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Author Topic: Please assess my risk  (Read 2630 times)

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Offline dilwalas

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Please assess my risk
« on: October 01, 2012, 12:57:20 AM »
Hi Ann, Andy and others,

Last night I had a serious bad encounter with a CSW.please assess my risk.

I fingered that girl. There was a small cut in my finger. The cut happens 10 mins before I fingered. It happend when I removed the dry skin from my finger. I was stupid to finger with that finger.

I know you guys will say me that it is NO risk, but can you please explain me why this is no risk. First of all the cut is fresh, it was small bleeding, then y can it not be considered as open wound and pathways for HIV..

NOw I am very worried..

Please advise.

Offline Ann

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    • Num is sum qui mentiar tibi?
Re: Please assess my risk
« Reply #1 on: October 01, 2012, 06:11:14 AM »

Cut the drama. You did NOT have a "serious bad encounter", you had a NO RISK encounter.

Hiv can only infect a very few, very specific types of cells. These cells are NOT found on the surface of the skin nor are they found in small cuts or sore skin left behind by peeling dry skin off.

If you had a cut that could possibly pose an hiv risk, you would NOT be putting that finger into anyone's body (nor would they let you), you would be on your way to the nearest hospital to get it sewn up.

Not one person has EVER been infected through fingering and you aren't going to be the first.

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.

ALTHOUGH YOU DO NOT NEED TO TEST FOR HIV SPECIFICALLY OVER FINGERING, 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. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test.

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

Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline dilwalas

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Re: Please assess my risk
« Reply #2 on: October 01, 2012, 06:46:00 AM »
Thanks Ann,

Just last(probably) question, why you guys do not consider cut as a risk when HIV can pass through this cut,scratches..

Whenever there is a cut, blood comes out and it gets mixed with HIV ..and then get into blood stream..it is normal is not it ? Then y you guys are telling it is not at all a risk ?

PLease clarify.

Offline dilwalas

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  • Posts: 3
Re: Please assess my risk
« Reply #3 on: October 03, 2012, 12:08:14 AM »

Could you please answer my query..I will be very thankful to you.

I am very stressed...

Offline jkinatl2

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Re: Please assess my risk
« Reply #4 on: October 03, 2012, 12:13:27 AM »
Due to formatting issues, the only pre-made post I have involves fingering - though it touches on saliva and cunnilingus as well. I shall endeavor to spend some hours this evening rewriting my posts regarding saliva and cunnilingus specifically, as well as seeing what new science is out there.

Here is what seems to be transferring from my desktop to this forum intact. Again, it concentrates on fingering, but leads off into a discussion of HIv transmissin science and the rather specific methods by which HIV infects CD4 cells and specific dendritic cells:

In fingering, only menstrual blood carries any significantly infectious fluids. This is because the vaginal secretions found in the vaginal walls and the opening of the vagina are relatively uninfectious. it is the cervical fluids, deeper in the vaginal area, which pose a greater infectivity risk due to a higher concentration of active HIV.

Note I use the term ACTIVE and not alive. technically, HIV is not alive. It cannot reproduce on it's own. It requires a very specific type of white blood cell to infect with it's genetic material and essentially turn into an HIV producing factory. These receptive cells are commonly found in the urethra, in the dendritic cells under an uncircumsized foreskin, in the anus, and in the vagina. To a far lessor degree, there are some in the tonsil area as well.

So we have established that even if infectious fluids got into a cut in your finger, they would have to travel through your bloodstream and encounter one of these receptive cells. Not as likely event, at all. To the point where forcing it to happen in a lab using monkeys/primates and SHIV is largely unsuccessful. In a petri dish? Perhaps. In a bipedal organism? Difficult, if not impossible to achieve.

Now, about those infectious fluids. You realize that HIV mutates constantly, correct? Part of it's difficulty as regards a cure or vaccine is this constant mutation. Not the sort of mutation that makes a blood-borne pathogen airborne, but one which, in the long run, helps it to survive. HIV wears down an immune system by stimulating an immune response once the host is infected. And the host then produces antibodies, which destroy the viral particles and infected cells that are recognized.

At this point in infection, almost all the HIV is purged temporarily from the blood. However, reservoirs in the brain, organs, and lymphatic system are still there, and they mutate just enough so that the body must re-recognize them and mount another immune defense. This goes on for years and years in most cases, until the ability of the body to mount further defenses is compromised to the point where the immune system basically collapses. During this time, the host is left more and more defenseless against common pathogens, until finally it succumbs, either to an external pathogen or an internal function that an intact immune system would otherwise regulate.

Knowing this, and keeping in mind that the virus constantly mutates, it is not a particularly efficient virus. Most of the mutations are worthless, lacking one protein or another which makes it basically inactive, unviable. It is Darwinism at a miscroscopic scale, and greatly advanced.

