Questions & Answers

HIV - Questions & Answers
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Our Most Recent Question
Hello Mark,

HOPEFULLY you're still replying to emails because I need your expertise. Couple weeks ago I was messing around with a girl who was on her menstrual cycle. There was never any penetration, but for about 1-2 minutes, there was genital to genital contact where my penis was touching her vagina, but not going inside. Assuming she is HIV +, how much risk am I in?

There weren't any visible open cuts or soars on my penis, but I do scratch my penis sometimes, so perhaps there were small abrasions there that I couldn't see with my eye. Some people say an "open cut/soar" can only be a route for HIV if it is fresh and bleeding. Others say a papercut or microscopic cut would be sufficient. What do you think?
Thank you!!!
The Reply...
Hi, Yes I am still replying to my e-mails - and often putting the messages online too. As for needing my expertise, I would never claim to be an expert on the matter, though my knowledge of HIV is nonetheless, pretty thorough.

To become HIV+, you need to find a way of getting the infected fluid from the HIV+ person into your bloodstream somehow, a cut would seem at first thought, a good way, but it is not - thankfully - that simple.

Even if you have a fresh cut that is oozing a little blood or clear fluid, the general flow of fluid is FROM you body outwards. Your blood stream is pressurized and therefore for something to get into your bloodstream this way, you would need to "push" the other fluid in. It can happen during intercourse where the friction of the penis inside a vagina or rectum can push the virus into the bloodstream.

In your case however, your penis would have needed to have the vaginal fluid or blood from her "pushed/rubbed" into any abrasion that may have been there. In theory, the virus can also enter the bloodstream through the delicate lining of the meatus (pee hole) but again, there would need to be some kind of force present to "push the virus in".

Certainly you could easily prove in a laboratory that a "paper / microscopic cut" is large enough to allow the virus to be pushed into your blood stream, however you can prove lots of things in a laboratory that hardly ever occur anywhere else.

From what you have said, the chances of your contracting HIV in this way would seem to be very very small indeed, there is however at least a "theoretical risk" that it could have happened. To try and put things into perspective, on perhaps a similar scale of probability, I might win the Jackpot on the lottery next week. Bloody unlikely but it could, at least in theory, happen.

I'm afraid the only way you will know for sure is if you decide to have a test. If you do take this option, you will need to have a test at least three months after the encounter above that you mentioned - because it takes this long for the virus to become detectable (by causing your body to make antibodies which then show up on the test). Depending on your personal resources and where in the world you live, you could pay privately for a more complex and expensive test - the "Antigen" test - which actually detects the presence of the virus itself (rather than the antibodies), this test can be done much sooner but due to it's complex and lengthy procedure is only likely to be available if you pay for it.

If you would like to discuss this more, please feel free to write to me again. For more information about the test, please see the paragraph "Testing Times" on the HIV info page - http://www.mark.lineisp.co.uk/hiv1.htm

I hope that helps to answer your question.
Mark

Next Question....
hello,hope that this letter finds u in the best of health n spirits.i got ur email address thru one of my buddy and he was really appreciating you for helping us out with our queries. i would like you to throw more light regarding hiv transmission. 1 week back i had this episode with a callgirl which is slightly bothering me.i got her to the bedroom and inserted one of my finger into her vagina .this stuff lasted for a couple of seconds(say 25-30 seconds). i did not do any thing else with her and i did not even allow her to kiss me.at the time of this episode i could not see any visible cut on my finger and i did not se any visible blood or any thing of that sort.i made sure that i did not do any thing silly with my finger after this episode. do you think this incident has put me at a risk for hiv? i would really be very pleased to hear from you soon. thanks a lot and sorry for bothering you with such a long letter. best wishes,  KEEP UP YOUR GREAT WORK!!!!!!!!!!!

The Reply...
Thanks for your kind words. Also, there is no trouble in "bothering me" with a long letter. It helps to know what is involved as sometimes it can make a difference.

From what you have said, the risk is virtually nil. To become exposed to HIV infection, the virus needs to find a way into your bloodstream. Either through a needle, sexual intercourse or (extremely rarely) oral sex. The way this happens is if semen, blood or vaginal fluid is "rubbed into a wound" - eg: a cut or sore in the mouth, vagina or anus.

Fingering or "digital sex" is generaly regarded as extremely low risk. (To contract HIV, the person you are fingering needs to be positive, you need to
get HIV+ fluid on your finger and then the finger would need either to have a cut or sore on it - or the finger would need to be placed on a cut elsewhere and the fluid "rubbed in".

Just to keep things super-safe, there is no harm in making sure you finger is free from any cuts or sores before you begin. Then, when you have finished, rinse the finger(s) under running water. Some people choose to user "finger stalls" which are basically tiny condoms for fingers, you can get them from chemists. Many people consider this to be excessively cautious - but if you have a cut or sore finger, it can help to keep things ultra-safe.

What you did, would generally be regarded as being EXTREMELY low-risk from an HIV point. I hope this has helped to clarify things for you.

Mark

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hello.i got 2 incidents in mind which are kinda worrying me a bit.  let me first tell u abt the 1st incident  i had gone to a bar and there were a few girls dancing seminude(exposing  their breasts). i presses one females breasts and played with her nipples
.i  did not suck them or expose my penis .i only fondles her breasts for sometime and then i made sure that i do not touch any part of my penis,mouth or eye.i then washed my hands with soap after some while. does this activity pose me at risk to hiv?
the 2nd incident is also exactly the same.but in that incident i only touched the female's nipple and then washed my hand after some time. in both the incidents the female touched my pants in the area covering my penisand tried fiddling there.but i had not removed my pants or underwear.
plzz reply

The Reply...
As there was no contact with vaginal fluid, semen or blood (breast milk is only a risk to babies), AND you washed your hands, you were exposed to no risk from HIV unless there were other activities that I am unaware of. In short, what you did amounted to very safe sex from an HIV point of view.

Hope that helps, Mark

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About two and a half weeks ago I met a girl at a bar and proceeded to have oral sex with her that evening. I performed oral sex on her with no protection for about 2-3 minutes. We did not have any type of sexual intercourse (Vaginal or Anal). The next day I had a sore throat that has not gone away. I also may have some sort of growth way on the back of my tongue, it is so far back that it is difficult to see. It does seem like I get the chills once in a while but I have not had any fevers, swollen glands, diarrhea or anything else. I have really been worried about this, there is not a minute that goes by in the day that I don't think about it and I am starting to stress out about it. Does this sound like possible HIV infection or is this possibly something else?

The Reply...
First of all, sorry for the long delay in replying. I was overseas for a fortnight and was unable to retrieve my e-mail. HIV does not really have any "useful" symptoms as such, those that can exist are nearly always the symptom of something much more simple - like the common cold. The symptoms you describe are nothing even vaguely near the mark anyway. As a point of fact only around 20 cases in the whole world of HIV have been liked to oral sex, of these nearly all of them are from sucking a penis rather than a vagina and of these few vaginal ones (about 3 I think last count), it seems dubious if that was the only method the virus could have been transmitted. All sex - other than masturbating yourself - could be argued to contain a theoretical risk but with vaginal / oral sex, the likelihood of you contracting HIV would appear to be in the order of hundreds of millions to one against. However, it does sound as though you may have picked up a little something, quite possibly nothing to worry about but I would suggest that you might like to visit a GU clinic (nice name for the clap clinic) just to put your mind at rest. You can always give a false name but they operate under extremely strict codes of confidentiality anyway. Without knowing more about the growth I am unable to suggest terribly much. It is remotely possible that you have contracted genital warts there - I believe they can live in the mouth but I am NOT familiar with all the possible infections that can be acquired - only HIV.. Hope that helps a bit.
Regards, Mark

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What are the chances or contracting HIV from fingering a women's vagina and from getting a blow job from a women?

