a number of factors than can influence the risk of HIV transmission. Because there are so many factors, it's virtually impossible to interpret per-act or per-contact risk numbers when making personal decisions about sexual activity (or looking back on previous decisions). For example, HIV-positive people with very high viral loads (high amounts of HIV in their blood and genital secretions) may be more likely to transmit the virus to their partners, during unprotected insertive anal, vaginal, or oral sex. The presence of STDs, especially ulcerative STDs, can increase the risk of spreading (or becoming infected with) HIV. Trauma – such as abrasions or cuts inside the vagina, anus, mouth, or on the penis – can also increase the risk of transmission. All of these can increase the per-act risk of HIV transmission.

How can the sexual transmission be prevented?

Male Condoms

Several studies have demonstrated that male condoms made of either latex or polyurethane are effective barriers against HIV. The theory behind using condoms is clear: they cover the penis and provide an effective barrier to exposure to secretions such as semen and vaginal fluids, thereby blocking sexual transmission of HIV infection.

Laboratory studies have been conducted to support this theory. These studies involved placing a solution containing HIV inside the condoms. No leakage of HIV across the latex or polyurethane condoms was demonstrated. Similar studies have also demonstrated that other common sexually transmitted viral infections, such as herpes simplex virus (HSV) and hepatitis B virus (HBV), are also prevented with the use of these two types of condoms.

Condoms made of "natural" materials – such as lambskin – are not a consistently effective barrier against many viruses. In one laboratory study, HIV was found to pass through microscopic holes in lambskin condoms. Studies involving HSV and HBV reported similar results. In turn, lambskin condoms are not a recommended barrier against HIV and other viral infections.

There have been a number of epidemiologic studies – studies that are conducted in real-life setting, where one partner is infected with HIV and the other partner is not – that have demonstrated consistent use of latex (or polyurethane) condoms provide a high degree or protection against HIV. However, the key to effective protection is consistent and correct use of condoms.

Incorrect use of condoms can increase the risk of condom slippage or breakage, which diminishes their protective effect. Inconsistent use – for example, failure to use condoms with every act of vaginal or anal intercourse – can lead to HIV transmission. As is discussed in "What about the per-risk numbers," HIV transmission can occur with a single act of intercourse with someone who is HIV positive or has an unknown HIV status.

A word about polyurethane condoms: They are an effective alternative to latex condoms, especially for people with an allergy to latex. There have been at least six epidemiologic studies of polyurethane condoms. Three of the studies found that that slippage and breakage occurs equally (and rarely) with both latex and polyurethane condoms. The three other studies found that polyurethane condoms are more likely to break than latex condoms (with one of the studies also demonstrating that polyurethane condoms are more likely to slip than latex condoms). Still, if used consistently and correctly, they are considered to be a highly effective barrier against the sexual transmission of HIV.

Female Condoms

The female condom, approved in 1993 for use in the United States, is a polyurethane pouch with flexible polyurethane rings and each end. It is inserted deep in the vagina, much like a diaphragm. The ring at the closed end holds the pouch in the vagina. The ring at the open end stays outside the vulva (vaginal opening). If inserted properly, it lines the vagina and the cervix, which helps to prevent pregnancy, along with HIV and other sexually transmitted infections.

While female condoms are not approved for use during anal intercourse, some MSM have reporting using them for anal sex. However, at least one study has reported problems for the receptive partner using the female condom, including difficulty inserting the condom, discomfort, and rectal bleeding (removing the inner ring may alleviate some of the problems experienced during anal insertion and removal).

How are condoms used correctly?

Contrary to popular opinion, it's not only the sexually inexperienced who aren't familiar with how to use a condom effectively. Whether you're just starting to have sex – or have been going at it for years – a little information may be useful and important.

Men: Practice using male condoms while masturbating. MSM hoping to use female condoms for receptive anal sex are also encouraged to practice inserting and removing the condom before using it during intercourse.

Women: Practice using male condoms on penis-shaped objects, including ketchup bottles or bananas. Practicing the insertion and removal of female condoms, before they are used during vaginal intercourse, is also recommended.
Remember that the condom must be on the penis before it is inserted into the vagina or anus. The same holds true for female condoms – they must be inserted properly before intercourse begins.

