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IRONIC ANSWERS FROM YOU
Jul 23, 2008

Dear dr. Bob,

I posted a recent question with the title of "Local Delight" because I can't seem to find a similar case of mine in your forum.

However, I found these 2 answers to be ironic:

HIV, Breast milk & pasteurization Nov 16, 2006

Dear Dr Frascino, Please help me with your kind advice - I'll be most happy to donate to your cause!

I'm a 30 yo male, and unfortunately, I've always had a breastmilk fetish. I've managed to control this fetish. But recently I flirted with a single mother of an infant and though no intercourse was involved, I drank quite a lot of her milk - 4-5 ounces. I don't know her HIV/HEP status.

The thing is, I expressed her milk into a bottle & then I took a 6 hour trip home. The milk was transferred to a glass cup and it was put in newly boiled water in a kettle for about 5 minutes. This process was done twice before I drank her milk after it cooled down.

My question: Will this be sufficient to kill HIV or Hepatitis B/C in the milk???

I just couldn't help myself. Should I get tested?

Doesn't HIV die once outside the body for a short period of time?

Response from Dr. Frascino

Hello,

Sorry, but I'm not aware of any scientific data that specifically address your question. As you can imagine, the question just doesn't come up all that often! I can tell you, heat or no heat, the risk of HIV transmission via breast milk in adults is negligible. If you remain concerned, get a single HIV rapid test at the there-month mark.

Good luck.

Dr. Bob --------

and

--------

Mother to child transmission Mar 29, 2006

Hi Dr. Bob. Let me start off by saying THANK YOU for all you do. You're amazing and I read your posts every day. The reason I'm writing is because I have a very important question.

I do HIV Prevention for women in Alameda County. I recently came across info on the Women's Forum of thebody.com that I don't understand. I asked a question to them on Mar 14 but no response for 2 weeks now.

The Dr. said that transmission from mother to child can happen DURING the pregnancy. At my CHOW training we were told that this is very rare and usually only happens during high risk pregnancies or if the sac is punctured. As far as I understood, it's mostly transmitted during vaginal birth or from breast milk. Can you please clarify so I can give my clients the accurate info. I guess a simpler way to put it - how exactly is HIV transmitted from mother to child? Your response is much appreciated. Keep up the good work.

And thanks for the laughs. Some posts and responses make me laugh until I almost cry and definitely make the day go by much quicker!

Rachelle

Response from Dr. Frascino

Hi,

I lived in Alameda when I first moved to the West Coast. I still remember jogging on the beach with a great view of San Francisco every morning before rounds at the hospital.

OK, enough memory lane and on to your question!

Infants may acquire HIV antepartum (in utero), intrapartum (during birth) or postpartum (after birth via breastfeeding). For women who do not breastfeed, intrauterine transmission previously accounted for 25% to 40% of infections, while delivery accounted for 60% to 75%. [MMWR 2001; 50(RR-19):63] More recent data from the WITS study in the U.S. shows in utero transmission now accounts for more than half of mother-to-child transmission (MTCT) in the U.S. (J. Acquir Immune Defic Syndr 2005; 38:87). The risk of HIV transmission with breastfeeding is 10% to 16%. This risk is greatest in the first four to six months.

I'm glad you enjoy the forum. I'll repost a few classics from the vault to hopefully start your day with a chuckle.

Stay well.

Dr. Bob

Will Procrit help? Jun 16, 2005

Hey Bob,

Feeling really tired and run down lately. Will Procrit improve my energy level? I'm not HIV positive and have no idea if I'm anemic but I sure feel low. I broke up with my girlfriend. She caught me in bed with a guy. It really wasn't going to work out with her anyway. As if things couldn't get any worse, I was laid off from my job and for financial reasons and now I've had to move back in with my mother. My ex called her and told her about my sexual adventures. Mother who is Bapist didn't take the news well. She refuses to let gay books or movies in the house. She's even screening my calls. Thank god she doesn't understand computers or the internet! So what do you think Dr. Bob, should I give Procrit a try?

Dirk

Response from Dr. Frascino

Hello,

OK, Dirk, sorry, but it sucks to be you. Your girlfriend finds you mano-a-mano with the UPS guy making a special delivery in the boudoir, so she calls your mother??? Dude, you are so right. It would not have worked out with Little Miss Tattletale.

And then after getting laid, you get laid off and have to move back home with the Church Lady? Damn, no wonder you're feeling down and out (or should that be down about being outted?).