The Reply...
Dear Anon, Providing the finger in question is healthy and has no open cuts, sores, abrasions or other damaged tissues, the chances of contracting HIV by fingering a vagina (or penis, anus for that matter) are NIL to all intents and purposes. The only time risk becomes present is if the finger is not in good health and there is either broken or damaged skin around. In essence, the virus needs to get into your blood stream before it can infect you.
With regard to oral sex, it tends to very low risk anyway but with HER giving YOU the blowjob, the risks are again NIL to all intents and purposes. For you to contract HIV from her, you would need her to have an open bleeding cut in her mouth and to be "blowing" on you rather than sucking you - or using very heavy friction with the lips. This could in theory "push" the virus through the delicate membranes on the head - or glans - of the penis. Obviously if you have an open sore / cut on your penis, the risk would increase. I think the only way to sum up the question is to tell you that as far as I am aware, there has yet to be a SINGLE case of HIV being passed on through fingering, and only a dozen cases or so WORLDWIDE have resulted in someone being HIV+ as the result of a blowjob, in ALL cases, the person doing the sucking was infected from the suckee. In short, have fun and enjoy, if your finger/penis or her mouth is bleeding or has open cuts sores, play safe, otherwise, go for it.
Have Fun, Mark

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Mr. Tibbert I am very afraid that I may have put myself at risk for HIV infection. About one month ago, a woman that I have recently found out may be HIV+ (unconfirmed, but she has had numerous unprotected encounters) performed oral sex on me (fellatio) to the point of ejaculation. I then stimulated her vagina with my fingers and hands, and did penetrate her vagina with my fingers. We at no time had actual sexual intercourse. We continued these activities for a few hours. We then proceeded to shower, at which time I stimulated her with my hands again. While stimulating her vagina (I was standing behind her, reaching around her waist), she attempted to insert my penis into her vagina. As soon as I realised this, I backed away from her, ending our contact. As far as I can tell (again, standing behind her), my penis may have grazed against her vagina, but did not penetrate. Now for my chief concern. I had nicked one of my fingers a few days earlier. The cut had already started to heal, and stopped bleeding for about two days or so. Also, I had used Neosporin (antibacterial cream) on the cut in combination with a plaster, so there was no scab present. I noticed after the contact with the woman, the cut had still not completely healed. I don't recall having seen the cut bleed any time during the entire episode. None the less, the cut had not completely sealed up yet, so I consider it to have been an open wound. Incidentally, the cut sealed up about one to two days later. Based on this account, do you think I may have been infected through the nick on my finger, and would you consider me to be at high risk for HIV and/or other diseases? Please respond as soon as possible, as I am very afraid and concerned over possible infection.... Thanks for your time and concern in this matter! Mr. A

The Reply...
Dear Mr. A For some reason - a very pleasant one - almost every single letter written to me these days seems to have involved - at most - only marginal risk, this is no exception.

From what you have told me, the chances of you having been exposed to HIV are remote in the extreme. Oral transmission from female to male is - as far as I am aware, still unheard of. The stimulation on her vagina with your fingers is also mightily low risk - even notwithstanding your cut. In the first place, if you cut yourself you "bleed out", that is, the blood/plasma would wash any virus away unless you used excessive friction to "push the virus in". Also while I take on board the fact that your finger did not have a scab on at the time, it had nonetheless healed itself from what I can gather. The ointment would also be another helpful factor to take into account. Even after all of this, transmission would still be impossible unless she was in fact HIV+. I do not think your cut would still be classed as an "open wound" just because a scab had not formed. Cuts under plasters don't always scab over and yet heal perfectly well. If the contact with your penis was simply "brushing against her vagina", again I think you can dispense with the fear of contracting HIV from this encounter, the virus needs to find a way into your bloodstream, it just can't leap over and infect you in this manner. IF she was HIV+ AND your penis had an open cut or sore AND you got vaginal fluid on the penis AND you PUSHED vaginal fluid into the sore then you WOULD have faced a risk. On a more practical nature however, other nasties, pubic lice, warts etc can be transmitted by very causal contact. Syphilis and Ghonorea (sp?) can also be spread by oral sex, and - rarely - even from mouth to mouth. On a practical note, I would suggest you sleep easy tonight, your risk of contracting HIV from this encounter are as close to NIL as you can get. It is just possible you may have acquired something more however. Don't forget that oral sex can pass on herpes very easily. As a general rule, never accept any oral sex from someone with cold-sores on their mouth. If you really must, then use a condom and you should be protected.
Very best wishes, Mark

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Mark, Thanks for a great site. I notice it was last updated in October of 1998, so I hope you are still actively answering questions. I am desperate for some information. My fiancé and I have been together for many years, and we are both monogamous. I have, for as long as I can remember, suffered from cold sores occasionally -- perhaps 5 or 6 outbreaks a year, which are always inside my mouth, never along any exposed skin. I often perform oral sex on my fiancé, but we are careful never to engage in oral sex when I have an outbreak. The problem is that two nights ago, I performed oral sex on him without knowing that I had a cold sore far up my gum line, between the lip and the gum. I noticed it the next morning. Does the cold sore have to come in contact with him for infection to occur? Is the saliva infected? What are the chances that a single occurrence can infect him? In short, have I just transmitted herpes to my fiancé????? Please advise me if possible. J

The Reply...
Greetings. Thanks for the comments and YES the page is still updated. In fact I'm curious to know where you got the date from as I last updated this page no more than about two weeks ago - see next question down! Anyway, although I will do my best, my knowledge is with regard to HIV rather than other STIs. That said I will do my best. The first thing that grabbed my attention is that you say the cold sores are INSIDE your mouth. So far as I am aware this is NEVER the case with a genuine cold sore. It IS the case however for a canker sore. These are oral lesions that are characterised by small round, yellowy-white areas inside the mouth surrounded by a sharp halo of red. The good news is that while cold sores ARE contagious, canker sores are not.

The upshot of all this is while someone - possibly even an ill-informed doctor MAY have told you that you had cold sores, it would seem almost certain that this is NOT the case. I cannot guarantee that what you do have is a canker sore but is seems exceedingly likely as canker sores appear on the inside of the lip or cheek and sometimes on the tongue. They are caused often from minor injuries - a slip with the toothbrush, a jab from a taco shell and even some sharply acidic citrus fruits CAN trigger one. Although they can hurt like hell they don't usually last very long. Using a styptic pencil (barbers often use them to stem bleeding from a minor nick), carefully dab the blister, this will help to numb the nerves. Avoid spicy foods and reduce smoking and alcohol while the sore is present and it should give you less pain and heal faster too.

If it WAS a cold sore - which I will lay you money against it being - then the saliva CAN transmit the virus. This is why it is unwise to even share cups - let alone kiss if you - or the other person - has cold sores. If you have a blister that develops on you lip you may well have Herpes but if the blister is elsewhere you almost certainly have something else. My money is on a canker sore - painful but not harmful or contagious.

If you need any more reassurance, feel free to get back to me and/or consider popping along to a clinic for a quick check-up.
By the way, the great news is that once you have confirmed that this is definitely not a cold sore, it means there are no more "no-go days" for you and your partner!
Very best wishes, Mark

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Hi. I've had a few "risky"? sexual encounters in the past 2 years. I've given blowjobs to a few guys without protection. None of these went to climax, no ejaculation whatsoever, but I'm still a bit nervous. I have read some news about precum being infectious. Should I be worried. Is precum that infectious since its in such small amounts. I have pretty good oral hygiene. see a dentist regularly etc. Please respond.

