Welcome, Guest. Please login or register.
January 21, 2018, 01:42:52 PM

Login with username, password and session length

  • Total Posts: 725361
  • Total Topics: 59132
  • Online Today: 365
  • Online Ever: 1421
  • (August 13, 2016, 05:18:44 AM)
Users Online
Users: 5
Guests: 271
Total: 276


Welcome to the POZ Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Welcome to Am I Infected

Welcome to the "Am I Infected?" POZ forum.

New members -- those who have posted three or fewer messages -- are permitted to post questions and responses, free of charge (make them count!). Ongoing participation in the "Am I Infected?" forum -- posting more than three questions or responses -- requires a paid subscription.

A seven-day subscription is $9.99, a 30-day subscription is $14.99 and a 90-day subscription is $24.99.

Anyone who needs to post more than three messages in the "Am I Infected?" forum -- including past, present and future POZ Forums members -- will need to subscribe, with secure payments made via PayPal.

There will be no charge to continue reading threads in the "Am I Infected?" forum, nor will there be a charge for participating in any of the Main Forums; Meds, Mind, Body & Benefits; and Off Topic Forums. Similarly, all POZ pages, including our "HIV Transmission and Risks" and "Am I Infected? (A Guide to Testing for HIV)" basics, will remain accessible to all.

NOTE: HIV testing questions will still need to be posted in the "Am I Infected?" forum; attempts to post HIV symptoms or testing questions in any other forums will be considered violations of our rules of membership and subject to time-outs and permanent bans.

To learn how to upgrade your Forums account to participate beyond three posts in the "Am I Infected?" Forum, please click here.

Thank you for your understanding and future support of the best online support service for people living with, affected by and at risk for HIV.

Author Topic: Help to assess level of risk from this encounter  (Read 1855 times)

0 Members and 1 Guest are viewing this topic.

Offline b2400

  • Standard
  • Member
  • Posts: 4
Help to assess level of risk from this encounter
« on: October 23, 2013, 10:09:47 AM »
I had a sexual encounter with someone who did not tell me he was positive.  I am wondering how infectious you think his semen and/or pre-cum would be given that I later found out that he:

Seroconverted 8/2012
Got on medicine 5/2013
Became undetectable 7/2013 (3 months ago)

I have read conflicting information about undetectable blood levels vs. semen levels - but the majority of the opinions seem to say it is still in semen even if the blood does not have it.  Another issue is that he had receptive anal sex with 4 men earlier that same night (I was unaware of this until later), and he also performed oral sex on all of them in the same night (and did similar things in the two prior nights - I don't have details but he's versatile).  So, he may have another STD (chlamydia or gonorrhea) which again raises the infectious factor.  These activities were all done in a bath house. 

So (1) Based on the above info, how infectious do you think he was?

And (2) Regarding transmission, I had a cold a week ago, and one tonsil still has a white dot pus / WBCs (I didn't realize this before - they are not tonsil stones).  That's another concern for me since his pre-cum got in my mouth and we had sex for 4-5 hours, so there was repeated exposure and some roughness / abrasion.  Some also got in my ass - briefly (via finger not penis). It's hard to even know, at this point, what fluids got where.  All I know for sure is that he did not cum in my ass or mouth - but pre-cum got in both locations.  He also performed oral sex on me, which I know is basically no-risk - but not sure if the risk is higher given he blew 4 other guys that night (and more in the prior 2 days) and may have had an oral STD.  He supposedly got HIV from topping...so I don't know - I guess anything can happen (if that's even true).  At the time, I had a bad ingrown fingernail that was swollen - and applying hydrogen peroxide to that burns like hell - so I am guessing this is considered "open" or it wouldn't burn - but more relevant - it would be receptive to infection given the WBCs present.  With all the contact, I am sure some pre-cum got on there too (via JO). 

Thank you for your help.

P.S.  I have been sexually active sine 1996...so I mostly learned about HIV during the hyper-fear era, so that is why this might sound overly paranoid.  I have always been pretty careful...I just have major surgery coming up that is going to prevent me from having sex for up to 6 months - so got a little more into the anonymous thing than I normally do (also, the medication may cause abnormalities in my pre-op labs so I would gladly stop it).  I have already read the posts about the different levels of risk from similar sexual behavior, but there are some variations here.  My friend on PREP just gave me Truvada because he & his partner both thought it was too risky.  But, I started it at 48 hours post... which isn't great.  I would stop it if it is unnecessary because of the side effects I am having. My stomach is going crazy and my urine is already dark and almost greenish from just 3 days of Truvada, so of course I am seeing a doctor this week.  It was just easier at the time to get it from my friend who said he has no side effects and was on it for a year.
« Last Edit: October 23, 2013, 10:27:49 AM by b2400 »

Offline Andy Velez

  • Global Moderator
  • Member
  • Posts: 32,271
Re: Help to assess level of risk from this encounter
« Reply #1 on: October 23, 2013, 10:31:56 AM »
Let's keep this simple, B. The only confirmed risks for the sexual transmission of HIV are unprotected vaginal and anal intercourse. As long as condoms are used consistently and properly for those activites you'll be well protected.

It's not clear to me from your comments as to whether or not you have had unprotected anal intercourse. Please clarify if I am missing something.
Andy Velez

Offline b2400

  • Standard
  • Member
  • Posts: 4
Re: Help to assess level of risk from this encounter
« Reply #2 on: October 23, 2013, 11:22:41 AM »
Hi Andy,

Thanks for your quick reply.  There was no receptive anal sex.

