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Risk of HIV Transmission Through Blowjob

A recent news report by Channel News Asia titled “HIV-positive man who donated blood during pandemic faces charge of lying about sexual history” may have caused some concern in the community with regards to the issue transmissibility of HIV through oral sex.

Based on the report, people may wonder just how transmissible is HIV via oral sex and how does it compare to other forms of sexual practices like vaginal sex.

Sexual Practice and HIV Transmission Risk

Based on the Department of STI Control Clinic in Singapore, the table below summarizes the risk of transmission of HIV based on the type of sexual practice.

Sexual Practice Estimated risk of HIV transmission from a known HIV-positive individual not on effective HIV treatment

 

Receptive vaginal sex 10 per 10,000 persons
Insertive vaginal sex About 8 per 10,0000 persons
Performing oral sex < 1 per 10,000 persons
Receiving oral sex < 1 per 10,000 persons

 

Can HIV be transmitted via oral sex yes, but the risk is roughly 10x less likely than vaginal sex.

 

So when is there no risk of HIV transmission?

  • Breathing the same air as someone.
  • Touching a toilet seat or door knob.
  • Drinking from a water fountain.
  • Hugging, kissing or shaking hands (although kissing may transfer fluids the level of virus in saliva is so low as to make the risk negligible).
  • Sharing food or utensils.
  • Sharing gym equipment.
  • Skin to skin contact with an HIV positive person even if they happen to have fluid of unknown origin on them (particularly applies to commercial sex workers).
  • Biting or scratching that does not break the skin or draw blood

 

How can we reduce risk of HIV transmission?

  • Monogomous relationship
  • Avoid casual sex or paid sex
  • Always use condoms
  • Regular testing if you are at risk – protect yourself and your loved ones

 

There are no way to know your HIV states unless you go for a HIV Test.

 


 

 

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What are the Common Misconceptions that People have about HIV?

There are multitude of misconceptions associated with HIV. These are some of the most common ones:
1) HIV is the same as AIDS. HIV (Human Immunodeficiency Virus) refers to the virus itself, whereas AIDS (Acquired Immunodeficiency Syndrome) refers to a spectrum of potentially life-threatening conditions that are caused by the virus.

Read: HIV, AIDS & Opportunistic Infection

2) HIV is a death sentenceThis may have been the case several decades ago, where without prompt and adequate treatment, the infection progresses and causes the immune system to weaken, leading to AIDS. However, thanks to advances in modern medicine, most HIV infected patients today may never develop AIDS. This is why it is imperative to be on treatment, ideally as soon as possible after a diagnosis of HIV is made. It is also important to undergo regular HIV screening.

READ: HIV Treatment & Management

3) HIV can be spread by kissing, sharing of food or close contact. It is extremely unlikely to contract HIV via these methods as HIV is not spread by saliva. However, if the person you are in contact with has mouth sores/ulcers, bleeding gums or open wounds then there is a possible risk. HIV is spread by 3 main routes: sexual contact, significant exposure to infected body fluids/tissues such as semen, blood, vaginal secretions or breast milk, and lastly, mother-to-child transmission.

READ: How Long Can HIV Survived Outside The Body


Is a person infected by HIV any different from that of an uninfected person?

With or without treatment, a person infected with HIV may not appear any different from that of an uninfected person.
HIV infection undergoes 3 stages. The first stage (Acute Stage) may present with flu-like symptoms, fever and a rash. The second stage may present with lymph node swelling, but most patients do not have any symptoms at all. The second stage (Clinical Latency) can last anywhere from a few years to over 20 years. Thus, many HIV infected patients, especially during this stage, may not even know that they have contracted HIV. Lastly, the third stage is the presentation of AIDS symptoms.
HIV infected patients should receive prompt long term treatment and undergo regular follow up blood tests in order to reduce the viral load in their bodies to low levels. This allows their immune system to continue to function well and minimizes the risk of progression to AIDS. By doing so, they can essentially live very normal lives not any different from that of an uninfected person.