Regarding Procrit, it's a wonderfully effective medication to treat certain types of anemia; however, you most likely are not anemic. To find out, you would need a simple blood test called a hemoglobin level. If you have less than 14 g/dL of hemoglobin, you are anemic. But again, I strongly doubt this is your problem. Your lack of energy is most likely due to situational depression. After all, Dude, you just had to move back in with Mom and now you have to sneak gay stuff into your bedroom? How about this forum? Do you have to sneak us in as well? We love it when guys sneak us into their rooms. It's so Baptist-sleep-away camp! Hey, there's an idea. Maybe your mom could send you to Baptist-sleep-away camp. Then you'd have two whole weeks of gay freedom! But if that doesn't work out, for the time being I guess you'll just have to grab your dick and double click.

Good luck, Dirk. I think you may need it.

Dr. Bob

I don't know if I got a lap dance. Jan 20, 2005

Hello - I was just wondering what you consider a lap dance. I had a naked chick rubbing her pussy all over the tip of my dick. I was wearing uderwear and a bathing suit. (1) is that what you call a no risk lap dance. (2) whats my risk? Thanks

Response from Dr. Frascino

Hello,

Not only do you not know what a lap dance is, but apparently you can't tell the difference between a swimming pool and a titty-bar. Why were you wearing a bathing suit and your Calvins??? Oh, never mind.

If a naked chick is rough riding your fully dressed big bopper, chances are you are indeed getting a lap dance, especially if she's wearing red cha-cha heels, there is loud bad disco music playing and a burly sweaty dude named Bruno is sitting nearby with a raincoat in his lap.

I would consider your HIV risk to be essentially nonexistent. I think your biggest worries should be 1) Bruno and 2) being busted by the fashion police.

Stay well.

Dr. Bob

----------

There you said "heat or no heat" breast milk cannot transfer HIV.

But on the 2nd article , you said it accounted about 10-16%.

Which is true?

Is breast milk only transferable to BABIES or NEWBORN? And NOT to adults??

I'm confused.

Eugene, Seattle.

Local Delight (Submitted Jul 17, 2008)

Dear Honorable dr. Bob,

My name is Eugene and I am from Seattle, Washington. Last week or so, I planned a trip down to Bali, Indonesia with a bunch of my friends to have a break from boring schoolwork and have fun at the beach surfing or so.

Then came the night life which was very interesting. We all went to a massage place where they also provide "extra" services.

The problem was that the Balinese masseur said to me that she had just given birth to a son who is now 2 months old. And that while giving me that "extra" service of a hand job, I opened her clothes to suck and lick both her nipples. I also kissed her chest above her breast and it tasted salty, I assume it was her sweat. But I didn't remember tasting the saltiness on both her nipples.

Anyway, I was freaking out when my friend told me that she might get infected with HIV and that while she is still breast-feeding, she might transfer her milk to me and I happened to suck her nipples.

I ask one of my friends who is a local there and he told me that most Indonesian masseurs who work that kind of place usually lie about their condition (having babies etc) to earn extra tips because we sympathize them.

But I am still freaking out if she has HIV and I suck her nipples, what if the milk also got suck out??? What is the chance?

I don't remember tasting anything "milky" nor "watery". I can only taste my own saliva and feel it as I tickle her nipples.

When I observed her body too, she didn't seem to have just given birth because her stomach was not even bloated or seemed after giving birth.

I did see some fats coming out from the tightness of the bra though.

HELP ME PLEASE Dr. BOB. Please answer me, I promise I will make a donation!!!

Freaked out boy in Seattle.

Response from Dr. Frascino

Hello Eugene, aka "Freaked Out Boy in Seattle,"

I combined some of your questions below. I'm not exactly sure what you mean when you say my answers are "IRONIC." Ironic is an adjective defined as "marked by or displaying contemptuous mockery of the motives or virtues of others." I don't really think that applies to my responses! (However, I did enjoy rereading some of the funny posts from the vault included in one of the questions you referenced!)

Eugene, the bottom line on breast milk is that it can contain high concentrations of HIV. HIV transmissibility via breast milk, however, depends on who and how. An adult can ingest a small amount of breast milk with very minimal risk. But an infant, with its very small body and immature immune system, consumes vast quantities of breast milk relative to its size and weight. Consequently, an infant is at risk from breast milk, whereas an adult probably is not. I have addressed this concern multiple times in the past. (See below for an example.) Also, from reading the details of your Balinese boob-a-thon, your HIV-acquisition risk is nonexistent. If you don't believe me or need additional reassurance, get a single rapid HIV test at the three-month mark. The result will undoubtedly be negative. That should put all your residual (and unwarranted) worries permanently to rest, OK?

Thanks for your donation and for unearthing those vintage humorous posts from the past!

Be well.

Dr. Bob

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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