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Question from South Africa
Aug 7, 2003

Dear Robert,

Thanks for the wonderful work you and your colleagues are doing.

I have two questions: 1) I have read recently (somewhere on this site) that the risk of HIV transmission from an HIV+ to an HIV- individual through a single act of intercourse is 1000 to one. Could you clarify if this is for PROTECTED or UNPROTECTED intercourse ? If it is for UNPROTECTED intercourse, it implies that HIV is actually a very difficult virus to transmit !

2) Is the concentration of viral load in the blood of an HIV positive person more than that in his semen or her vaginal fluid and could this be a factor in the risk of transmission to a negative partner (assuming the transmission is through sexual intercourse)?

3) Could transmission occur through "heavy petting" ?

Many thanks.

Response from Dr. Frascino

Hello South Africa,

The statistics are for unprotected per-contact probability of transmission from an HIV-infected person. The current statistics place the risk per episode of receptive vaginal exposure at 0.1 - 0.2 percent. That's unprotected. Yes, it's true that HIV is not all that easy to acquire. And that's lucky for us; otherwise, it would have wiped out most of the planet by now!

As for HIV viral load in the semen or vaginal fluid, this usually, but not always, is similar to what we measure in the blood. However, some studies have shown differences with, for instance, detectable virus in the semen, but no detectable virus in the blood.

Last, can transmission occur through "heavy petting?" No, absolutely not. Stay well.

Dr. Bob



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