The Reply...
Well precum (cowpers fluid) DOES contain the virus if the person in HIV+. The virus is present in large enough quantities to be regarded as a "transmittable fluid", this is because it contains semen. Although the quantity is usually fairly small, there is STILL enough virus in a drop of pre-cum to infect someone. However, before you despair, although thoughts ARE rather divided on this one, it does not appear that transmission occurs from oral sex very often - even when the person being sucked IS positive.

It is pleasing that you have good oral health, providing your mouth and gums are in good condition (and throat too) it is unlikely that the virus will find a way into your bloodstream. Swallowed semen / pre-cum seems not to be a problem as the virus is destroyed by the contents of the stomach extremely quickly. Although I cannot say that unprotected oral sex is safe, it is certainly a lower risk activity than intercourse. Indeed as condoms DO fail from time to time, I would suggest that it is safer to have unprotected ORAL sex, rather than protected intercourse. At present there are only a handful of cases WORLDWIDE where infection seems to have resulted from oral sex.

Keep looking after your mouth/gums/throat, avoid giving oral if you have brushed or flossed you teeth within the last three hours or so. Also avoid if there are any other curs/sores/abrasions in the mouth or throat.

It is safer to swallow rather than spit as a rule as the virus is killed in the stomach BUT if spat out, the pressure build up in the mouth while spitting could possibly "force" the virus through the delicate lining under the tongue.

In short, I do not think you have put yourself at anything more than a theoretical risk. If you are still unsure / unhappy you could consider having a test but I think this would probably be rather over reacting. Keep in mind that HUNDREDS of MILLIONS of guys get sucked of EACH DAY. So far less than a dozen MAY have contracted HIV this way. Be happy, enjoy your sex, look after your gob!
Very best wishes, Mark

Next Question....
Hey Mark! Just read your HIV info page and I must say, you're doing a lot of people a great service by answering their questions. It seems you've done a great deal of research on this topic, as have I. However, while I don't know your motives for the exhaustive research, I can tell you mine. I'm worried. Actually, I think "worried" understates my condition. I obsess on the remote chance of being positive. I've tested negative, twice, and by current risk category definitions, as I know them, I haven't put myself at risk anyway. But tell me what you think: The riskiest thing I've done is giving unprotected oral sex to some women. No penetration during this, and never during menses. The activity mostly consisted of licking and sucking of their clits, to be graphically accurate... My own dental hygiene is good, no bleeding gums, except occasionally after brushing my teeth, and only a small bit then... also, I never engaged in oral sex immediately after brushing (or flossing, for that matter). To my knowledge, none of these girls were positive, but working on the worst case assumption (that they _were_ positive), what if any, are my chances of catching HIV. (I'm aware of the other things one can catch from unprotected oral sex). What's spawned my current set of fears (which are hardly ever abated anyway), is my girlfriend's first yeast infection.. not a recurrent one, or even an overly severe one. But we've been dating for about 6 months now, in an exclusive and monogamous, albeit unprotected sexual relationship... and I just want to put my mind at ease that I've put her at any risk whatsoever. Any thoughts on this would be greatly appreciated. I've scoured the net for info, but it hasn't calmed my nerves. Thanks!

The Reply...
Well, thanks indeed for your kind words. My motives for the site are simply that I have lost a few people I knew to HIV and as well as making sure I was taking no chances with my own health, I decided to spend a little time in trying to help educate those who are willing to listen.

I have to say that I consider you have put yourself at practically no risk whatsoever. As you correctly delay oral sex after brushing/flossing your teeth, it really is rather difficult to see how any virus could find its way into your blood stream. I think you are extremely wise keeping your mouth/gums in good order - and for that matter, it is prudent to regard a badly sore throat as a temporary "no-go" sign too - particularly if any blood is present in any thing expectorated.

I think it terribly hard to try and "explain away someone's fears". The fears and concerns are very real for those experiencing them and I feel that no matter what I - or anyone else says, you will still be slightly apprehensive. If you can control these fears and rationalise them for what they are - minute in the extreme - then I suppose the extra diligence you will make in having safer sex can only be regarded as a good thing.

With regard to the yeast infection, this really has no connection in any way shape or form with HIV. As you correctly state, other infections ARE easily transmitted orally, but a yeast infection is neither untreatable, nor life threatening. As an aside, your girlfriend may find the application of NATURAL LIVE yoghurt both soothing and an effective treatment. Do not apply if using an electric blanket though or she will find the yoghurt has curdled overnight in the heat! Yeast infection (thrush - candida- most often) can often be acquired without any sexual activity whatsoever - new born babies sometimes have it in fact. If your girlfriend has recently had antibiotics for something, this may trigger a yeast infection - NB: If you girlfriend uses the contraceptive pill ever, antibiotics can render them ineffective. Another reason to stick with the Condom.

I don't think you have put yourself at any real risk with your oral sex in the past. Therefore, I do not consider that you have put your girlfriend at any risk. Clearly however, if you are having unprotected sex at the moment then if your present girlfriend had the virus, she could pass it on to you through vaginal / anal sex. As I noted above, if you are having penetrative sex and she has a yeast infection, you may like to check what form of contraception (unless you wish to conceive) you are using and that is working effectively. If you have any further questions, please feel free to drop me a line.
Very best wishes, and thanks again for the kind words, Have Fun. Mark

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First of all, I must say you have a very informative site. I learned quiet a few things from the questions that were posted there. I, too, have a question. I have heard that the chances of contracting HIV are higher for men who are the receptive (bottom) partners than they are for the penetrative (top) partners during unprotected gay sex. Is there any validity to that and if so, why?
Thanks for you time

The Reply...
Thanks for your kind comments, they are appreciated. In answer to your question, the chances of contracting HIV if you are the passive partner (male or female for that matter) ARE higher than for the active. Here's why: When sex takes place - particularly anal sex even the most gentle of lovemaking results in minor tearing of the lining of the rectum. These tears and abrasions are often so tiny that they do not "bleed blood", but just seep a little clear liquid - plasma. Now if an unprotected penis is present inside the rectum, any semen OR pre-cum (cowpers fluid) that finds its way to those tears and abrasions present a risk of infection if the active partner is HIV+. If the active partner continues to "thrust" after he has ejaculated, the friction can also help to "push the virus" into the tiny tears and abrasions.

Now, if you assume for a moment that the passive is the person living with HIV and the active partner is uninfected, how is the virus going to enter his bloodstream? The only likely way is through either the hole (meatus) in the penis OR under the foreskin (if present) where the tissues of the penis are both delicate and also fairly thin. Although HIV transmission to the active person most certainly DOES happen, it needs either blood (or plasma) from the rectum of the passive partner to enter either the meatus OR the delicate tissues of the penis. These tissues and membranes are so fine that it believed that the virus CAN cross through into the bloodstream. Obviously if the penis has piercings (Prince Alberts etc), or is in a grazed/sore state, then this risk increases. The reason therefore that transmission is less likely from passive to active is that penis is generally much more robust than the rectum lining and when the active person ejaculates, he will hopefully "flush-out" any infected fluid from the tip of the penis. I do not know the percentage differences of risk for having unprotected passive sex compared with unprotected active risk but would strongly advise the use of a condom in which ever role you choose to play. A bit of a lengthy answer but at least you now know the reasoning behind the logic!
Take Care, Have Fun. Mark

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Dear Sir / Madam, I guess I am over sensitive, but I tend to worry a lot lately. This is because I have a friend whose boyfriend is a drug addict and she use to have sex with him quite frequent. The problem is, I use to share drinks and food with my friend. I am worried if , the saliva could transmit the virus to me. I know the possibility is very small but I couldn't help worrying. Sometimes if someone sneezes at me or cough at me I would start to worry a lot too. I would appreciate if you could enlightened me on this. Thanks and best regards.

