Inflammation And Oral Hiv/siv Susceptibility
Although infants are exposed to HIV-containing breast milk for many months, even in the absence of antiretroviral prophylaxis, only a relatively small number of infants born to HIV+ mothers will become infected . Indeed, if we assume a 40% MTCT infection rate, then each infant born to an HIV+ mother has a 16% chance of acquiring HIV during breastfeeding. This suggests that certain infants may be particularly susceptible to HIV. Understanding the factors that enhance oral HIV transmission will be critical for developing effective interventions to protect infants from postpartum transmission of HIV.
It is well documented that different types of mucosal inflammation at multiple sites impact sexual and vertical transmission of HIV . Oral mucosa inflammation is also a risk factor for oral HIV transmission. For example, infant oral candidiasis increases the risk of MTCT of HIV through breastfeeding . The risk of HIV acquisition associated with oral sex is increased in individuals that smoke crack cocaine, which is known to cause oral lesions , and oral sores are associated with HIV infection in crack cocaine users who performed ROI . In contrast, studies in HIV-uninfected, highly exposed individuals indicate that low levels of CD4+ T cell activation and quiescent CD4+ T-cell phenotypes are associated with reduced HIV susceptibility . These studies suggest that inflammation at the oral mucosa increases susceptibility to HIV.
Can Analingus Result In Hiv Transmission
For this answer, we turn back to Bob Frascino, M.D.:
“Although there have been no documented cases of acquiring HIV from rimming or being rimmed, there are a number of other significant STIs that can easily be transmitted through rimming, including hepatitis A, herpes, and intestinal parasites. You can decrease the risk by using a dental dam barrier .
“As for whether to rim or not, only you can decide what level of risk you are willing to take. At least now you have the facts.”
Estimating The Risk Per Exposure
A satisfactory answer to the question, How high is the risk of HIV transmission through oral sex? has been notoriously elusive. Collecting reliable data is challenging for several reasons:
- Very few people report oral sex as their sole risk.
- If a person practises any other form of unprotected intercourse in addition to unprotected oral sex, any resulting HIV infection is usually attributed to the higher risk behaviour.
Many reports of oral transmission are in the form of isolated and anecdotal reports, rather than from observational cohorts or other studies with more rigorous follow-up.
Most cohort studies following men who only practiced oral sex, or serodiscordant couples, have tended to show very low levels of risk, in many cases approaching zero. A few studies have given higher estimates which are difficult to reconcile with the others.
antiretroviral
A substance that acts against retroviruses such as HIV. There are several classes of antiretrovirals, which are defined by what step of viral replication they target: nucleoside reverse transcriptase inhibitors non-nucleoside reverse transcriptase inhibitors protease inhibitors entry inhibitors integrase inhibitors.
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Can A Man Give Himself Hiv/aids Or Another Sexually Transmitted Infection By Masturbating
The best answer to this question came years ago from one of our longtime experts, the highly respected HIV physician Robert Frascino, M.D.:
“No, there is absolutely no chance you can contract a sexually transmitted illness from yourself!
“STIs involve germs that spread from an infected person to another person via sexual activity. Masturbation, choking the chicken, spanking the monkey, or whatever you want to call it, involves only you and your hand. Some folks may refer to their hand as Mrs. Palm and her five daughters, but really we are only talking about one person here. And that’s you, right?!
“A person cannot give himself a disease he doesn’t already have. Just as you can’t give yourself a million dollars , you can’t give yourself HIV, because you don’t have that either.
“The bottom line is that your jizz is perfectly safe, so no worries unless you spunk up your parents’ furniture. And even those kinds of stains, although they can lead to problems, they can not lead to STIs, OK?”
How Can You Prevent Contracting Hiv During Oral Sex
Using dental dams, male and female condoms during oral sex reduces the likelihood of contracting HIV, but you must use them correctly, says Neilan. Refraining from oral sex when risk factors are present, and avoiding seminal or vaginal fluids in the mouth also lessen the risk, but does not completely eliminate it.
STIs like gonorrhea or syphilis can cause sores on the mucous membrane, increasing the chances of getting or transmitting HIV, so get tested regularly and seek treatment if needed.
“Having you and your partner tested for HIV and other sexually transmitted infections also reduces risk. Many people with sexually transmitted infections don’t know that they have them because they often have no symptoms,” says Neilan.
For long-term prevention of contracting HIV, take pre-exposure prophylaxis , though this is only necessary in circumstances where risk of HIV transmission is high). It is a highly effectiveprescription drug that lowers your HIV risk, but its efficacy depends on strict adherence and consistent use. The only FDA-approved medications for PrEP use are Truvada and Descovy.
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How Can You Prevent Getting Or Transmitting Hiv Through Sex
If you are HIV-negative, you can use HIV prevention medicine known as pre-exposure prophylaxis or post-exposure prophylaxis to protect yourself. You can also use other HIV prevention methods, below.
