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women to man transmission answered . Is that guy an alien from another planet like mars.
Sep 30, 2003

Dear bob I read the forum every day. What is up with the dude that says women to man hiv transmission in developed countries does not happen. Is he an alien from another planet. Hiv carries high concentration of the virus in cervical cavity of the vagina. The uretha of the penis is the launching pad where infection can take place. When the penis enters the vagina unprotected by latex, we cannot just say condom it must be latex condom. this is another issue that has to be addressed. It is exposed to whatever viral infection is present. Transmission of hiv from the womens vagina to mans penis happens when the cervial secretions come into contact with the uretha of your ding dong. Uretha is the hole you pee pee out of. WOMEN TO man guy is this making scense. Here let me give you stupified version. When the hole of your penis goes in and out like a plunger sucking viral secrestions into your body you are making a major mistake if you think you cannot get hiv from a positive female. This is russian roulette. I hope you read this. Bob another important question I would like you to address is Pcr hiv testing. "Check it out" most of us that read the safe sex forum are wondering about companies out there that pray on worried suckers. Ha ha. Internet adds read: For early detection of hiv a dna test can be performed 14 days after possible infection. This test has 95 rate at 14 days. A rna test after 28 days can be performed that is 98 accurate in detecting hiv. So many of us have forked out a lot of coinage to take these test because of our anxiety. I took a dna test 18 days after exposier and the counselor said the dna test is diffentive and no other testing is required. Is this true.

Response from Dr. Frascino

Thanks for writing.

The guy who continues to claim woman-to-man HIV transmission cannot happen is not from Mars! As it turns out, Martians (as well as all creatures in our solar system) know at least the very basic facts about HIV transmission! So, I'm thinking this dude is probably from another galaxy, perhaps that far-away star "Nincompoop" with its moons "imbecile," "cretin," "damnfool," and "jackass." Hopefully your "ding-dong, plunger sucker" explanation will help him.

Regarding your question about PCR (polymerase chain reaction) technology for HIV DNA and RNA, laboratory testing is definitely improving. This applies not only PCR testing, but also "branched-chain DNA" (bDNA) and other nucleic acid sequence-based amplification assays. The reproducibility of some of these commercially available tests can vary do to multiple factors. Briefly, I'll comment about their sensitivity and specificity.

1. Routine antibody tests (ELISA) have a sensitivity of 99.7%. It's readily available worldwide and relatively inexpensive (compared to the other testing methodologies). Its "specificity" is greater than 99.9 %.

2. DNA PCR sensitivity is 99%. It's used to detect cell-associated proviral DNA. "Specificity" is 98%. This is not considered sufficiently accurate for diagnosis without confirmation and therefore is not FDA-approved for this use. Its main use is for viral detection in the case of possible neonatal HIV infection, as well as for indeterminate antibody tests.

3. HIV RNA-PCR has a sensitivity of 95 to 98%. False positive tests occur in 2 to 8% of cases, usually at low titer viral loads. Sensitivity depends on viral load, threshold of the specific assay used, and status of antiretroviral therapy.

4. P24 antigen sensitivity ranges from 30 to 90%, depending on various factors. It's sometimes used as an alternative to HIV RNA to detect acute HIV infection due to reduced cost. "Sensitivity" is about 90%.

So are the Internet claims true? Perhaps, but would you really want a test that's only 95% accurate (misses 5 out of every 100 cases!) or that has as high false positive rate??? Yes, there are specific reasons for using these tests, but routine HIV screening is not one of them, at least not yet!

Stay well!

Dr. Bob



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