The Reply...
OK, nice simple one this. You can stop worrying about HIV being transmitted through Saliva. It simply CANNOT be spread in this manner. To put it bluntly, you could "drink" half a pint of someone's saliva who was HIV+ and you would be at NO RISK whatsoever from contracting HIV from them. You may like to bear in mind however, that certain things like colds, flu, hepatitis, CAN be transmitted through saliva however and you might like to bear in mind that sharing a cup with someone MAY result in you catching a cold etc. To repeat however, there is ZERO danger of contracting HIV from saliva. For that matter, urine, sweat, tears, mucous are also considered to be entirely harmless (when it comes to transmitting HIV) - even if they come from someone who is HIV+
Hope that helps. Mark

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Mark, I Have been dating a fella for 9 months and decided finally to become intimate. We engaged in oral sex (unsafe). I had experienced a yeast infection some 4 days prior to this event and treated it. Now we both have what we believe is oral candida, sore mouth, tongue and throat. The sore mouth and other symptoms started 4 days after the event. We are being treated with an anti-fungal (Diflucan) and have not seen any results in 10 days. What do you think, should I be loosing my mind thinking this is HIV? I have gone for testing, however, don't think enough time has passed. He refuses to be tested. He claims his last relationship was 3 years ago. I don't want to panic, but I have never experienced anything like this before. Any words of advice or encouragement?
S

The Reply...
I think the assumption that it is likely to the yeast infection is a fairly safe one. Although HIV can be passed on through oral sex, it only happens very very rarely. I think the fact that both of you are having similar symptoms also demonstrates the fact that this was something "new" to both of you (OK, you have the original Yeast Infection, but neither of you had the oral candida). Not only does HIV very rarely have any symptoms in the early stages, it would also be unbelievably unlikely that you would both develop such similar symptoms - when presumably one of you would have been already living with it for some time. What however we cannot ignore is the possibility that HIV *may* have been present in one of you in addition to the yeast Infection - and that there are (as if often the case) not symptoms of that in evidence.

As for advice, I think you have already chosen to take a test, which, if you feel comfortable doing, was a good move. You correctly observe the time needed for HIV to generate the antibodies - which are looked for in the test. The antibodies can take upto three month to develop - sometimes even longer. This means that if you have a negative result today, all it really confirms is that you were almost certainly negative three months ago. If you have only had safe / safer sex in the meantime (and not shared injecting equipment etc), then you should still be negative now.

Incidentally, if your mouths are still sore/blistered/open/tender etc, it *may* be an idea to avoid unprotected oral sex for the time being. Although the chance of contracting HIV are still very low, the risk IS higher if the mouth/gums are in poor condition.

As for the encouragement, well I think you have behaved responsibly in having a test and addressing the issue. I also think that unprotected oral sex - providing the mouth/throat/gums etc are in reasonable condition - is fairly low risk. It is everyones choice what they consider to be an "acceptable" risk but, putting things into perspective, it seems likely that in the whole of the world, there have been fewer than a dozen cases of HIV being transmitted through oral sex - even with these cases, there remains an element of doubt as to whether there may have been other more likely routes of transmission. In short, no, I don't think there is any need to lose you mind over it being HIV, it would seem to be extremely unlikely. The fact however that your fella refuses to take a test may be something you would like to consider discussing with him if it is giving you cause for concern. It may be a hatred of needles - or perhaps he thinks you have to go along to your own GP. (You can go to the GU clinic in any large hospital and even give a false name so it can be utterly anonymous).

Some yeast infections take a while to clear up, if you have finished the course of Diflucan and nothing has improved, you might like to go back and request a different product. In the meantime, if you enjoy natural (live) yoghurt, this may provide some relief if you keep popping some in your mouth and leaving it there for as long as you can. Live yoghurt tends to kill the fungus - indeed when babies get thrush - as they sometimes do - one of the gentlest - and effective - home treatments is to simply rub the yoghurt over the affected area. (Side note, if you apply internally and leave it overnight, DO NOT use an electric blanket. You'll wake up with a kind of low-fat cheese. Not pleasant.

I hope that puts your mind at rest a little, I really think the chances of you contracting HIV from oral sex are remote in the extreme and the symptoms you have at present are not suggestive of HIV in any way at all. Take care, be safe.
Mark

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Hello, On the 4th of July I had done some messing around with a person I had met that night. I had given her oral sex for about 5 seconds is all and from what I read in your previous responses that doesn't seem that bad. However the thing that we did that scares me is that she put me on my back and she sat on top of me and grinded back and forth on top of me for about 3 minutes.. she was Very wet from me Fingering her prior to that... however I had NOT ejaculated.. MAYBE precum..., and I was NOT inside of her.... she was just sitting on top of me and sort of massaging my penis with her Vagina..... I am extremely scared.. . how risky is this.. Please make me feel better

The Reply...
Hi! Ok, well first of all, you are quite right in assuming that the oral sex part of the day is - in all probability - nothing to get unduly concerned about. There ARE risks but the risks are very small and, providing your mouth and throat are free from weeping cuts or sores I don't consider there to be too much cause for concern here. The part about her grinding around on top of you IS potentially more significant. As you indicate that you were not inside her however, the sex was definitely not as risky as having penetrative sex would have been. I wish I could tell you there is no risk at all, but this would be misleading and I guess that is not very helpful. I am also working on the premise here that there were no condoms involved - if there were, then the risk is very low from what you describe. As it is, and if condoms were NOT used then there is an element of risk. However, before you become too distraught, the chances are fairly heavily in your favour. For you to contract HIV, the virus has to find a way into your bloodstream - one way or another. Assuming that your genitals and surrounding area are free from open cuts or sores, the only way the virus could possibly enter would be through the meatus (or hole) at the end of the penis - or through the delicate membranes underneath the foreskin - if present.

Even though you mention the fact - helpfully - that she was very wet, the chance of the virus - if present in the first place - actually managing to enter your body is far from guaranteed. Oddly enough, if you ejaculated soon afterwards this would have been possibly beneficial as it would tend to "wash away" any vaginal fluid that HAD entered the tip of your penis. I think you might like to consider the possibility of having a test - more to resolve the issue and hopefully put your mind at rest, rather than anything else. In summary, I'm sorry but you have been exposed to a slight risk, the balance of probabilities are in your favour however and I suspect that the test - if you choose to take one - is most likely to be uneventful. If you would like to discuss this further, you can either write to me again - and I'll answer in e-mail only - to make the response faster. Alternatively, if you are in the UK, you can call the National AIDS helpline on 0800 (free) 567 123. If you are overseas I can try and locate another number for you there. If all else fails, if you are prepared to make a potentially costly long-distance call, I will give you my number and arrange a time when you can ask a few questions in "real time".

I hope you feel a little better, things could most certainly have been far far worse, as it is, the odds are in your favour. Do get in touch again if you feel you would like too.

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For the first time I had Sex with my partner who is HIV+. I used two condoms which made me feel safer. I am the only one that is doing the performing. I will not be receiving. We are kissing, but I still have my doubts about that activity. As far as the sex, what risk did I put myself? Is it safe for me to continue this and should I be tested so often if I'm going to continue this?

