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Watersports for HIV+ people
Mar 26, 2002

Hello from Italy and thanks a lot for your care Doc. I was just wondering if it's dangerous for me to drink somebody's piss. I've been recently tested poz (I was neg in June 2001) and the cd4 count is at 621, whereas the viral load is at the moment <400. Take care.

Response from Mr. Kull

Your question is somewhat difficult to answer because there isn't a whole lot of discussion in the scientific community about the risk of infections through watersports (getting pee/piss/urine on or in your body). There are certain infections that are known to be spread through contact with urine, and there are also a lot of gray areas. Be careful of people who are not speaking from a purely scientific perspective: people who tout urine therapy as a cure-all and those who wave their finger at you because they think it is a "dirty" activity.

Urine, when compared to other fluids in the body, is relatively sterile. Urine is primarily comprised of water, urea (proteins and amino acids), uric acid, and other bodily waste products.

There is no known risk of HIV transmission through contact with urine in or on your body. HIV cannot always be isolated in urine, and if it is, HIV concentrations are too small to pose a threat of infection. Some conditions contribute to blood being present in a person's urine, which would contribute to a risk of HIV transmission if your partner was infected. (This clearly does not pose a risk to you since you are infected, but it is something to keep in mind if you are the dominant/active/insertive partner).

Cytomegalovirus (CMV) is a virus that can be transmitted through urine. Many people are not adversely affected by infection with CMV. In some cases, CMV infection can lead to a mono-like illness, which usually resolves on it's own. Certain groups are at high-risk for more serious CMV-related complications: the unborn baby during pregnancy, people who work with children, and immunocompromised people, such as organ transplant recipients and the HIV infected.

Other infections of the urogenital tract could theoretically pose a risk of infection to you when you get urine in your body. Microorganisms that "live" in the urethra (like those that cause gonorrhea or chlamydia) or others that might be present in genital fluid (like hepatitis) could be carried out by urine and into your body. Mucosal contact (the lining of the mouth or rectum) with these organsisms could pose a risk for infection, but again, there isn't a whole lot of proof to support this.

So there is no absolute advice on your question. It is important as an HIV infected person to avoid infections that may compromise his/her health and facilitate disease progression. Whether or not urine poses a significant enough risk to you will be for you to decide.

RMK



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