[Question #2777] Can you get HIV from breasts discharge if damaged tissue in mouth

40 months ago

At a strip club 4.5 weeks ago I sucked on a strippers nipples. While doing so something was sucked into my mouth. Some particle of something. I don’t know if it ended up down my throat, onto the roof of my mouth or on my tonsils. Later I learned that she has a 3 year old child & is very active sexually. Scaring me further, a few hours before this I drank some very hot tea forgetting that it did not have milk & burned the roof of my mouth. I read that cuts in your mouth seal quickly but what about a burned, raw roof of the mouth? Would the aggravated skin not be sealed and provide access to cells that might be susceptible to HIV infection? Also, I still have tonsils. I read in a medical study that the HIV virus is more susceptible to attach to the type of cells that are on tonsils. If she is HIV positive with a very large viral load what would be the risk of me contracting HIV if a drop of infected breast milk or if it was a drop of blood, ended up against the raw, burned roof of my mouth or my tonsils? Since this episode I have been having some night sweats (which I believe could be an HIV symptom) & hot flushing on my head & neck. I hate myself for doing this & being so stupid. I read there have been no documented cases of an adult contracting HIV by sucking on breasts & I certainly do not want to be the first. I am stressed out and going crazy. In light of the unusual circumstances in this situation can you please assess my HIV infection risk?

Edward W. Hook M.D.

40 months ago

Welcome to the Forum. I'll do my best to help and to assure you that the exposure that you describe was a no risk event. No adult has ever gotten HIV from sucking on an infected person's nipples (newborns in their first few months have been infected because their gastrointestinal tracts are not fully developed), even if they are lactating, and you are not going to be the first. Further, your list of "what ifs" is long and each is improbable in itself. When you put them all together, again, this was a no risk event-

- if she has a three-year old at home, she was tested for HIV during pregnancy and her infection would have been detected;

-if she has gotten this far in life without becoming infected, the likelihood that she has gotten infected since giving birth is low;

-if she gave birth three years ago, she would typically no longer be lactating. I have no idea what you got into your mouth while you sucked on her breast but I suspect it was not a bodily secretion;

-swallowing HIV is not known to transmit infection in adults- the acids and enzymes of the GI tract inactivate the virus;

-the burn on the roof of your mouth is NOT a risk factor for HIV, even if exposed, just as gum or dental disease is not a risk factor

- as you point out, no one has ever acquired HIV from ingestion of infected material .

Night sweats and flushing are not signs of recently acquired HIV.

Given your concerns, I have several bits of advice. These are:

1. Please stay off the internet. The information there is all too often misleading because it is taken out of context or just plain wrong.

2. If you wish, you could get tested at this time. A 4th generation, combination HIV antigen/antibody test of the sort done in most testing settings would detect well over 95% (and probably closer to 99%) of recent infections. If the test is negative, it will definitively PROVE that your symptoms are not due to HIV (when symptoms are present, the tests are positive) and should provide you with reassurance that you were not infected.

I hope my comments are helpful. If any of what I say is unclear, feel free to use your up to two follow-up questions for clarification. EWG

---

40 months ago

Thank you for the work that you and your colleagues do in general and your reply to me specifically. It did make me feel a bit less terrified. I do have an appointment to get a test (at that time it will be 7 weeks since the incident) hopefully by then I am more “mentally prepared” for a result. In the meantime, if you could please afford me another potentially OCD response.

I don’t know where that particle went. If I sucked a drop of milk “down the wrong pipe” and it ended up in the deep tissue of my lungs would the air in my lungs make it inactive before it could infect me? I doubt anyone knows the answer to that question so what about this one? Is one drop of infected bodily fluid enough to infect someone if it goes into deep tissue?

Also, any response about the tonsil tissue?

Has there never been a documented case of an adult getting HIV from the sole act of getting infected milk in the mouth because such mouth on breast activity would most often not be an isolated activity? I am scared, now I have diarrhea and body aches and pains. How stupid was I? What have I done?

Edward W. Hook M.D.

40 months ago

Your OCD is working overtime. No matter where the thing you swallowed or ingested went it would not cause infection. Not in your G.I. tract not in your lungs not on your tonsil.

Further, I can assure you that there are many people that participate in one sort of sex act. On some occasions that is oral sex, on some occasions that would be kissing or sucking on a partner's nipple.

Finally about your fear of being tested. Please remember that no matter what the test results is, it gives you the power to move forward. I am confident that your test results will be negative and when it is, that should unburden you of your concerns. If the result did show that you were infected then you would have the knowledge to initiate treatment and benefit from that going forward. The most harmful situation you could BN is not knowing. Go get tested because of the dead did your test results will be negative. EWH

---

40 months ago

Hi Doc, I am assuming that in your last response the spelling/grammar check caused wording was meant to read “if you did indeed”. … No matter, I had a 4^th generation combination HIV antigen/antibody blood test at 5½ weeks. It was negative. This proves what you said that the symptoms that I was having were not caused by an HIV infection since you said that when symptoms are present that are actually caused by HIV the test would detect the infection. So was this test definitive and the last one needed for this incident and I can put this incident behind me and move on or should I get another test at 12 or 24 weeks to be more definitive? This is my second and therefore last permitted response so I would like to thank you and your colleagues again for the work you do.

Edward W. Hook M.D.

40 months ago

Thanks for your follow-up. I apologize for the typos in my earlier response. As you indicate, your negative test at that time of your symptoms is absolute proof that your symptoms were not due to HIV.

As far as whether your test results were definitive or not, I should acknowledge that some HIV infections are aquired without symptoms and that currently the CDC suggests that results of combination HIV antigen/antibody tests are not definitive until 6 weeks after a potential exposure. At 5.5 weeks after exposure however, well over 99% of tests would be positive if HIV had been acquired and, given the nature of the exposures that you report, I would urge you to accept your results as final. If you feel you must absolutely prove that you were not infected, a further test at any time more than 6 weeks after exposure will be definitive by all criteria. I personally do not think you need further testing at all.

I hope my comments have been helpful. As you note, this will be my final response to this thread and the thread will be closed later today. EWH

---