I know this has been debated ad nauseum - but the oral sex risk is part of my concern  (http://hivinsite.ucsf.edu/InSite?page=pr-rr-05  and
http://www.poz.com/articles/348_2126.shtml (paragraph 3)

Since he had sex with 4 guys that night (and the two nights before) he may have a secondary STD like chlamydia or gonorrhea which raises the risk:  http://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm  (also on the first link).

And, it is in pre-cum / has been transmitted by pre-cum: http://vimeo.com/18978846 

So I am just trying to sort through this information because on one hand - people say you cannot get it through oral sex (or precum doesn't have enough) but on another hand, people say you can & it's more risky if the person has another STD (and multiple bath house partners in a 3 day period make me think another STD is probable).  And, last - I had some kind of white patch on my tonsil and an infected cut.   (I can't find this website now - but it was a university website explaining why infected skin or mucosa is higher risk than in-tact or broken skin)

Sorry my posts are so long - I am trying to get it all in w/ the restriction before paying.  I don't think I'll need enough help to have to ultimately start paying - but there's the info I am working with.

Is there any way to know if someone is undetectable in blood - how much that corresponds to their semen?  Would 3 months of undetectable mean anything? 
« Last Edit: October 23, 2013, 11:26:16 AM by b2400 »

Offline jkinatl2

  • Member
  • Posts: 6,007
  • Doo. Dah. Dipp-ity.
Re: Help to assess level of risk from this encounter
« Reply #3 on: October 23, 2013, 04:26:20 PM »
Given that performing oral sex (fellatio) is considered close to no risk even with  high viral load, and the person is on meds - you had no risk for HIV even if he had a secondary STD.

The caveat for seminal viral load blips only applies to unprotected anal and vaginal sex. Moreover, the studies you cite did not record the seminal viral load count, nor did they verify if the viral particles found were viable.

None of the sites you cited mentioned the three serodiscordant studies of which you are undoubtedly aware, which lasted ten, five and three years on two continents. In these studies serodiscordant couples used barrier protection (condoms) for anal and vaginal sex, and no protection whatsoever for any form of oral sex. No infections were linked to oral sex in any of these studies. This, of course, comes as no suprise to people aware of the powerful HIV inhibiting properties of saliva, which breaks down the glycoprotein shells surrounding HIV and render it incapable of infection.

In short, even taking into account your caveats, our risk assessment regarding fellatio remains unchanged.

You had no risk in the scenario you described.

"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

Welcome Thread

Offline b2400

  • Standard
  • Member
  • Posts: 4
Re: Help to assess level of risk from this encounter
« Reply #4 on: October 23, 2013, 07:41:06 PM »
Maybe my doctor is being too aggressive...  I just got back from there and he wanted to give me a rocephin shot again without even getting a positive  gonorrhea result...he wants me to complete the full 28 day PEP.  I am not giving him any different facts than I am stating here.  He is an infectious disease doc from Africa - so he has seen a lot of HIV/AIDS.  Maybe he is going overboard?  He said it IS "low risk" and I kept saying "I really think it's no risk - except the other STD caveat" (which you said has nothing to do with oral anyway) and then he just acted like there's no point to stop the PEP because it's more risky to go off. When I said I had diarrhea from it & my pee was green, he said "that shouldn't happen." Well, it's the first side effect listed...and it says to tell your doctor if your urine is dark.  ugh.

I didn't understand this: "Moreover, the studies you cite did not record the seminal viral load count, nor did they verify if the viral particles found were viable. "  I am not sure what this referred to.

Btw - I didn't write one line in my last post right - there was no unprotected anal - but there was like 2 minutes of anal with a condom (me on the bottom). So, my doctor kept insisting that the condom may have broken (in the 2 minutes)...because I said I didn't "inspect" it after (and he didn't ejaculate) so he really wants me on the drugs (he said no ejaculation doesn't matter).  I said I highly doubted it broke in 2 minutes... but he didn't seem to like that answer.  He also saw the white dot in my throat and just said he didn't know what it was.  That's weird to me..for an infectious disease doc.  He just said "it's not thrush" (duh). Btw, I asked him and his secretaries if a lot of HIV patients come in there - and they said a lot do (and he's right by a big gay neighborhood where all those crazy ads for that belly fat reducing drug were on every bus stop last year).

I am going to go to a dedicated STD clinic tomorrow so I can just probably stop taking this stuff.  I think they will mostly agree with all of you.  In the meantime, he sent me to Quest with a dozen labs - He also had me tested for Hepatitis AB&C, Syphilis, Chlamydia and Gonorrhea through urine and oral (I don't think any of this will even be positive yet if I got it - but he said he wants a baseline). 

I know about the serodiscordant Truvada study... and honestly there is a lot to read on this - and yes, I saw the oral study (or studies) referred to in a post somewhere - but never a  link to the actual text anywhere.   Can you send me the link?  I have tried looking on google and google scholar and it's not coming up with my search terms.  A case of oral transmission did come up when I searched, but it was a case report dealing with a drug-using prostitute so I am going to ignore that one.

Well, this is my last post - so thanks for your help.


Terms of Membership for these forums

© 2017 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.