Male condoms should be used only once. Use a new male condom for each episode of intercourse. One study has suggested that female condoms can be reused up to five times, provided that they are disinfected with bleach and water. However, experts caution that the safest way to use female condoms is to use them only once and then discard them.

Here are the key points that always need to be remembered when using male condoms:

Putting on a condom:

 Condoms are individually sealed in aluminum or plastic wrapping. Be careful not to tear the condom while unsealing it. Never use a condom that is torn or seems brittle or stiff, past its expiration date, or exposed to extreme heat or cold.
 If not circumcised, pull back the foreskin before rolling on the condom.
 Leave a half-inch space at the tip of the condom to collect semen. Pinch the air out of the tip with one hand while unrolling the condom over the penis with the other hand.
 Roll the condom down to the base of the penis.
 Smooth out any air bubbles and lubricate the outside of the condom generously.
 Use only one condom at a time. Using two condoms at a time, including two male condoms or a male and a female condom, can increase friction and lead to breakage.

Taking the condom off:

 Be sure to pull out of the vagina or anus before the penis goes soft.
 Clasp the condom against the base of the penis while pulling out.
 Throw the condom away immediately.
 Wash the penis with soap and water before post-sex intimacy.

If the condom breaks during intercourse:

 Pull out quickly and replace it. Men should be able to tell if a condom breaks during intercourse. To learn what it feels like, men should purposely break a condom while masturbating.
 If semen leaks out during intercourse and the insertive partner is HIV positive (or his HIV status is not known), contact a healthcare provider or hospital emergency room to discuss the risk and the possibility of post-exposure prophylaxis (PEP).

PEP involves a 28-day course of anti-HIV drugs that needs to be started within 72 hours of possible exposure to the virus. Generally speaking, only people who have had a high-risk situation (e.g., condomless receptive anal or vaginal intercourse with someone known to be HIV positive) are considered to be good candidates for PEP.
 

A word about lubricants

Only water-based and silicone-based lubricants should be used with latex condoms. K-Y Jelly®, Wet®, and Astroglide® are three examples of water-based lubricants that can be used with latex condoms. Examples of silicone-based lubricants include Millennium ID® and Eros Bodyglide®

Never use oil-based lubricants, including hand or body lotion, baby oil, vegetable oil or shortening, massage oil, mineral oil, or petroleum jelly (e.g., Vaseline®). Oil-based lubricants can damage latex and cause latex condoms to tear more easily.

Some pre-lubricated condoms and separately sold lubricants contain a chemical called nonoxynol-9. While nonoxynol-9 has been shown to kill sperm (and potentially reduce the risk of pregnancy) and various sexually transmitted infections, some men and women are allergic to this chemical. This can cause irritation inside the vagina and anus, which can increase the risk of HIV transmission if the condom breaks.

When In Doubt, Test!

While we know that some types of sexual activities are much lower risk than others (with some activities only being a theoretically risk, not a proven risk) and the proven effectiveness of condoms, there are no guarantees. The fact is, it is very difficult to be 100% certain that you did not engage in any risk behavior, especially if you have any sort of unprotected sexual activity with a person known to be HIV positive or you do not know what his or her HIV status is. Abstinence – or sexually activity only in a monogamous relationship in which both partners are HIV negative – is the only way to eliminate the risk of HIV infection.

The only way to know for sure whether you have been infected, even after an activity that is considered to be very low risk for HIV transmission, is to get tested. For more information about testing, please read AIDSmeds.com's comprehensive lesson on this subject.

Thus endeth the Transmission Lesson. Go forth and transmit no more.

[sunny]

Ann,

thanks a lot for posting the transmission lessons! I really appreciate your help! I think it has something to do with the ".shtml" ending of the lesson pages that I can't open them. Sorry for the annoyance...

So I've read them a couple of times and I agree with your statement from yesterday that the 1/20,000 number is pulled out of thin air if there has never been a documented case.

But there are a couple of other statements I would like to clarify -

The first of the following statements is from the lessons -

"HIV enters the body through open cuts, sores, or breaks in the skin;"

while the following one is a reply from you to a "fingering while nailbiting" question

So basically I could have a fresh cut on my skin that slightly bleeds- rub HIV vaginal fluid on it and be ok?[/i]

Ann : Yes, that's absolutely correct.