The Reply...
Well as far as the kissing goes, you'll see from my comments to the next question, the risk is so incredibly tiny I wouldn't worry unless you have cuts or sores in the mouth. If your partner ALSO has cuts or sore at the same time, I would tend to be cautious, otherwise, kissing should be entirely safe for you. Please note though, that if your partner has a fairly low T-cell - or seems prone to infections, try to avoid kissing him if you have a cold, cold-sores, flu or other easily transmitted illness as YOU could pose a small risk to him. The use of condoms makes great sense and the use of two may reduce your risk even further. You do need to make sure though that you are using a WATER based lubricant rather than anything oil based (hand cream, massage oil, body lotion, baby oil etc all rot condoms and make them "leaky" before they break - this can mean the virus can be passed THROUGH the condom even if it does not appear to have broken.) A potentially painful but interesting idea of checking to make sure that the condoms have not failed is to put on the first condom, then apply a LITTLE chilli pepper sprinkled over the first condom and then apply the second. If either condom fails one of the two of you is going to know about it pretty quickly!!

Providing you use your condoms sensibly (make sure they are not past their sell-by date and are stored in a cool place) then you are putting yourself at a fairly low risk. I'm afraid the risk IS present but you can reduce it further by trying to "come" on him rather than "in him". If this is too much to ask, then at least withdraw quickly afterwards, remembering to hold onto the base of the condom to make sure it doesn't slip off inside him. Remember, HIV is not the only virus that a condom can help to protect against, so doing this will help protect your partner even if he is already HIV+. As for testing, there are reasons for and against testing on a regular basis. In its favour is the fact that it may put your mind at rest if negative and allow you to start treatment early if you are positive. Against is the fact that some people find it difficult to handle a positive result and some people assume a negative result means they can take more risks! Bizarre but true. If you want to be aware of your antibody status from time to time, perhaps a test every year may be in order. For some people one test every few years is what they want, for others, they test more often. Why not discuss this with your partner if you can, or the adviser at the clinic when you next go?

I note that you say that you will not be receiving, however please continue to use good sense and condoms, the virus CAN and DOES go from the passive to the active partner, usually through the meatus (hole in the cock) or through the delicate membranes on the glans (head). Keep yourself covered and enjoy yourselves.
Mark

Next Question....
My friend is HIV + . We never had Sex but we deep kissed a lot. That was the best thing about the relationship. We had just met a few weeks ago and I said I could not have sex until I knew the status of the test, but I felt the Kissing was OK and I used my finger for penetration. I never gave oral sex but received it twice and I was hesitate about that. I have been told that what I did was of very low risk and there was no need for testing unless I wanted to clear my conscience. Am I overly analyzing this?

The Reply...
Certainly I agree with what the other source of information told you - you have only put yourself at an extremely low risk. In your place, I would not go for a test because the chance of being killed by a bus on the way to a clinic would be greater than that of having contracted HIV from what you have done. Hope that clarifies the risk a little!
Mark

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I'm confused about French Kissing when it comes to HIV. Is it true that If there were blood present, it only has to get on your tongue or gums and soak through the moist skin to the blood stream. (Is this theoretical) I thought you had to have a fresh cut or sore in your mouth for the virus to get into your blood stream.

The Reply...
There are mixed feelings on this. In theory the virus CAN permeate - pass through - some of the more delicate linings and membranes on the human body, in particular under the tongue, through the tip of the penis and inside the vagina and rectum. In practice, although I would tend to be extremely cautious about kissing ANYONE who had a bleeding mouth - for reasons like Hep A,B & C etc, I would not be overly concerned about contracting HIV that way. I think the answer is YES, the virus CAN pass through membranes but the evidence would suggest that this does not happen very often. The risk therefore is present but relatively small. Certainly building up a pressure in the mouth - blowing gum afterwards etc - would be unwise as this may help to "push" the virus through the membrane. Sorry I cannot be clearer on this, but even the experts disagree strongly on quite what risks are involved. With HIV, it is best to avoid blood where possible - even if there is no obvious way for it to enter someone else's bloodstream.
Mark

Next Question....
My friend is HIV positive and I love to French Kiss. Is this something I should be careful with or stop doing. I find myself being hesitant because of potential blood. How careful should I be?

The Reply...

The risk should be zero. The virus is NOT present in sufficient quantities in saliva (or urine, sweat, tears etc) to pose any risk whatsoever from HIV transmission. The only reservations I might make are: 1) If you friend has just had dental work or has a cut in his mouth etc where blood may be present, then clearly the risk is very slightly higher. Even so, unless you had sores / bleeding gums etc the risk would be incredibly small. The other comment to make is that although HIV transmission from French kissing (notwithstanding the presence of any blood in the mouth) is nonexistent, transmission of Hepatitis is a definite possibility and so is herpes. As someone with a damaged immune system is more susceptible to these illnesses than others, it might be a wise precaution for you to have vaccinations against both Hep A and Hep B. There is no vaccination for Hep C but this is less common anyway. As for herpes, if there are signs of cold sores on the mouth, it would be advisable not to kiss until these have healed.

In short, unless there IS blood present in HIS mouth for some reason, there is no reason to stop French kissing your friend at all as far as HIV goes. Just be aware that there are other things (herpes, hepatitis etc etc) that can be transmitted much more easily than HIV. I suggest you have your Hep A and Hep B vaccinations, depending on the country you are in, they may be free if you explain that you are involved in "care work" with people living with HIV. Hope that answers your question.
Mark

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About a month ago on a business trip, I picked up a girl in a bar and we had both unprotected oral (extremely limited, no more than a minute each) and sexual intercourse. I was almost soft during the intercourse (alcohol) and the intercourse only lasted 3-4 minutes. I have never tested positive for HIV, but I do not know if she ever tested. About a week after the sex, I had a sore throat for two days, no fever, no lymph node problems. I went to a clinic and had test ran for Syphilis, Gonorrhea, and NSU. All tests were negative. What are my chances of having contracted HIV?

The Reply...
Well, as far as the oral sex is concerned, the risk is almost nonexistent. With regard to the intercourse however, there is a chance that you have put yourself at some degree of risk. In your favour is the fact that you were "almost soft" at the time which will probably have lessened the chance of abrasions on your penis. The sore throat could be for any number of reasons, probably the least likely of which is anything even remotely connected with HIV. I'm afraid the only way you are going to know for sure on this one is to have a test. There are a couple of things to bear in mind here. Firstly, HIV has a "window period" of around 3-6 months. In English, this means that the human body will take between three and six months from contracting HIV before it can be detected on a standard test. If you have the resources available - and depending upon where you live - you can opt for an "antigen" test which actually tests for the presence of the virus itself. The test is complicated and expensive - which is why it is not available on the State. The other point to make is PLEASE do not go to your doctor for an HIV test. You will receive a much higher level of confidentiality if you attend a GU clinic - you can even use a false name if you wish, though if you give any false information, you MUST remember what you said - as it will be verified when you return to collect your results.

So, what does all this mean? Well unless you pay for an antigen test, you are not going to know for sure if you have contracted HIV for upto five months. The chances are you will probably be lucky - on account of the fact that the sex probably generated fairly little friction on your penis. As a side note, if a person, male or female is prepared to have unsafe sex with you, they will almost certainly have had unsafe sex with plenty of other clients. It is a rather depressing thought, but it is worth assuming that ANY prostitute could easily be HIV+, let alone one who engages in unsafe sex. In future, if you choose to use a condom, you will greatly reduce you risk and greatly improve you peace of mind.
If you want any more information on this, please write to me again - and let me know what country you are in.
Mark

Next Question....
OK here is my question I hope this is where I am supposed to send it to....I have a vaginal yeast infection that I have had a hard time getting rid of. I am going to the doctors next week to get it checked out. Also I think that it has spread to my mouth now too....I was wondering if it was possible that this was a symptom of HIV. I have had some unsafe sex in the past, but I tested negative 1 year ago...please tell me my chances of being infected.... Followed by.... Well I guess my main concern is a yeast infection one of the early signs of an HIV or would I have had other symptoms along with my yeast infection to indicate that I had something to worry about?

