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Breast milk adult transmission
May 19, 2006

Dear Dr. Bob, I am the guy who had protected vaginal sex with 3 condoms and then checked the outermost condom for leaks until it burst..Your answer really made a big difference in my life. Remember me? I sincerely express my most heartfelt thanks to you. I have seriously started addressing my OCD and gained some ground in my fight against OCD.

However, one incident about breast milk adult transmission is putting a spike in my OCD recovery. I sucked a girl's right nipple and 1-2 drops of white breast-milk entered my mouth..She was not pregnant, but she was lactating due to a breast surgery which she had done 1 or 2 weeks before this episode of nipple-sucking to increase her boobs. Two months have passed since the incident, and I have encountered no ARS symptoms. I have researched your archives, and you have mentioned that the HIV risk of nipple-sucking is "essentially non-existent" and "no testing is needed". My questions are as follows: 1) Does nipple-sucking remain no-risk, even if 1-2 very small drops of breast-milk enter my mouth? 2) How likely is it to get HIV-infected during breast surgery in a developed country (Japan)? 3) Assuming she got infected during her breast surgery, her viral load would be sky-high. In such a situation, could 1-2 small drops of breast milk transmit HIV? or would it still remain no-risk? 4) From a medical standpoint, would you recommend HIV testing for this exposure? I have had no other risks and I always play safe to the point of obsession. 5) I could not find any statistics on breast milk transmission among adults, but I estimate that the risk should be less than 0.5 in 10000 exposures (oral sex risk) since semen quantity in oral sex is much more and semen contains higher concentration of HIV than breast milk. Can you give me some statistics about adult breast milk transmission via nipple-sucking?

Dr. Bob, please help me to bounce back in my fight against OCD. If Elvis was alive, he would have sung the song "You are the ANGEL in disguise" for you! From a nipple-sucker (now an OCD warrior)

Response from Dr. Frascino

Hello,

Three-Condom-Guy! How could I forget you?

OK, on to your questions:

1. Breast milk from an HIV-positive woman can transmit the virus while breastfeeding infants. There are no recorded cases of HIV transmission via breast milk in adults. However, there is at least a small hypothetical risk. Do I think you should worry about 1-2 drops? No. Absolutely not.

2. Not at all likely.

3. This hypothetical situation is so hypothetical as to make the question unanswerable.

4. From a medical standpoint, no, I do not feel HIV testing is warranted. From a mental health standpoint, if you are worried, get tested! A simple 20-minute rapid test three months after your titty nosh will calm all your residual or lingering fears.

5. There are no statistics, because there are no reported cases. Consequently the risk remains only theoretical.

Dr. Bob



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