[Question #11582] Question about Dr Handsfield hiv risk assessment
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13 months ago
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Hello
I was reading questions and answers on medhelp website and Dr Handsfield estimated that if a woman has a high viral load (recent hiv infection) and the man has asymptomatic hsv, the risk of catching hiv from that woman is 1 in 5 (%20) for insertive vaginal sex .
My question is if the man has other STD’s and the woman has other contributing factors such as vaginal sores etc , each of those factors can increase the original risk by numerous folds and this will virtually make the hiv risk above %100 in this example.Is it the right way to calculate hiv risk? If both man and woman suffer from several risk factors then catching hiv is guaranteed?
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H. Hunter Handsfield, MD
13 months ago
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Welcome back to the forum. I see you had a past question deleted -- sorry I can't review it. Often our replies and the quality of our advice is improved when we can know the context that may be available from previous discussions. Let's plan on this one remaining up and available -- OK?
Thanks for your interest in our advice over the long term. But honestly, I cannot imagine how I might have estimated that high a risk for HIV transmission. Our MedHelp forum ended many years ago, but the data on HIV transmission haven't changed all that much. I have to believe that you misunderstood my comments, or that there were special circumstances for the exposure or question that was asked at that time. I have never heard of any kind of exposure that would elevate the risk of HIV during a single episode of insertive vaginal sex any higher than around one chance in a thousand.
Having said that, HSV2 probably is the STI that has the greatest effect in increasing the risk of HIV infection, if sexually exposed to HIV. However, it only increases the risk by two times. (That is, if the risk of HIV was say 1 chance in a thousand, if the exposed person has HSV2, double risk means one chance in 500 -- still very low!) Other STIs that cause genital inflammation -- gonorrhea, chlamydia, and sypihils -- undoubtedly raise the risk of HIV as well. However, there is no known combination of factors that would make HIV transmission 100% (i.e. "guaranteed"). And of course for there to be a risk of HIV, one partner must already be infected -- and the large majority of random sex partners (e.g. sex workers) don't have HIV anyway.
If you would like to describe the details of one or more exposures you are concerned about, I would be happy to comment further about the HIV risks. But most likely your risk for acquiring HIV is lower than you might fear.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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13 months ago
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Hello doctor. Thank you for your answer. I been diagnosed with HPV and asymptomatic HSV . I got a lab dance from a stripper and she was fully naked. Unfortunately I penetrated her with my under wear and pants. It lasted around 5-6 minutes. The fact that she allowed this to happen was sketchy. If she had recent hiv infection with high viral load along with other factors such as vaginal ulcers , then if we multiply all those the risk will be %100
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13 months ago
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Some doctors say cloths are not barrier at all. You estimated zero risk for some people experiencing the same situation but on the other hand, for others you estimated some risk.
Once again thank you for your help and sorry I asked so many questions
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H. Hunter Handsfield, MD
13 months ago
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I don't know how you come up with an estimate for "all those" risk factors making the risk of HIV 100%. This was exactly the opposite: zero chance you acquired HIV, even if your partner had recently acquired HIV with high viral load -- and probably she doesn't have HIV anyway.
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HPV does not raise the risk of HIV. If you have tested positive for HSV2, you might be at slightly increased risk of HIV. If your test was positive for HSV1, it makes no difference in HIV risk. (And even HSV2 isn't important, for the reasons I discussed above. Did you read my reply? If so did you misunderstand? Or do you just not believe it?)
---What "Some doctors say clothes are not a barrier" to HIV or STI transmission? I have never heard of any STI or HIV penetrating cloth or clothing, and certainly no knowledgeable or experienced STI/HIV specialists have said this. It seems you are being seriously misled by online searching, and paying no attention to the source. Anyone can write whatever they want online. I suggest you stop searching about HIV risks -- or at least limit your searches to professional or professionally moderated sites. And definitely avoid websites by and for people at risk -- like Reddit, for example.
There is almost no chance you have HIV. You don't even need testing for HIV. However, you might want to test anyway; the negative result probably would be more reassuring than my words.
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13 months ago
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Thank you Dr Handsfield. I truly believe your opinion and that's why I'm using your service. Before closing this question, I want to ask you a very short question. Since my penetration with cloths lasted like 5-6 minutes ,can this change your risk assessment? In the past, the majority of people in this forum with similar situations only had brief exposures. . once again thank you and have great weekend
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H. Hunter Handsfield, MD
13 months ago
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No, the duration of the event does not change my evaluation or advice.
That concludes this thread. I hope the discussion has been helpful. Thank you for your kind wishes; same to you.
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