The Reply...
Well, to be honest I need rather more information than this to give a really informed opinion. You see although you tested negative 1 year ago, all this will tell you is if you had the virus about 3-6 months earlier. HIV antibodies take between 3 and 6 months to develop in the body and until they are present, someone will test HIV negative - even if they have recently contracted the virus. This is because the standard test can not detect the presence of the virus itself, only the antibodies it creates. Having said that, I think it extremely unlikely that HIV has anything whatsoever to do with your yeast infection - although a weakened immune system CAN make yeast infection more likely, there are many many alternative reasons why this may happen. For instance, if you have had a course of antibiotics recently, this frequently leads to yeast infections - particularly with women. Assuming that you had your test for HIV at least 3-6 months after ceasing unsafe sex, I think you have very little to worry about. If you had unsafe sex later than that, it would be helpful to know what type of unsafe sex. If you mean unprotected oral sex, then your risk is miniscule. If you mean unprotected vaginal sex (and particularly anal sex), then the risk is higher. If you can give me a little more information I will respond within 24 hours.

As I said above, there are very very few true "signs" of early HIV infection, you should really go to a GU clinic for a test if you are concerned about this - better than going to see your doctor as the GU clinic have far stricter confidentiality policies in place. A yeast infection can be a symptom of a weakened immune system, but this is more likely to be caused by a cold, flue, or any one of hundreds of other ailments. It is NOT a reliable indicator for HIV status. I repeat, I need to know more about the interval between you having unsafe sex and your last test to give more information. Also an indication of what kind of unsafe sex you were having would be helpful.
Best Wishes, Mark

Next Question....
>>The original text has been lost due to the editor crashing but the question was along the lines of: "Hi, I have started taking a course on massage at the local college and would like to know what benefits massage has on people living with HIV"<<

The Reply...
Hi.
Well the treatment tends to be known as a "complimentary therapy", rather than anything else. Although some might argue that the increased circulation et al is of direct benefit to the person being massaged, it seems likely that the real benefit is probably more in relaxation, attention, comfort and relief of aches - as anything else.

You might wish to enquire specifically though about massaging skin which has been damaged, particularly things like KS (Kaposis Sarcoma), this is where the skin has lesions, ranging in size from a 1p piece to the size of your fist - or larger. The colour can range from purple through to a reddish brown. I am unaware of any specific problems in giving massage to people living with KS as that tends to be a little outside my remit but would suggest you raise the point with your college.
If you are planning on giving massage to people - even if HIV- but particularly if people are HIV+, you may wish to consider taking a course of Hep B jabs. Hep B is fairly easily transmitted by casual(ish) contact and can be extremely injurious to health, many people living with HIV atre also Hep B positive too.

Sorry I can't be more helpful on this, I suggest you contact someone like the National AIDS Helpline (0800 567123) if you are in the UK for more information though.
Best Wishes:
Mark

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I'm thinking of having unprotected sex with a man who used to use dirty needles and have multiple sex partners. That was 8 years ago. His lifestyle has drastically changed and he's tested negative for HIV 5 times since then. I know this decreases my risk, but I'm wondering about the latest research on the dormancy of the virus. How long can it remain undetected in the blood stream?

If there are articles in recent journals that I can read, or more "user friendly" reading materials summing up recent research on the above issue, please let me know. Thanks.

Mark Replies:
Well, whilst I appreciate that his lifestyle may have changed completely, I feel you might need to think long and hard before proceeding with  unsafe sex without a great deal of very careful consideration. In the first place, although you mention "dirty needles" and "multiple sex partners", you do not actually say if the dirty needles were used by others - or simply his own needles that he himself used repeatedly. Also it is safer to have sex with several people using SAFE sex practices rather than have unsafe sex with just ONE person. If you mean that he shared needles with others and had unsafe sex with others then he has very clearly put himself at serious risk. While I do not wish to question his honesty or motives, I wonder how sure you are about him having 5 negative tests and his claimed change of lifestyle.

Just one unprotected sex act is enough, you do not need "multiple partners". If you are UTTERLY convinced that the five HIV- tests are true (and that they weren't followed by an HIV+ one which he forgot to mention) then provided he never has unsafe sex again and never shares injecting equipment again, you may consider the risk worthwhile. HIV does not remain latent (as in undetectable by a test) in the system for years at a time, it can remain undetectable for upto six months however due to something called the "window period" - which is the time it takes the body to make "antibodies" - which is what the test looks for. Apart from HIV, there are other sexually transmitted diseases too which can be more easily transmitted - Hep B for example - which can kill.

Do be very careful please, there are warning bells going off in my head. Is there a really good reason for having unsafe sex with this guy? At least consider BOTH of you going for a joint test, you will be properly counselled (if in the UK) and you will both be able to proceed with a little more certainty once you have the results back.

Next Question....
My husband and I recently went to a "swingers" club. We did not engage in ANY type of sexual activity with other people, but we were in a jacuzzi in which two other couples were having sex. The water was not very hot; probably around body temperature. Can a person contract the HIV virus or other STDs in this manner. Also, we did have sex on a bed that other people had had sex on, although it was not damp or anything. My husband and I use no protection, are exclusive, and are both negative. Could we have contracted anything from our trip to this club? S.

Mark Replies:
Dear S. From what you have told me, you have not put yourself at ANY risk whatsoever from contracting HIV. HIV really CANNOT be transmitted through casual contact whatsoever. Even if every other person in the jacuzzi had been HIV+ it would be utterly and entirely harmless for you to relax in the tub with them. As for other STDs again the answer is no. It is possible you may have contracted athletes foot or a verruca from around the jacuzzi area but nothing more sinister than that! As for the bed, utterly safe with regard to HIV and pretty much anything else - if the bed / previous occupant had fleas/lice etc there is a theoretical chance of getting them - but you would know that by now already. Have a little read through some of the main HIV page (page before this one) for more information if you like, but to summarize, HIV can only be transmitted through infected blood, semen, vaginal fluid and through sharing injecting equipment. (Babies are also at risk from HIV+ breast milk). Even with these fluids, they have to find a way into your bloodstream to pose any threat. If you want my thoughts, it sounds like you had a great break, had some fun and have a sensible attitude. Why not let your hair down again soon! Best wishes, Mark

Next Question....
Hi, I saw your web site and really appreciate the effort spent in answering the Qs regds HIV.
I am an Indian Businessman. I am married. I have a doubt which has been giving me a lot of uneasiness of late. I never had any sex - vaginal, anal, oral - outside my marriage. This January I had been in Bombay on a Business trip. There I met a girl on the street who took me to a hotel, she undressed and I too did the same. I asked for a massage only. I lay down on the bed, she also got onto the bed and for a second or two she sat on my buttocks while performing the massage. I had an ejaculation while lying with my penis pressed to the Bed. Once I turned back she asked me to wash up and I did with the water in the bucket in the room. Then I dried myself with a towel in the room. She then lay beside me, and performed a handjob on me. She also touched my nipple with the tip of tongue (no licking but just a touch). I came again, then we got up and dressed and parted. I was really terrified after that, lest I should have caught something, from the Bed, Water or Towel or by the handjob. When I got back to Bangalore, I got myself immediately tested and got a negative result. Then later on after 6 weeks after the incident I tested negative again and later on after 13 weeks I again tested negative. I am very very worried about the 2-5 secs during which the lady sat on my buttocks, the inner reaches of my buttocks have some kind of rash which gives me itching feeling sometimes, when I scratch I do bleed very slightly from these rash. Kindly let me know if there is a need for some more tests. I am really getting very very worried thinking about it. Please help.
Regards V

