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Author Topic: Cunillingus HIV Risk  (Read 622 times)

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Offline stranger01

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Cunillingus HIV Risk
« on: April 28, 2020, 08:19:12 am »
Hi all, hope everyone’s doing okay in these times.

I had a question regarding HIV risk, in relation to cunillingus. Essentially a few months ago I performed cunillingus on my ex girlfriend without protection. I didn’t have any open sores or ulcers etc in my mouth and as far as I remember my gums were not bleeding. I want to find out my risk of acquiring HIV from this situation? 18-19 days after this exposure I actually did a HIV DUO test (4th gen) testing for antigen and antibodies which came out negative, is this result of any meaning given it was within the window period?

I have seen comments posted before on here that Cunillingus doesn’t carry a risk because the bartholin glands do not carry infectious levels of HIV. Whilst this is reassuring is it possible to see a link to the actual research for this? Because I couldn’t find this sort of commentary anywhere else online.

Sorry for the message and thanks in advance for all the work done on this forum. 

Offline Jim Allen

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Re: Cunillingus HIV Risk
« Reply #1 on: April 28, 2020, 08:54:13 am »
Hiya,

It's not a concern for multiple reasons, not just the fluids. Now I've included a few references at the end of this post for you to start with, but I'm not a library service.

Regarding fluids, what has been proven is HIV is present at infectious levels in the cervicovaginal fluid as an example. The Bartholin's glands, however, secrets a lubricating fluid that has never been found to contain levels of HIV that can infect, same as saliva, sweat or tears.  Saliva, sweat and tears are not HIV infectious fluids.

Anyhow, asides from the lack of exposure barriers like the mouth lacking the route (Cells to infect) for HIV, then saliva & air also acts to neutralize HIV by damaging the receptors needed to infect human cells, etc, etc, etc.

All in all, if this was your only sexual activity then move on with your life, use condoms for any intercourse and test out of standard routine at least yearly for STI's/HIV.

Here's what you need to know in order to avoid HIV infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions.  Consider starting PrEP as an additional layer of HIV prevention going forward.

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

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

More information on HIV Basics, PEP, TaSP and Transmission can be found through the links in my signature.

Kind regards

Jim

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Firstly understand the basic life-cycle of HIV and its needs before reason on. https://www.poz.com/basics/hiv-basics/hiv-life-cycle

Baeten J et al. Genital HIV-1 RNA Quantity Predicts Risk of Heterosexual HIV-1 Transmission. Sci Transl Med. 6; 3(77): 77ra29, 2011

Fiscus SA et al. Changes in HIV-1 subtypes B and C in genital tract RNA in women and men after initiation of antiretroviral therapy. Clin Infect Dis, 57(2):290-7, 2013

Wu L Biology of HIV mucosal transmission. Curr Opin HIV AIDS 3(5): 534-540, 2008
Gupta K et al. How do viral and host factors modulate the sexual transmission of HIV? Can transmission be blocked? PLoS Med 3(2): e79, 2006
CDC

Baeten J et al. Genital HIV-1 RNA Quantity Predicts Risk of Heterosexual HIV-1 Transmission. Sci Transl Med. 6; 3(77): 77ra29, 2011

Fiscus SA et al. Changes in HIV-1 subtypes B and C in genital tract RNA in women and men after initiation of antiretroviral therapy. Clin Infect Dis, 57(2):290-7, 2013
Oral transmission of HIV, reality or fiction? An update

J Campo1, MA Perea1, J del Romero2, J Cano1, V Hernando2, A Bascones1
Oral Diseases (2006) 12, 219–228

Romero J et al. Evaluating the risk of HIV transmission through unprotected orogential sex. AIDS 16:9:1269-97, 2002.

No incident HIV infections among MSM who practice exclusively oral sex.
Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WePpC2072)??Balls JE, Evans JL, Dilley J, Osmond D, Shiboski S, Shiboski C, Klausner J, McFarland W, Greenspan D, Page-Shafer K?University of California, San Francisco, San Francisco, United States

Oral transmission of HIV, reality or fiction? An update
J Campo1, MA Perea1, J del Romero2, J Cano1, V Hernando2, A Bascones1
Oral Diseases (2006) 12, 219–228

AIDS:  Volume 16(17)  22 November 2002  pp 2350-2352
Risk of HIV infection attributable to oral sex among men who have sex with men and in the population of men who have sex with men

Page-Shafer, Kimberlya,b; Shiboski, Caroline Hb; Osmond, Dennis Hc; Dilley, Jamesd; McFarland, Willie; Shiboski, Steve Cc; Klausner, Jeffrey De; Balls, Joycea; Greenspan, Deborahb; Greenspan

Page-Shafer K, Veugelers PJ, Moss AR, Strathdee S, Kaldor JM, van Griensven GJ. Sexual risk behavior and risk factors for HIV-1 seroconversion in homosexual men participating in the Tricontinental Seroconverter Study, 1982-1994 [published erratum appears in Am J Epidemiol 1997 15 Dec; 146(12):1076]. Am J Epidemiol 1997, 146:531-542.