See, the perfect HIV, the "goal," if you will, of HIV is to infect a host and reproduce and spread without killing the host. Not due to any altruism on it's part, but a dead host can't infect others. This is why outbreaks of Ebola and Marberg viruses are almost always brief and contained. it would take much engineering to reproduce a species-killer like "The Stand." It would involve a virus behaving in a totally different fashion than any other.

So the odds of an active, VIABLE viral particle finding it's way INTO your bloodstream, finding a receptive white blood cell (dendritic and T cells) and then successfully injecting it with it's genetic material - through a cut in the FINGER which almost instantly seals itself from external danger, and which bombards the area with elements specifically dsigned to protect and heal the skin - is purely in the realm of the theoretical. Why is there so little research? because it can't be forced to happen with any regularity in a lab, in a primate, in a monkey.

It has never been documented to happen. In the real world, the one we live in, it does not happen. It is hell on wheels to even make something like that occur in a carefully monitored laboratory. Even a petri dish is no friend to HIV.

Why do some doctors and scientists still caution? Because people mired in academia are rarely in touch with the actual, quantifiable world. The notion of "theoretical risk" and 'actual risk" are merged into a single hysterical message. There is a theoretical risk that a planet-destroying asteroid will smash the earth. There is a theoretical risk that our sun will explode. I think you get my intent here.

Let me recap:

Vaginal secretions: extremely unlikely to infect even if exposed to dendritic cells. Thus, cunnilingus is not considered a viable HIV risk.

Fingers: self sealing, and not containing receptive cells which HIV needs in order to infect.

Brothel: in western and industrialized nations, sex workers have a relatively low HIv rate compared to sex workers in Africa and other industrialized nations. However, even an HIv positive female is not going to have enough active viral particles in her vaginal secretions to present a risk to a finger or a tongue.

Fingering is not a risk for HIV, and PEP/testing is not warranted for such an activity.

That's not me talking, it's the science and the epidemiology talking.





I try to stay away from studies which rely solely on post-infection patient reports. They are notoriously unreliable, and even with multiple screenings and interview, the science is not solid. I also try to keep my patient-tracking study to within the last ten to fifteen years (as in the case of the Romero Study, where a ten year period of time was used to track serodiscordant couples). HIV transmission science is relatively new, and the means and methodology by which we are able to pinpoint what does and does not cause HIV infection was ONLY made possible by the advent of the protease inhibitor breakthrough in the mid-1990s. Prior to that, people simply did not remain healthy, and sexually active long enough post diagnosis to form a long term study.

However, I do not hesitate to use laboratory-based findings from the late 1980s and 1990s. The science which illuminated the inhibitory elements in saliva, for example, have been clarified since the original studies were published. But the initial science was sound. I am certain that as time goes on, further clarification will reinforce these initial studies.

I know that Ann has at her disposal reams of documentation regarding the female anatomy, and the specific types of fluids which are considered infectious (and why). I shall endeavor in the future to fill in my own gaps in knowledge insofar as this is concerned.

The serodiscordant studies I referenced are as follows:


An exerpt from the paper:

<<Page-Shafer et al., 1997; Vittinghoff et al., 1999; Celum et al., 2001). Keet et al.(1992) found that more than half of incident HIV infections attributed to receptive oral sex (fellatio) were misattributed due to response bias, wherein a high proportion of study participants did not report anogenital sex in written questionnaires, but later did report this practice in face-to-face interviews, leading researchers to conclude that oral acquisition of HIV occurs, but its frequency may be overestimated because of reluctance to report more stigmatized practices, including anal sex. Two more recent studies underscore the very low infectivity of HIV in association with oral sex in heterosexual and MSM populations. In a longitudinal study of serodiscordant heterosexual couples, del Romero et al.(2002) found no incident HIV infections in over 19,000 unprotected orogenital contacts with an HIV-infected partner. In a study of MSM HIV testers in San Francisco who practiced only oral sex (Page-Shafer et al., 2002), no prevalent or incident HIV infections were detected in an estimated 1519 person-years of risk exposure (Balls et al., 2004).>>






You will note that almost ALL of the oral sex transmission studies have focused on fellatio, specifically receptive fellatio (swallowing semen) - though not to the exclusion of cunnilingus. The reason being, there is simply NO documentation which suggests that cunnilingus is a viable HIv transmission vector. And the absolute dearth of subjects to study makes such specific experiments nearly impossible.

I do not know if all this is too much information. And I do not know if even armed with the science, your fears will be assuaged, Fear, I note, is immune to reason in many cases. However, the science is all I have to work with.
"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

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