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having sex with a person who is HIV
Aug 5, 2009

I have been HIV for 2 year and 3 months and my viro load is undetectable tcell count is 573. What is the odds of having sex withsome and them contracting the virus? I also hear that it is easier for us women to get the virus verse us women giving it to men is that true?

Response from Dr. Frascino

Hi,

The CDC estimates the per-act risk for acquiring HIV from insertive penile-vaginal sex with a partner confirmed to be HIV positive (negative male partner, positive female partner) to be 5 per 10,000 exposures. If your HIV plasma viral load was driven down to undetectable levels with effective antiretroviral therapy, the risk of transmission decreases significantly, but it is not completely eliminated. In other words condoms are still necessary!

As for the ease of transmission, yes, it is easier (more efficient) for an HIV-positive man to infect an HIV-negative woman than vice versa. See below.

Dr. Bob

M to F transmission Nov 10, 2004

Dear Dr. Bob,

Thank you for your wonderful service. I would like to make two comments before I ask my question.

1. I appreciate your sense of humor. I believe such is theraputic and contagious as is evident by reading your forum.

2. I appreciate the cajones you display in expressing your political views and would like to add one point. Bush threatened [did he actually do it?] to withhold AIDS education funding in the SF Bay area for such education including sexual topics. I believe this is not a conservative agenda. It is hate.

Off my soap box and to the questions.

1. I am amazed at how many people still believe this is a homosexual disease. Further, many, even HIV+, believe it is impossible for a woman to trasmit the virus to a man. My ex and I used to go at it until there were clear points of entry [yes I was an idiot with an out of control libido,] regardless of what time of the month it was. So to speak. So, could you please spell out the ways in which a woman can transmit HIV to a man?

2. I understand the statistic of .1% - .2% odds of tranmission as stated here and in other forums and recognize that it is often qualified in some way. However, I believe that such statistics offer false security to heteros that are practicing unsafe sex. I have even heard medical professionals [where I receive my healthcare] refer to hetero transmission as extremely rare. To use your analogy, if a person buys a lottery ticket one week or 1000 weeks in a row, his odds of winning are the same. All that is required is the right numbers coming up or in the case of HIV transmission, the right physiological scenario [port of entry] to occur. Odds do not matter in my opinion. So, finally [whew, I am out of breath,] and respectfully I ask, is it not irresponsible to be throwing those stats around knowing that people will use it to rationalize unsafe behavior?

With respectfully and with admiration,

A fiend that learned the hard way....

Response from Dr. Frascino

Hi,

Thanks for your kind comments. Yes, the Bush Administration has cut off funding to some very effective AIDS prevention programs in the Bay Area, such as the Stop AIDS Project.

Next, are my cajones really on display??? Now I'm going to get arrested for sure.

OK, on to your questions:

1. It's really quite simple. HIV can be transmitted from human to human. After all, it's called HIV Human Immunodeficiency Virus, not GMIV Gay Male Immunodeficiency Virus. Yes, it is true that male-to-female transmission is more efficient than female-to-male transmissionapproximately 2 to 8 times more likely. This, of course, makes perfectly logical sense. If an HIV-positive dude spunks in an HIV-negative love canal, there is a large amount of infected material present that is in direct contact with mucous membranes that can absorb the virus. By comparison, if you have an HIV-positive love canal being poked and prodded by an HIV-negative unprotected one-eyed monster, the mucous membranes of the urethra (pee hole) do come in contact with the HIV-positive cervical/vaginal secretions. The urethral mucous membranes can absorb the virus; however, the amount of love canal HIV+ love juice and the amount of HIV-negative urethral mucous membranes exposed to the infectious juice are both considerable less than in the reverse situation, right?!? Hence, the up to eight-fold difference in male-to-female, compared to female-to-male, transmission.

2. Quoting true statistics is never irresponsible. The facts are the facts. The science is the science. The critical piece here is understanding what those statistics and facts mean. You are absolutely correct that each and every similar type of exposure would carry the same degree of risk. A sexual "Russian roulette" analogy might work well for understanding that each time you pull the trigger, you have the same risk of having a disastrous and very messy outcome. Is that a risk anyone, hetero or gay, wants to take, considering a thin piece of latex is all it takes to drastically alter the odds? Odds do matter. They help rationalize safer sexual behavior!

I prefer to think of you as a "friend" rather than "fiend."

Stay well!

Dr. Bob

Dr Bob, please help this crushing anxiety Jul 19, 2005

Love the forum DR. Bob- OK, here's my story- about 2 months ago, called a massage provider and she showed up at my house. Ended up having unproteced sex ( too much to drink)for about 30 seconds and then realized what I was doing-Arghhhhh.

So, have had reaccuring fever (3), sore throat and now Diarriha- Yes, am very concerned and just this side of freaking out, and took the PCR/DNA today along with Antibody test- My question, - How risky was my behavior and do you hear alot of stories about HIV infection female to male?

Thank you and will be making a 100.00 donation

Response from Dr. Frascino

Hi,

The estimated per-act risk for acquiring HIV from unprotected insertive vaginal sex is 5 per 10,000 exposures to an infected source. Your estimated risk would be even less, as we don't know the status of your rub-a-dub-dubber.

Regarding heterosexual HIV transmission, certainly male-to-female transmission is greater than the reverse. In fact, it's about 1.9 times more likely! However, that's just common sense. The receptive partner is always at greater risk than the insertive partner. If an HIV-positive guy spunks a load right into an HIV-negative love canal, the chances of infection would be greater than HIV-negative love canal fluids finding their way into an HIV-negative thrusting one-eyed monster, right? However, female-to-male HIV transmission is fact and accounts for a significant proportion of total HIV cases.

Do I hear a lot of stories about female-to-male transmission? Yes. The risk is real.

Thank you for your generous donation. Your one gift will touch many lives. On their behalf, please accept my heartfelt thanks.

Good luck.

Dr. Bob



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