Studies which show the fallacy of relying on anecdotal evidence as opposed to carefully controlled study insofar as HIV transmission risk is concerned:

Jenicek M. "Clinical Case Reporting" in Evidence-Based Medicine. Oxford: Butterworth–Heinemann; 1999:117

Saltzman SP, Stoddard AM, McCusker J, Moon MW, Mayer KH. Reliability of self-reported sexual behavior risk factors for HIV infection in homosexual men. Public Health Rep. 1987 102(6):692–697.Nov–Dec;

Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990 Nov;108(3):339–362.

http://www.aegis.com/conferences/12wac/21143.html

Saliva neutralizes HIV-1 infection by displacing envelope gp120 from the virion.

Int Conf AIDS 1998 Jun 28-Jul 3; 12:267 (abstract no. 21143)

Malamud D, Nagashunmugan T, Friedman HM, Davis CA, Abrams WR
Dept. Biochemistry Univ. Penn Dental Med., Phila 19104-6003, USA.

BACKGROUND: Incubation of HIV-1 with human saliva decreases infectivity. This inhibition is specific for HIV-1, with no effect on adenovirus, HIV-2 or SIV and appears to work at the level of the virus rather than the host cell. We have now identified an active protein fraction and provide evidence that the mechanism of action involves stripping of gp120 from the virus.

CONCLUSION: The specific inhibition of HIV-1 infectivity by human submandibular saliva is associated with removal of gp120 from the virus. The active fraction contains several proteins, including two high molecular weight glycoproteins.

http://www.aegis.com/conferences/4croi/412.html

Mechanisms of anti-HIV-1 activity of human submandibular saliva.
Conf Retroviruses Opportunistic Infect 1997 Jan 22-26; 4th:140 (abstract no. 412)
Nagashunmugam T, Malamud D, Davis C, Friedman HM; University of Pennsylvania, Philadelphia, PA.

http://www.aegis.com/conferences/12wac/60770.html

Neutralizing effect of secretory IgA to HIV in parotid saliva of HIV-infected patients.

Int Conf AIDS 1998 Jun 28-Jul 3; 12:1142 (abstract no. 60770)

Moja P, Desgranges C, Pozzetto B, Lucht F, Genin C
Gimap University of St.-Etienene, France.

BACKGROUND: The aim of this study was to test S-IgA purified from secretions of HIV seropositive patients in a neutralization assay to determine whether specific S-I&A can protect from HIV infection.

CONCLUSION: These data demonstrate that secretory IgA, which is the predominant isotype in secretions, can inhibit HIVMN infection of MT4 cells. HIV neutralization has been carried out with CD4+ T cell line adapted virus strain as a standardized model system, but the use of mucosal autologous primary isolates in neutralization test would be useful to estimate the actual protective effect of these antibodies in each patient.

Wu L Biology of HIV mucosal transmission. Curr Opin HIV AIDS 3(5): 534-540, 2008
Gupta K et al. How do viral and host factors modulate the sexual transmission of HIV? Can transmission be blocked? PLoS Med 3(2): e79, 2006
CDC

HIV 101 - Everything you need to know
HIV 101
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline stranger01

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Re: Cunillingus HIV Risk
« Reply #2 on: April 28, 2020, 09:27:07 am »
Hi,

Cool, thanks for the response and the references. As far as the test goes that I took I presume this was pretty meaningless given it wasn’t at 28 days? And just a final question, if cunillingus is a no risk activity how come blowjobs constitute a theoretical risk?

Offline Jim Allen

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Re: Cunillingus HIV Risk
« Reply #3 on: April 28, 2020, 09:36:00 am »
Hiya,

Semen can contain a high concentration of HIV being directly ejaculated into the inside of the mouth. However, it's such a minute risk we don't recommend testing over it outside of routine, you did not even have this level of risk.

As for your test, pretty meaningless as you had no exposure that warranted testing, although, not a waste as it gives a high level of certainty you did not acquire HIV 6 weeks before testing.

Also, if you don't already test at least yearly this is a good time to put the date in your calendar and start doing so, just remember to also test for far easier to acquire STI's as well.

Jim
HIV 101 - Everything you need to know
HIV 101
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline stranger01

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Re: Cunillingus HIV Risk
« Reply #4 on: April 28, 2020, 10:41:04 am »
Hi,

Okay - thanks for your response. No further questions from me.

Have a good day.

 


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