If you have HIV, the most important thing you can do to prevent transmission and stay healthy is to take HIV medicine exactly as prescribed. People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load can live long and healthy lives and will not transmit HIV to their HIV-negative partners through sex. This is sometimes called HIV treatment as prevention or undetectable = untransmittable . There also are other options to prevent transmitting HIV, below.
How Is Hiv Not Passed From One Person To Another
You may have just read the section above and thought to yourself: Wait, that seems like a really short list of ways HIV gets transmitted. What about mosquitoes? Blowjobs? Kissing? Sharing food or utensils?
As weve previously discussed in this guide, there are a lot of myths and misconceptions about HIV transmission. At some point, people without HIV may worry they have been exposed to the virus. And when people get freaked out about their health, they tend to start scouring the internet for answers.
At TheBody, weve spent the past 25 years fielding questions about HIV exposure fears and talking with experts about the realities of HIV risk. So we know an awful lot about the HIV transmission concerns people tend to have in common.
These are the top five recurring fears about HIV transmission that are way, way more than theyre cracked up to be:
Lets break each of these down in more detail.
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Tips For Safer Oral Sex
If a partner who is living with HIV has an undetectable viral load, their risk of transmitting HIV during oral sex is zero, whether or not they use the tips below.
If a partner living with HIV is not taking HIV drugs and/or has a detectable viral load, the chance of HIV transmission during oral sex is still low. The tips below can lower that chance even further. If you are not sure of your or your partners HIV status, and are not taking PrEP or if the partner living with HIV is not on treatment or is known to have a detectable viral load oral sex can be safer if you and/or your partner:
- get treatment for any other STIs you may have
- do not have gum disease
- wait to have oral sex until any mouth sores or genital cuts, scrapes, or sores have healed
- wait until after having oral sex to floss, brush your teeth, or do anything that could create cuts or cause bleeding in your mouth
- If you want to freshen up before oral sex, consider using a breath mint instead
What Is The Risk From Oral Sex
Results from the PARTNER study show that if someone with HIV is taking effective HIV medication and has an undetectable viral load, they cannot pass on HIV.
According to Public Health England, around 1-3% of sexual HIV transmissions in the UK are because of oral sex. Other studies found that the risk is very low but is not zero.
The risks are higher if the person giving oral sex has:
- cuts, sores or abrasions in their mouth or gums
- a sore throat or infection in the mouth or throat.
Or if the person receiving oral sex is:
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Should I Have Oral Sex
Talking to your partner about protection before you start having oral sex will help make things easier. This may feel embarrassing but taking responsibility for protecting yourself and your partner is an important part of having sex. If you find it too awkward to talk about then you may not be ready to have oral sex just yet.
You should never give or receive oral sex just because you feel forced into it. Dont be pressured into any sex act by comments like it doesnt mean weve had real sex youll still be a virgin, or if you dont want sex at least go down on me, or its not as risky as having intercourse. If one of you isnt comfortable with the decision it can ruin the whole experience. Oral sex should be fun for both of you.
Our article Am I ready for sex? will help you work out what is right for you.
Possibility Of Hiv Transmission Associated With Sexual Acts
Vaginal-penile intercourse:
Where neither a condom nor effective antiretroviral therapy is present, vaginal-penile intercourse poses a low possibility of transmitting HIV.
Where a condom is used or where the HIV-positive individual is on effective antiretroviral therapy, vaginal-penile intercourse poses a negligible possibility of transmitting HIV.
The estimate of the per-act probability of HIV transmission associated with unprotected penile-vaginal intercourse without antiretroviral therapy is often cited as one instance per 1000 sexual acts. Estimates based on the most recent scientific studies range between four and eight instances of transmission per 10,000 sexual acts.
The use of effective antiretroviral therapy by individuals living with HIV has been shown in clinical trials to result in a very significant reduction in HIV transmission to HIV-negative individuals. Overall, the evidence suggests that the possibility of sexual transmission of HIV from an HIV-positive individual to an HIV-negative individual via unprotected vaginal intercourse approaches zero when the HIV-positive individual is taking antiretroviral therapy and has an undetectable viral load. Given that the possibility of HIV transmission is already approaching zero, using a condom in such circumstances would not alter the possibility of HIV transmission in any meaningful way. It would protect both partners from other STIs and unwanted pregnancy.
Oral sex:
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Which Bodily Fluids Can Pass Hiv
HIV does not spread throughout the body evenly. Some bodily fluids have it, but most dont. In fact, HIV can only be transmitted to another person through these three types of bodily fluids:
Thats it.
HIV cannot be passed from person to person via other fluids like tears, saliva, vomit, or feces. This is an incredibly important point about HIV transmission that is often misunderstood.
For decadesand still todaypeople have worried they might catch HIV from a toilet seat, perhaps by touching the urine or fecal matter of an HIV-positive person. This absolutely does not happen.
