[Question #4503] Clarification

29 months ago
Hi,

In question  #3416 Dr Handsfield states this:
Second and perhaps most important, your own assessment ("I think it was safe") is exactly right. Kissing is no risk, as just discussed, and oral sex is no risk either, even without a condom -- and you used one! Even if she had HIV, you definitely were not at risk.


While in question #4488:

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.

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?


H. Hunter Handsfield, MD
1 days ago
Yes, I would recommend testing in that circumstance. 

This confused me more than clarifieds the matter for me, and since it is a paid service, I feel like I am not satisfied with the clarification. In question 
#3416, even is she was hiv psitive, there is no risk, but in answering my question (#4488), testing would be recommended is she had HIV.

Not trying to be disrespectful, just trying to understand. Any opinion from Dr Handsfield or Dr Hook is welcome, as you can imagine nobody wants to go on dates and nnot kiss until they get tested. Please be direct and succint. Much appreciated.
29 months ago
A second opinion from Dr Hook would be very apreciated as well.

The bottom line question is: tongue kissing is zero risk for HIV or not(assuming kissing and HIV+ partner)?
Edward W. Hook M.D.
Edward W. Hook M.D.
29 months ago
I'm sorry you feel the need to return to pursue this line of questioning.  I have reviewed your earlier exchange with Dr. Handsfield and agree with all that he said'  There are no data and no proven cases in which a person has acquired HIV from kissing, including deep kissing.  Your earlier interaction with Dr. Handsfield involved a number of unlikely, "what if" questions and in his answer he noted your continuing anxiety over this issue.  No professional is going to try to keep you from testing for HIV if they believe that it will relieve your anxiety, irrespective of whether that anxiety is warranted or not.  Nothing in the exchange that I reviewed suggested any need for concern.  If I were you, I would not have felt any need to be tested in relationship to the encounter you describe BUT, I would not argue against you testing for the sake of proving to yourself that there is no reason for concern.  This is in-line with what Dr. Handsfield said earlier and which I have pasted in below:

"Since you have no reason to believe your kissing partner has HIV, let alone an acute infection, if I were you I would not be tested and would continue unprotected sex with 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"

There is no known risk for HIV from tongue kissing with an HIV infected person.  I hoe this will clarify things.  EWH
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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
You're splitting hairs; your OCD is in evidence. There is no signficant difference in those statements. There are few or no proved cases of HIV transmission by kissing or by exchange of saliva, but that doesn't prove it cannot happen. For all practical purposes, the risk of transmission through open mouth kissing ("tongue kissing", if you prefer that term) is low enough to be considered zero, even with an HIV infected partner. But most anxious people are more reassured by negative test results than by expert opinion, which is why many persons might seek testing even after an essentially zero risk exposure.

There are few absolutes in biology and medicine. Don't expect them; it's almost always a question of probabilities, even if our wording sometimes suggests otherwise. That's life, and it's the best we can do. (Dr. Hook and I do not comment on each others threads unless we ask ourselves. Having worked closely together for over 3 decades, our opinions and advice always are the same, even if our writing styles differ.)

Do not ask any more questions along these lines, and there will be no opportunity for follow-up comments. I've previously advised you about repetative, anxiety driven (or OCD driven) questions. Here is our formal statement about it, which includes the reasons:  Please note the forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions on this topic may not be answered, in which case the posting fee will not be refunded. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers; because experience shows that continued answers tend to prolong users' anxieties; and because such questions have little educational value for other users, one of the forum's main purposes. Thank you for your understanding.

HHH, MD

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Edward W. Hook M.D.
Edward W. Hook M.D.
29 months ago
FYI, Dr. Handsfield and I happened to answer your question simultaneously.  There should be no need for follow-up. EWH---
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
Dr. Hook and I crossed signals, so you have replies from both of us after all. You'll note we agree with one another.

HHH, MD
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