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HIV and AIDS

Transmission of HIV Following Numerous Risky Sexual Activity

03/03/2006

Question:

I`ve recently had a risky experience and need to know how likely it is that I`ve contracted HIV. 7 days ago I performed unprotected oral sex on a female. I had no obvious cuts in my mouth and don`t recall swallowing any of her vaginal fluids (only absorbsion with my tongue at best). Then I had protected sex with her using a condom.

That female then performed oral sex on another female, washed her mouth with mouthwash, then french kissed me. Now it`s 7 days later and I have no symptoms such as rash, fever, nightsweats, etc. I know symptoms normally don`t come for another 2-3 weeks, but I am noticing slight twinges all over my body as if my body is fighting an infection. I had these same twinges years ago when I had mono right before my lymphglands swelled up to monumental proportions and I fell seriously ill.

This brings me to my questions: 1) I`ve read various articles siting studies proving both that oral sex is and isn`t linked to HIV contraction. What are the risks if a man performs unprotected oral sex on a woman who is HIV positive if the man has no open sores or cuts in his mouth? Low, medium, or high? Is it more or less risky than having unprotected sex with a woman?

2) I also helped the female masturbate. Her fluids dried on my fingers. A couple of hours later I took my contact lenses out then went to sleep. Is this a risky behavior since her dried fluids may have came into contact with my eyes? How long does it take for HIV to die outside the body?

3) Is there more viral load in semen or vaginal fluids? When is there the most viral load in a person infected?

4)What other realistic conditions/infections could I have other than HIV/mono that could cause these slight twinges in my body?

5) In that time frame, I kissed a lot of women. How possible is it to contract mono twice in life?

6) What percentage of people infected develop symptoms after 2-4 weeks of infection and what percentage never develop symptoms? Is it possible that this female never developed any symptoms yet and has HIV?

7) If the female who kissed me after performing oral sex on the other female contracted HIV through that oral sex act, how possible is it to spread it to me through our French kiss moments later?

I know those are a lot of questions. Thanks for your help!

Answer:

Transmission does appear to be more efficient from men to women than the other way around. In general, there will be 3 transmissions out of 1000 episodes of intercourse. There are no separate estimates for people with visually intact mucosal surfaces, but that does not preclude the possibility of microscopic breaks; HIV is definitely more efficiently transmitted in both directions in the presence of ulcerative genital lesions. People should not be complacent about the risk of sexually transmitted diseases, including HIV, when skin and mucosal surfaces look normal.

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Response by:

Pamposh   Kaul, MD Pamposh Kaul, MD
Assistant Professor
College of Medicine
University of Cincinnati