Mark Replies:
I do not think there is any need whatsoever for a further test from what you have told me, certainly with regard to HIV. HIV can NOT EVER be transmitted by beds, water, towels - even sharing cutlery. When she sat on your buttocks there was no risk for either of you contracting HIV from the other. I take into account your rash, but for you to have been exposed to any realistic risk of HIV, she would have had to massage her blood or vaginal fluid into your rash. The virus cannot be "caught" - as you might a cold - it is the result of infected semen, vaginal fluid or blood being put into your bloodstream, either through sex (usually penetrative) or sharing injecting equipment. You may have run a very slight risk of other infections which are both treatable and relatively insignificant, for example pubic lice (AKA crabs) and so on. In short, you have had a fright but have not placed yourself in any risk with regard to HIV. Take care. Mark

Next Question....
I am a diabetic, my Husband is hiv+ what is the risks involved for transmission to me?? Is it greater because of the diabetes? What can I expect, I am starting azt400mg (the cocktail), I have tested negative for the virus,but I am symptomatic.
thanks, asap

Mark Replies:
Well, I would very much like to know what sort of symptoms you are experiencing if you are HIV negative. It is unusual for someone to have any real symptoms for several years AFTER they have become positive, it is - as far as I am aware - almost unheard of for someone to be genuinely symptomatic before they even test positive.. I am also very perplexed as to why anyone would put YOU (as opposed to your husband) on ANY form of HIV medication let alone zidovudine if you are HIV negative. Admittedly the window period (see previous page) can sometimes means someone can test a false negative but the chance of them having any real symptoms is almost zero. The "cocktail" is usually a mixture (hence the term cocktail) of zidovidine (AZT), acyclovir and other compounds too. Are you taking a cocktail of drugs or are you just taking AZT?

Perhaps you would explain some more about this in another note to me because I'm slightly concerned that some rather unusual things are happening. As far as the risk of transmission to you go, the same methods of transmission could apply to you as to anyone else (see previous page for full details), anal or vaginal sex is basically the main route of transmission. One thought occurs to me, if your husband is positive and you are not, it would be useful to know his method of contracting HIV because IF he is an injecting drug user, you must make sure you NEVER use one of his syringes for your insulin - even if that means you will be late for a "jab". Just contact your doctor/hospital/chamist for a new supply of hypodermics. Make sure these are used only by you and then disposed of. Other than the possibility of your husband being an injecting user, I can see no additional risk for you as a diabetic.

I also checked with the UK National AIDS helpline ( 0800 567 123 ) - in case I had missed something recently. They confirmed that there should be no additional risks other than the same hypodermics being used by your husband and THEN by you. As you know that your husband is HIV+, obviously safe sex should be a high priority for you, using condoms and water based lubricant if required - especially if you ever practice anal sex. As a final note, if you were planning to have children, it IS possible to have your husbands sperm "cleaned" in order that you can conceive without risk of contracting HIV, unfortunately you will almost certainly have to pay for this service and you should also consider the long term implications involved. I wish I could comment further but there are some things that need clarifying first, for example you seem to claiming you are HIV+ (although testing negative) and you ask how your husband could transmit the virus to you. Please contact me if you can clarify the situation.

Next Question....
I'm worried that I might have put myself at risk by fingering a female that may have been HIV positive. Afterward I looked at my finger and there is a small rash on it. I think its eczema. There was no open cut or bleeding at all, just a small rash that I had from before. What kind of health risk have I put myself into?
Please reply ASAP. Thanks - M

Mark Replies:
You have put yourself at almost NIL risk whatsoever from this. If the finger was neither cut or bleeding the virus (if it was present in the first place) had no way into your bloodstream. The rash doesn't matter at all unless it results in bleeding - and even then the risk is very small if the finger isn't bleeding at the time. Unless you have done something else with this female I wouldn't worry about it in the slightest. Your chances of contracting HIV from this are so incredibly remote as to be almost impossible. Obviously you need to be careful before doing it again to make sure that the finger is still not bleeding or has an open cut/sore. Perhaps it may be an idea to pop around to your local doctor to see if he can advise you on a good ointment or cream to get rid of the rash in the first place. Anyway, no problems with what you did so far. Take care, have fun, play safe!

Next Question....
I believe I have put myself at high risk of contracting HIV from a prostitute 4 months ago. I am getting tested this week, but thought you may be able to shed some light on my chances of becoming infected. Here's why I am concerned. Although I had protected sex with a prostitute, I had also shaved my pubic area within 24 hours prior to intercourse. In addition, she was apparently at some stage of her period, because there was some bleeding. Two months later, I have contracted genital warts on the shaft and base of my penis just past the edge of the condom. Obviously, it seems vaginal secretions came in contact with the skin of my penis where the condom ended at the base of the penis. This is why I am concerned about HIV. What if vaginal secretions came in contact with a tiny cut from having shaved in the pubic area? Can you help me shed some light on my risk? Thanks.
J

Mark Replies:
Well J, I suppose there is a miniscule and theoretical risk from HIV transmission through the shaved area but only if you had JUST shaved - rather than sometime within the last 24 hours - AND had nicked the skin AND she was HIV+ AND the virus was "pushed into" the cut - eg: from friction. You need to remember that if you cut your skin, you bleed OUT - very much like a ball deflating - the air is pushed out. In the case of bleeding, the blood coming out would wash away any fluids rather than "sucking them in". On the understanding that this was the base of your penis, it seems pretty unlikely that there would have been that much friction at this point. Genital warts (sometimes called condyloma) are relatively easily contracted - as are a host of other STDs (Sexually transmitted diseases). Genital warts are caused by the papilloma virus. Although some warts may disappear spontaneously, treatment is generally needed.

There are several ways of treating genital warts and most of these procedures can be performed in your doctor's / practitioner's office. Cold cautery, like liquid nitrogen, destroys the warts by freezing. Podophyllin can also be used, this chemical should be washed off in 4-6 hours after applied or as specified by your practitioner. This might be suitable for you as you are male but should not be used on the cervix or by pregnant patients. Bichloracetic acid (BCA) or trichloroacetic acid (TCA) is another chemical treatment but this chemical does not have to be washed off after application. Other chemicals - such as 5FU can also be used. While these treatments can destroy visible warts, the wart virus can remain in nearby normal-looking tissue after treatment. This virus can then produce new warts, sometimes weeks or even months after the old ones have been destroyed. In that case, you'll need to return to your practitioner for another treatment. You may feel frustrated or depressed when new warts appear, but repeat treatments on a weekly basis almost always solves the problem.

It is important to have the warts treated as recent evidence suggests men with condyloma (Genital Warts) may have some increased risk of penile and other cancers if diagnosis and treatment does not occur. Similar risks apply to women with respect to cancer of the cervix. For your reference, genital warts can also be transmitted through oral and anal contact too.
Back to the subject of HIV though, you may be advised (and almost certainly will) to come back for another test in a few months time, this is perfectly normal practice as the test for HIV relies on the detection of antibodies. Sometimes these antibodies are not made by the body for upto six months, this is often called the "window period". From what you have told me, I would estimate that your chances of contracting HIV from this encounter are very remote to say the least, keep wearing the condom and shave carefully. It is indeed a sensible precaution to leave a few hours between shaving and intercourse.