What are some of the treatments that a patient will receive upon diagnosis of HIV infection?

Upon diagnosis of HIV infection, a patient will have to start taking a combination of long-term daily medications. These are antiviral medications that work to prevent the virus from replicating. The patient will then be required to return regularly for blood tests to monitor the levels of HIV and the immune system. The goal of treatment is to keep the levels of HIV low, and thus allow the immune system to continue to function well.

How does AIDS affect a person’s health? What do AIDS patients die of?

Without adequate treatment, up to 50% of HIV infected patients develop AIDS within 10 years. Elevated levels of HIV affect the patient’s immune system and prevent it from functioning properly, eventually leading to AIDS. This may result in the individual being more prone to infections. Patients may develop symptoms such as prolonged fever, tiredness, swollen lymph nodes, weight loss and night sweats. HIV Related Opportunistic infections such as tuberculosis, recurrent pneumonia and esophageal candidiasis,  may occur as well. AIDS patients could also develop various viral-induced cancers.
The leading causes of death worldwide in patients with AIDS are, as mentioned, opportunistic infections and cancer.

Recently it was reported that in London, an HIV patient who underwent a bone marrow transplant subsequently had undetectable HIV levels. Does this mean that he is fully cured of HIV?

This is the 2nd ever reported case of an HIV patient being “cured” of HIV. In 2007, a patient in Berlin was also reported to have been cleared of the virus. Both of these cases have similarities: both HIV infected patients concurrently suffered from cancer (Berlin patient had Acute Myeloid Leukaemia; London patient had Hodgkin’s Lymphoma) and both patients received bone marrow transplant by donors who carried the rare CCR5 genetic mutation.
CCR5 is a protein on the surface of white blood cells that is involved in the immune system. It is one of the co-receptors that HIV uses to enter target immunological cells. This means that via CCR5, HIV is able to gain a mode of entry into a person’s immune system. People with CCR5 genetic mutation have resistance to HIV infection because the virus is unable to enter into their immune system like it usually does.
In the case of the London patient, subsequent blood tests have shown that the virus cannot be detected. However, this does not necessarily mean that he has been fully “cured” – the virus may simply be in a dormant, or “sleeping” state.
While the outcome was favourable in the two examples stated above, this form of treatment is not a viable large-scale strategy because bone marrow transplants carry significant risks and are extremely costly. However, it is undeniable that these two cases are landmark moments in the war against HIV as scientists continue to hunt for a cure. The hope is that by conducting more research on the editing of the CCR5 gene, we will one day be able to develop a safe, cost-effective and easy solution.

READ: HIV CCR5 Mutation & CCR5 Testing

Do you think that mankind can eradicate HIV eventually? Before this happens, what kind of support can we give to HIV infected patients?

I believe that with continued advances in medical research, there is hope of a cure for HIV in the future. However, this is a long and slow process that may require many years or decades. Until then, the best option is to ensure that the public are able to gain access to undergo HIV screening even if the risk is not high, and that HIV infected patients are able to receive prompt and long term treatment.
From the initial shock and disbelief of receiving a diagnosis of HIV; having to accept the reality of the situation; to having to live with HIV daily, these are just a few examples of the tremendous challenges that HIV patients face in their lives, and for many patients these have a detrimental impact on their psychosocial well-being.
There is still a terrible stigma today surrounding HIV, and it remains very much a taboo subject that most people are afraid to speak about or face up to. Nevertheless, we can offer many forms of support for HIV patients. For starters, government and healthcare organisations need to continue in their best efforts to increase awareness and educate the public about HIV and its misconceptions. If you have a family member or loved one who lives with HIV, the best kind of support would be your understanding, care and acceptance.
Lastly, if you are a person living with HIV, do not despair. Seek the appropriate treatment that you require, and turn to your family and friends for moral support.
Take Care!
Tags: hiv screening singapore, hiv test


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HIV Transmitted Risk – A quick overview

