[Question #4488] Kissing

29 months ago
Good morning,

Quick question about deep kissing and hiv risk, I looked through some previous posts and the consensus is that no testing is warranted after such an exposure. I was out of town clubbing last week and made out 3-4 times with a girl for 5-10 seconds each. Now I’m back in town and feeling guilty.  Dr Handsfield stated that kissing is not a risk and if it is, it is exceedingly rare. That kind of stuck with me and wondering if I should use protection until I get tested to protect my gf. What is your final advice on this type of exposure? Nothing else happened besides french kissing a few times.
29 months ago
Dr Hook, please feel free to share your opinion as well, as it is highly valued.

Regards
29 months ago
Would anybody be available to reply to my question please?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
Patience, patience. The modertors are not on call 24/7. We endeavor to answer questions within 24 hours.

There are a very few reported cases of HIV transmitted by kissing, but it is very rare. No expoert would ever recommend testing for HIV if kissing was the only known exposure, except maybe if one partner were known for sure to be infected and not on HIV treatment. And on average, even among the most sexually active women in the US and other industrialized countries, under 1 in a thousand have HIV, so it is very unlikely the woman you kissed had HIV.  I do not recommend testing or protection with your regular partner. But of course you are free to be tested if you wish. Anxious persons usually are more reassured by negative test results than by expert opinion based on expert opinion and advice. If you do it, the purpose is strictly for reassurance, not because there is actually any risk.

You have been warned about repeated anxiety driven questions. "Repeated" doesnt necessarily mean asking exactly the same kind of exposure. You are very concerned about exposures that everybody knows carrry little or no risk and this is another example of the same thing. All you need to know about HIV avoiding HIV is to select partners with care, do not have insertive vaginal or anal sex with new or unknown partners except when using a condom, and do not share drug injection equipment with other persons. There are no other revents you are ever likely to experience that would put you at risk, so liet's have no more questions about such things. This definitely is your last one.  OK?

HHH, MD
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29 months ago
Thank you Dr Handsfield, sorry for my persistence but my anxiety is getting the best of me. 

So if you knew for sure the girl I kissed was positive and not on medication, you’d recommend testing? i can’t know if she was, I know the odds are very low but you probably know how the anxious mind works by replying to all us anxious people here :)

What would be the fastest test that i could do and would be accurate? I understand you don’t recommend testing, but just like you said, the best way to put my mind at ease would be to test.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
Yes, I would recommend testing in that circumstance. The fastest test -- i.e. quickest turnaround time -- is a rapidl test, done in the clinic while you wait. However, you need to wait until at least 2-3 weeks after exposure for a conclusive result. At that time, you could have both a DNA or RNA test for the virus itself, plus an antibody (or antigen-antibody) test. The combination of negative results would be about 99% conclusive. You would still need another AgAb test at 6 weeks to be truly 100% reliable. I don't recommend this appoach, but it is used by some anxious persons eager for the earliest possible reassurance.---
29 months ago
Thanks Dr Handsfield, I’ll just do the 6 weeks AgAb test. Until then, you still reccomend no protection and deepkissing with my gf?
29 months ago
Also, if there are no proved cases of hiv transmission through kissing in 40 years, why would you recommend testing for kissing if it was the only exposure? This is my last question I promise, just trying to understand the rationale.
29 months ago
*mnowing for sure that one of the persons is HIV positive, obviously
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
"why would you recommend testing for kissing if it was the only exposure?"

Because there is no proof that it cannot result in transmission; and testing (with a negative result) usually is the only way to complete reassurance. If you were in this situation, which would you trust more: expert opinion based on probability and statistics, or a negative test result? It's just common sense.

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29 months ago
Well, I think that many people that were not aware they were infected, in the acute stage when most infectious, and acting very promiscuously deep kissed (and didn’t go any further, just kissing) a lot of negative status people at raves, parties,  etc. I think we would’ve heard if there were cases where someone just kissed someone else at a party and got infected. 

So in my case what would you do? Would you continue unprotected relations with your significant other or wait to get tested?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
At any point in time, an tiny proportion of people with HIV are in the acute stage, so it would be rare to encounter such a partner in most settings. No more than 1 in a thousand sexually acrive young women have HIV, and I would gess fewer than 1 in a thousand of those acquired it in the preceding month. That would mean the odds of exposure are around one 1 in a million. And even there, most infections surely would not be transmitted. So maybe the risk is 1 in a billion or even lower.

I do agree that if kissing were a common source of infection, there would be more claims by infected persons that they were infected by kissing. And I've nefver heard of such a case.

Since you have no reason to believe your klissing partner has HIV, let alone an acute infection, if I were you I would not be tested and would continue unprotected sex wtih my wife without worry. (This is a different scenario than above, when you asked about my response if I knew for sure my kissing partner were HIV infected and not on anti-HIV treatment.) And by the way, none of this applies to social kissing, a quick hello kiss on the cheek or even the lips. All my comments assume sexual kissing (open mouth, tongue contact, saliva exchange.

That concludes this thread. It will have to be your last one about extremely low risk HIV events.

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