I believe that both statements are true and that any prima facie contradiction must therefore be based on imprecise language and mental concepts (on the reader's part). What is a "fresh cut", what constitutes a "break of the skin"?

In the end, I think it's almost impossible to go beyond the precision of that language without using a different medium to convey the information. Sometimes it is said that a picture says more than a thousand words - maybe that is also true in this context. Of course, that, too, is unlikely to entirely stop people from obsessing who are simply obsessing, but I believe it would help them much more than the words "small", "tiny". I know that seeing a picture of a thumb with a fresh biting abrasion next to the words "this does not constitute a fresh cut in terms of HIV transmission" would have helped me a lot.

From the lessons -

However, there have been case reports highlighting one case of female-to-female transmission of HIV via cunnilingus and another case of female-to-male transmission of HIV via cunnilingus.

It sounds like these are documented cases - if that is true, and cunnilingus is still considered a "no risk" activity like kissing (for which there was apparently also one documented case of blood-to-blood transmission), and not a "minimal risk activity" like receptive fellatio, what were the mitigating circumstances that made these cases special?

Thanks again!

Sunny

[sunny]

Hi Ann, Andy, RapidRod,

if I interpret your silence on my last post correctly, you don't want to get into this rather theoretical discussion with a worried well like me. Fair enough, although I would have certainly appreciated your wise words, as I have with respect to my "thumb touching incident" three weeks ago.

Thus, if you aren't interested in any further dissection of the advice given in various outlets, I am rather hopeful I won't be posting here again with respect to the above mentioned incident. Maybe my first HIV scare a couple of years ago equipped my brain to better deal with fear in this respect - thanks to your help, after the initial fear spike, I seem to have emotionally accepted that there was indeed "no risk" (I've got a headache today and my initial thought was *not* 'it could be ARS').

I'm pretty sure I'll always "play safe" (condom for every act of penetrative sex, but I'll also try not to rub any juices into anything freshly bleeding...) should I actually be able to develop a real sex life (one not just including me, my eyes, and accidental thumb contact with a stripper's "juicy fingers") despite my fear, but it is comforting to know that I will always have a little corner on the internet where I can ask - and count on an answer - even if would be loughed at somewhere else.

For that help, I would like to thank you again, you are truly amazing people, and you can't imagine how much I admire you for your willingness to help people in distress, those with a risk, and. possibly even more so, those without a risk.

Only my best wishes for you and your loved ones!
Sunny

[Ann]

Sunny,

That's right, we're not laughing, but we are saying you did not have a risk. No way.

Keep using those condoms for anal or vaginal intercourse, use them correctly and consistently, and you'll be fine. Make sure you check out the condom and lube links in my signature line for hint and tips on correct usage.

Ann

[sunny]

Hey,

sorry to bother you again. I think I do know almost the exact wording of your reply, but I'm still gonna ask the question...

So, it's been 7 weeks since the no risk thumbtouching, and I've been able to almost completely ban the thing from my mind. In fact being so happy about my apparent new ability to deal a little more rationally with HIV fear, I've been able to approach women much more freely No sex, but good times, and to a large extent thanks to you.

So now, 7 weeks into the no-risk "window period" I get a bad cold. At first I'm not even thinking how it could be possibly related to ARS. But then today, I got stomach aches as well, and light dizziness with about 39°C fever. I'm coughing, and until this afternoon my nose was running (which is, as I remember, a statistical counterindicator for ARS (I once read a paper at thebody.com that indicated that only 7% of reported ARS cases were with a runnning nose)).

So there you go. A cold with stomach behavior I did not experience before, and the fear enters my brain again... I know what you're gotta say:

"No risk, so no ARS. Most people seroconvert between 2 and 4 weeks, not after 7. And symptoms don't mean anything at all. And even if they did, yours aren't really indicative of ARS, which usually manifests without flu like symptoms. You very very likely have a simple upper respiratory infection, not even a real flu. But most importantly - no risk for HIV, no risk for ARS."

But could you just say it again for my worried mind? Thanks! So! Much!

[Andy Velez]

No risk. Did that help?

Are you seeing a therapist or other professional to deal with your emotional issues about this matter? Instead of repeatedly thanking us and then coming back with yet another just one more question, how about getting some real help to address your problem?