Next Question....
Are there some common symptoms for HIV ???
Anon

Mark Replies:
Not really, no. There ARE a few symptoms which MAY present themselves in the very early stages of infection (typically a few days after infection) but these are so vague and unreliable as to be little more than misleading. Symptoms CAN sometimes include inflamed lymph nodes - eg: under the arms, around the neck, loss of appetite, increased appetite or generally feeling a little "under the weather". As you can see the "symptoms" are, at best, terribly misleading and, at worst simply convince someone with nothing more than a healthy appetite that they have contracted something that they haven't. Even if you have ALL the symptoms in a short space of time, the chances are FAR FAR higher to be something entirely unrelated. The only sure way of knowing is to have a test - and then a repeat test some 6 months later.

Next Question....
I am a male who is bi-curious. How big a chance am I taking in becoming HIV+ if I allow a male to ejaculate into my mouth and I swallow his semen? What are the chances if I ejaculate into his mouth?
Anon

Mark Replies:
Well oral sex without a condom is not entirely without risk, however the risk is considered to be very small. Only a tiny number of people around the world are considered to have become infected through oral sex, the risk depends on several factors: Firstly, if your mouth and throat are sore or ulcerated then there is a theoretical risk that the virus from his semen could enter your bloodstream. Another factor is indeed if you spit or swallow. Swallowing is safer than spitting because in swallowing, the virus is killed almost instantly in the stomach whereas if you spit the semen out, you build up a small pressure in the mouth which can help to "push" the virus through a cut or sore.

It is also important NOT to brush your teeth before giving oral sex - or flossing which is even worse. The reason for this is that the brush or dental floss can cause minor abrasions in the mouth which provide a possible entry route for HIV. If you want to smell nice and fresh, gargle with some mouthwash.

As a simple guide, providing your mouth/gums/throat are in a fairly healthy state, your chances of contracting HIV from giving him oral sex is very remote. There is zero risk of you contracting HIV from him if he is the one sucking you and you have no other sexual contact with him. Saliva, tears, sweat, urine etc do NOT contain enough virus to pose any risk whatsoever. If you are still worried or concerned, you could always use a flavoured condom or choose not to take his semen in the first place.
Mark

Next Question....
"Hi, I am very scared of having AIDS even though I know that there is an almost 0% chance for me to have it. Around 3 months ago I licked a girls vagina for about 7-10 seconds and I don't know if that is enough to get infected. There is this other thing too though, I always eat (!) the side of my cheeks and sometimes have little cuts on my cheek, so please could you tell me what the possibilities of me having AIDS are. Also could you please tell me that if I go to a doctor now, three months after the oral sex, can he tell me for sure if I have AIDS. Thanks alot.
Anon

Mark Replies:
Hi. To get to the point you want first, the chances of you contracting HIV (the virus which may in time lead to AIDS) from what you described is very slim indeed. Even assuming that the woman in question may have been HIV+, and taking into account you enthusiasm for chewing the insides of your cheeks, the likelihood of you contracting HIV from licking her vagina for a few seconds is remote. You may have noticed that when you bleed, you bleed "out", your bloodstream is pressurized and when you cut yourself, the pressure forces blood out - which would wash any virus away from the wound rather than let it in. If you had taken some vaginal fluid into your mouth and then proceeded to blow up balloons - causing a pressure build up in the mouth - it would be possible that you could force some of the virus into you bloodstream. It would however be extremely unlikely indeed.

As for the test, if it has been three months since the incident took place, a reasonable guide could be given from a test now, however the doctor will almost certainly suggest you come back in a further three months. HIV has a "window" period of upto six months before it can easily be detected.

May I please suggest that you go along to a GU clinic (nice name for the clap clinic) rather than let your own doctor do the test, Apart from the confidentiality issues, the clinic will be able to give you some more information, and answer any questions you may have. Most doctors do not know very much about HIV unless they have chosen to specialise in it. GU Clinics know the latest information, have incredibly strict confidentiality rules, allow you to remain anonymous and some will even give you a cup of tea if asked nicely.

As a final note, the number of cases of HIV transmission from oral/vaginal sex are almost nonexistent. If you wish to be ultra safe however - and also protect yourself against other diseases which ARE more easily transmitted - you can use a "dental dam" stretched over the vagina. (They can also be used over the anus too). Dental dams are available from GU / safesex clinics, chemists and, unsurprisingly, friendly dentists. If you can't get one easily, cut a condom lengthways, all a dental dam is, is a square of latex.

Our Next Question
"My wife is positive and is pregnant, she's been told that the baby will have AIDS to start with and probably get over it later. I thought nobody got over AIDS".
Chris

Mark Replies:
Ok, there are several points here. First of all, the baby will NOT be born with AIDS, it will however almost certainly test "positive" because a new born baby has its mother's Antibodies to "tide it over" until it can make some for itself. As a result, the antibodies your wife has will be passed to the baby. Because the HIV test involves looking for the antibodies rather than the virus, the baby will test "positive" for upto 16 months while it still has the mothers antibodies. When the baby starts to develop its own antibodies, it gets rid of the ones inherited from the mother. At this point, the baby will then test "negative" unless it really does have the virus itself - in which case it will be making the antibodies for itself and will continue to test "positive".

In developed countries, the number of babies who contract HIV from HIV+ mothers is low - around 13% The reason is that the placenta does not allow blood from baby and mother to mix - although it is being speculated that the virus *may* cross the placenta. Providing the birth is reasonably uneventful, there is a very good chance that the baby will be HIV "negative". If your wife needs assistance during labour, they will probably use a suction cup rather than forceps to ease the child from the mother. This is because forceps can cause abrasions and allow for infection from the mothers blood / vaginal fluid as the head emerges. This is assuming that the delivery staff are aware of your wife's HIV status. If you are keeping this from them, it is vital that you tell them in the event of difficulties during birth, if at all possible, please consider telling them in advance.
The time taken for baby to produce its own antibodies can be an agonising wait - for you will not know from an ordinary test if the baby has HIV until this time. It is possible to have an "antigen" test instead which actually checks for the presence of the virus itself, this test however is relatively difficult, time consuming and therefore expensive. It may however be available to you, depending on your country and your own resources.

It is highly important that your wife does NOT breast feed - breast milk from an HIV+ woman contains enough virus to transmit the virus to the baby. Your wife may appreciate the purchase of an "Expresser" - a device for removing surplus milk from the breast which otherwise may prove to be very uncomfortable. Again, if you have advised the doctor / midwife / delivery team of your wife's HIV status, they should remind you of this anyway.

If your wife's status is to be kept from the staff, you should be able to find other sources of information - on the Internet for example - dealing with babies born to positive parent(s) and useful tips and tricks to know. If you want any specific help and cannot locate it easily, drop me another line and I'll send you a few relevant links to follow up.
Very Best of luck, Let me know how things develop please.

Well, that was our last letter for now, if you want to talk, e-mail me - but I may not answer anything already covered on these pages - so PLEASE read before writing!

By the way, if you came here by way of the old website AND you found the information here useful in some way, then if you have the time, it would be kind if you could please tell wherever you "clicked me from" that the site has changed. If it is a search engine you need not bother - they have already been notified. The new URL is http://www.mark.lineisp.co.uk/hiv2.htm - as I said though, only if you have the time and found the information useful in some way. Thank You.

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