Does All of this Add Up?
Sep 17, 2017
I am a CLL patient who last had Chemo in December, 2016. Since then I have had low IG levels and three rounds of IVIG to boost my immune system. I recently went to a strip club and sucked the breasts of a dancer that I later learned had given birth four months earlier and stopped breast feeding two months earlier. I asked her was she lactating and she said she could produce milk only if she squeezed her nipples hard. I also have a "pimple" type lesion on my gums from an impacted tooth: no blood in the saliva even after brushing. I do not know if any breast milk made it into my mouth or if so how much. I know from your forums that HIV transmission to an adult via breast milk is only theoretically possible (correct?). This incidence took place ten days ago and an IVIG treatment four days ago. I am having some types of symptoms: body and joint aches predominantly. No fever, no rash, no headache, I don't think any swollen nodes. I was very tired yesterday but better today. In your opinion when I add together lower than normal immune system + non bleeding lesion on my gum + I do not know the HIV status of the worker + I do not know if I ingested any/how much breast milk do I pose anything beyond a hypothetical risk? Do my symptoms of one day of fatigue plus minor joint and muscle aches indicate seroconversion? I will get tested at three months but man, that is a long time from now!
Thank for your help. In memory of Dr. Bob,
Response from Mr. Jacobs
Hi Max, thanks for writing in. Fortunately the events you describe are only hypothetical risks. Let's consider first and foremost the possibility that the dancer was a person living with HIV. If she had recently given birth then she would most likely be on ARVs (anti-retrovirals) to treat HIV while pregnant and breast feeding. With the current medications available, most people can obtain an undetectable viral load within a relatively short period of time. Once someone with HIV is undetectable for six months or longer, they can not transmit HIV to another person (http://www.thebody.com/content/77932/sex-58000-times-with-undetectable-partners--zero-h.html). So in that regard there is no risk there.
But let's then say for the sake of argument that she did have HIV, was not in treatment, had a detectable viral load in her breast milk. How exactly could it enter your body? You said you don't know if any entered in your mouth. Fair enough. But even if some had, even with a pimple-like sore in your gums, even if your gums were irritated, there is simply no opportunity for transmission.
Yes, you have read here at The Body.com that an infant can readily acquire HIV from breast milk if the mother has a detectable viral load. But there are no known cases or reports of this ever happening between two adults.
Interestingly enough, Dr. Bob was asked this question several times while he was writing this column. He complied a collection of his answers back in 2008 (http://www.thebody.com/Forums/AIDS/SafeSex/Q190879.html). The only thing that has changed about this in the past nine years is the confirmed knowledge that an undetectable viral load for six months or longer means untransmittable.
The other good news is here is that in most places you need not wait three months to get accurate results. With the current testing protocols you can often get accurate results within 7-28 days, depending on what kind of test is used (http://i-base.info/guides/testing/what-is-the-window-period).
So what's going on with all the body and joint aches? That would be up for a doctor to determine. If you are certain they are not side effects of cancer treatments, then I'd speculate they are coming from your anxiety. Fear can wreak havoc on our immune systems, and so can guilt if you are at all uncomfortable with any of the activities you enjoy. If you are physically reacting to HIV fear, especially when it is medically unfounded, you may want to consider speaking to a therapist in your area.
So I encourage you to relax, get tested, and once that HIV negative result comes in, think about how to take care of your body, mind, and spirit in a way that helps you to feel sexually empowered and medically confident. I hope things work out!
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