[thunter34]

OK....I just have to look back over this thread so I can find out what "no risk thumbtouching" is.

Runny nose, a bit of fever, coughing....I don't know where you are located (although not many in the US would use Celsius to describe a temperature), but I have to wonder:  Is it spring-like where you are?  Pollen and stuff?  Just sayin' that there's a LOT of people running around sniffling and coughing here.  Just wondering.

Andy is absolutely correct.  You need to consider seeing a therapist because this kind of anxiety is unbalancing you. 

Now I gotta go find out what no risk thumbtouching is...

[sunny]

Andy, THunter,

No risk. Did that help?

It did. Seriously.

Are you seeing a therapist or other professional to deal with your emotional issues about this matter? Instead of repeatedly thanking us and then coming back with yet another just one more question, how about getting some real help to address your problem?

I am not (yet). But I read a lot about OCD and I am quite certain that it is hereditary in my family, and just the realization thereof has made my life a lot easier. I'm certainly not as bad as Jack Nicholson in As Good As It Gets - I can walk on cobbled stone - but I am realizing I do have issues with OCD. I know you're not an OCD forum, although people like me are benefitting from your generosity. There, I thanked you again!

Believe it or not, telling myself that "this fear is unwarranted", or "this is your amygdala messing with the serotonin receptors in your cerebellum instead of letting your cerebrum handle the issue as would be appropriate..." for a couple of times seems to work now. And if you say "no risk", that keeps my amygdala shut up.

OK....I just have to look back over this thread so I can find out what "no risk thumbtouching" is.

Well, at least I made you laugh, thunter . And you're right. I need to consider seeing a threapist about this.

Pollen and stuff?

It is spring here - but it's not an allergy. I'm not allergic to anything (as far as I know), and I'm hardly ever getting something flu like. It's an infection. Are there allergies that manifest with fever?

Actuallly, I just remembered a "House" dialogue with a guy who presented in the clinic with similar symptoms - he asked "have you had unprotected anal sex with intraveneous drug takers in the last two weeks? No? Then it's a cold."

At the risk of being repetitive, thanks again, and I won't ask about this cold's risk again. Have a great spring...!

[sunny]

Hi again,

I'm not sure if I should have opened a new thread, as the red warning above the textarea said, so I put this question into my old thread even though it's only remotely related. Luckily, I am no longer obsessing about the incident below. Thanks again.

But I just realised that I have a small cut on my left middle finger, and for some reason, looking at it, I remembered the following statement by Ann -

So basically I could have a fresh cut on my skin that slightly bleeds- rub HIV vaginal fluid on it and be ok?[/i]
Ann : Yes, that's absolutely correct.

Now I think a picture does sometimes say more than a thousand words - so I have attached a macro-shot of the "small cut", no longer bleeding, and hope you might have a look at it and say, "yes, this is kind of cut I had in mind when I said that you could rub HIV vaginal fluids on a fresh cut and be ok". While I'll still try to avoid the scenario in question, I believe such an image-based-reply might be helpful as a reminder for possible future scare-incidents in my brain as well as the plethora of similar questions in the forum.

Thanks again for your help!

[Matty the Damned]

Sunny,

Please don't post pictures in this forum. It's not permitted.

MtD

[sunny]

Sunny,

Please don't post pictures in this forum. It's not permitted.

MtD

Oh, sorry, did not know that. That limitation obviously renders my post entirely obsolete. Too bad, but fair enough.

I can still see the image when logged in. I will un-attach it, hope that's sufficient, I can't see a "delete buttton" in the editor.

May I ask why pictures aren't permitted?

Sorry for the inconvenience.

Update - done - unattached, seems deleted to me.

Ann, if you see this, could you tell me if it would be ok to PM you with a message containing the referenced image of my "small cut" - if that is allowed / technically possible - I've not PMed anyone yet.

Thanks.

[Ann]

Sunny,

I don't need to see any photo of your finger to tell you NO RISK. I know what cut fingers look like.

I'll put it this way, mate. Your finger would have to be severely damaged for there to be even a remote possibility of infection and believe me, if you finger were that badly damaged, the last place you'd be sticking it is in a vagina.

Ann