People have also worried they might catch the virus from the saliva of an HIV-positive person who kisses them or spits on them. In fact, this fear is so pervasive that some states have made it a felony for people with HIV to spit at or bite someone else. Those laws are based on outdated science.
The only way it would be possible to transmit HIV through saliva is if the HIV-positive person had bleeding gums or sores, and somehow that bloody saliva got into the bloodstream of the HIV-negative person. However, experts agree that the risk of this happening is so statistically tiny that its not worth worrying about.
So, to recap:
- Among adults, the viruss most likely entry route inside the body is through blood-to-blood contact, or by an exchange of sexual fluids.
- Among newborns, HIV can be transmitted by HIV-positive people during pregnancy, delivery, or breastfeeding.
Challenges In Calculating A Number
It isnt easy for researchers to calculate the risk of transmission from an exposure to HIV through sex. To do this effectively, a group of HIV-negative individuals need to be followed over time and their exposures to HIVboth the number of times they are exposed and the types of exposureneed to be tracked.
As you can imagine, accurately tracking the number of times a person is exposed to HIV is very difficult. Researchers ask HIV-negative individuals enrolled in these studies to report how many times they have had sex in a given period of time, what type of sex they had, how often they used condoms and the HIV status of their partner. Because a person may have trouble remembering their sexual behaviour or may not want to tell the whole truth, this reporting is often inaccurate.
Furthermore, a person does not always know the HIV status of their partner. For this reason, researchers usually enroll HIV-negative individuals who are in stable relationships with an HIV-positive partner . Researchers can then conclude that any unprotected sex reported by a study participant counts as an exposure to HIV.
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Significant Factors Associated With The Sexual Transmission Of Hiv
The significant factors associated with the sexual transmission of HIV relevant to the formulation of our expert opinion are:
- type of sexual act
- antiretroviral therapy use and viral load in the HIV-positive individual.
Type of sexual act:
Condom use:
Antiretroviral therapy and viral load:
The medications used to treat HIV infection are referred to as antiretroviral therapy. Since the mid-1990s, HIV physicians have been using a combination of antiretroviral drugs to effectively manage HIV infection. Antiretroviral therapy stops HIV from making copies of itself, thereby significantly reducing the overall amount of HIV in an individuals body, which is referred to as viral load.
In Canada, the commonly used laboratory tests can detect viral loads above 40 copies of virus per millilitre of blood. When the concentration of HIV falls below the level that is detectable by laboratory tests, the HIV-positive individual is said to have an undetectable viral load. The goal of antiretroviral therapy is to render the HIV viral load undetectable. Most people living with HIV who take antiretroviral therapy are able to achieve an undetectable viral load. Being on effective antiretroviral therapy, with a controlled viral load, results in improved immune function and a dramatic decrease in illness and mortality.
Can You Catch Hiv From Oral Sex
HIV is mainly spread through unprotected sexual intercourse. So use condoms. The risk of catching HIV from giving or receiving oral sex is very small, but isnt zero. Lets go through the facts:
If youre a man receiving oral sex from someone with HIV, there is a tiny risk of catching it if you have a cut on your genital area, or if the person giving you oral sex has a cut in their mouth. So its pretty unlikely really.
If youre a woman receiving oral sex from someone who is HIV positive, there is only a tiny risk of catching it from them: mainly if they have cuts or abrasions on their mouth and you too have cuts or abrasions on your vaginal area. So its pretty unlikely.
If youre giving oral sex to an HIV positive woman, the risks are again very small unless she is on her period. Then sometimes the blood from her period will contain the HIV virus and you could catch it if you have cuts or abrasions in your mouth.
Bear in mind that if the HIV positive person is on effective treatment and has whats called an undetectable viral load then a recent study has shown that the risk of catching HIV from them is practically zero.
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Other Types Of Hiv Risks
Another less-common way HIV is transmitted in the United States is needlestick injury. This typically happens when a health care worker is accidentally jabbed by a used needle or syringe that contains HIV-positive blood. Again, this is very rare.
Thirty years ago, blood transfusions and organ donations were an especially dangerous way that some people acquired HIV. Nowadays, donated blood and organs are routinely tested.
How Is Hiv Not Spread
HIV is not spread by:
- Mosquitoes, ticks, or other insects
- Saliva, tears, sweat, feces, or urine that is not mixed with the blood of a person with HIV
- Shaking hands hugging sharing toilets sharing dishes, silverware, or drinking glasses or engaging in closed-mouth or social kissing with a person with HIV
- Drinking fountains
- Other sexual activities that dont involve the exchange of body fluids .
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How Safe Is Oral Sex
Giving oral sex to a woman is also considered relatively low risk. Transmission could take place if infected sexual fluids from a woman got into the mouth of her partner. The likelihood of infection might be increased if there is menstrual blood involved or if the woman is infected with another sexually transmitted disease.
The likelihood of either a man or a woman becoming infected with HIV as a result of receiving oral sex is extremely low, as saliva does not contain infectious quantities of HIV.