The neighbouring country has just built a wall to keep outsiders out. These outsiders do not have a passport and are trying to get over the wall through different means. The HIV virus is one of these outsiders, they will try all means to get across the wall
We will discuss in this article,  the vehicles the HIV virus can adopt to get over your wall. From taking a plane and DEFINITELY getting over the wall, to taking a ship around the border and MAYBE getting around the wall and lastly climbing over the wall which is NOT possible.
The HIV virus will need a vehicle to get past the wall and in the medical context, the HIV virus from a positive person will need to come into contact with a negative person. The fluids which carry the most viruses are blood and semen whereas saliva and vaginal fluid hold much less of the HIV virus.
DEFINITELY getting over the wall – definite transmission, for every 10,000 attempts this will be the number of times successful the HIV virus will get over the wall and cause infection during that activity

  • Blood transfusion – 9250/10000 (although this is rare, it still happens: https://www.bbc.com/news/world-asia-india-36457517).
  • Needle sharing in intravenous drug use – 63/10000.
  • Needlestick injury – 23/10000.
  • Receptive anal sexual intercourse – 138/10000.
  • Insertive anal sexual intercourse – 11/10000
  • Receptive penile-vaginal sexual intercourse – 8/10000
  • Insertive penile-vaginal sexual intercourse – 4/10000
  • Receptive and insertive oral sexual intercourse – low (too low for accurate numbers).

According to the Singapore Ministry of Health UPDATE ON THE HIV/AIDS SITUATION IN SINGAPORE 2014.

Estimated risk per exposure to HIV transmission: assume that the ‘source partner’ is always HIV-positive. For a partner of unknown status, the risk is affected by the prevalence of HIV in the relevant community – i.e., the chance that the partner does, in fact, have HIV. Unless otherwise stated, the sexual acts are always without a condom.

MAYBE getting around the wall – theoretical situations where there isn’t enough scientific data on where the HIV virus may get around the wall

  • Presence of blood getting into contact with an open wound, ulcer – this is a possibility but the risk is lower and unlikely. Open wounds should be treated early to reduce the risk of other infections such as bacterial infections. The risk of bacterial infections into an open wound is often higher than the risk of an HIV infection.
  • Blood getting into contact on mucosal membrane surfaces such as the eyes or mouth – this is again a possibility, but extremely unlikely
  • Dried blood on surfaces – some studies have shown that the HIV virus can survive in dried blood for a few days. However for that blood to infect another person, it would have to cross a thick layer of the person’s skin, mucous membranes and get into the bloodstream. The environment has to favourable for this to happen and transmission through dried blood is often very unlikely.

NO WAY of getting over the wall – not possible for transmission

  • Being in the same room as an HIV positive person and breathing the same air
  • Sitting on a toilet seat or touching a door handle
  • Hugging, Kissing (not french kissing), Shaking hands
  • Drinking from the same water cooler, water fountain
  • Sharing of food utensils.
  • Sharing equipment at the gym
  • Biting or scratching superficially that does not break the skin surface or draw blood.
  • Skin to skin contact with another person

We hope this short illustration answers and highlights questions people may have over possible ways of HIV transmission. Fluid-fluid contact is necessary for transmission and without this, there is NO risk for HIV transmission.
If you have any new questions, please feel free to ask them on https://www.dtapclinic.com/forum/
Take Care!


Other Reads:

  1. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
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  3. HPV Infection & HPV Vaccination for Men who have sex with Men
  4. STD Risk for Receptive Unprotected Anal Sex in Men
  5. Low HIV Risk Doesn’t Mean No HIV Risk
  6. HIV PrEP for Travel – How You Need to Know
  7. An Overview on STD from an STD Doctor
  8. Everything You Need to Know about Herpes Simplex Virus
  9. How Do I Treat Oral Herpes (Cold Sores)
  10. Syphilis Symptoms – Painless Sore & Ulcers
  11. HIV Symptoms – What You Need to Know
  12. 10 Common HIV related Opportunistic Infections
  13. The HIV Pro-Viral DNA Test can be done 10 days post exposure.