[Question #5050] HIV - 2 oral sex risk

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77 months ago
Hi,

I had asked a question earlier and left very assured and happy. However browsing the internet at night came across something that shook me up.

In brief, I asked about receiving a protected oral sex. However I had my scortum licked and sucked a lot and inserted my finger in the mouth of the person as well. I am HSV2 positive but have never had an outbreak.


I left assured that saliva does not transmit hiv and infact kills it.

Later I found out that that is only true for HIV-1 and not 2. Saliva has no affect on HIV-2.

Does that not put me at a risk 
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H. Hunter Handsfield, MD
77 months ago
Welcome back, but it was reallly unnecessary. I suggest you carefully re-read all my replies in your earlier thread. As we discussed, there has never been a proved case of HIV transmission mouth to penis, and that inclues HIV2 as well as HIV1. I have not heard that HIV2 is less affected by saliva than HIV1, and I'm very skeptical. But even if true, if there has never been a proved case, the biological reasons don't matter. The fact that saliva kills HIV (either type) may not much to do with lack of transmission by oral sex anyway. On top of all that, HIV2 is extremely rare in the US -- and although I'm not aware of data from Canada, I doubt it's much different.

So this does not at all change my opinions and advice. Stop worrying about this. Of course you are free to be tested if you'll find a negative result more reassuring than my analysis.

HHH, MD
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77 months ago
Im sorry doc. There is a lot at risk if I get infected and hence I want to ensure I am not due to this stupid mistake. And waiting for 6 weeks is killing me.

This is what I read https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2875783/ for HIV-2 not damaged by saliva.

Reading a previous response of yours that HSV-2 increases the risk even if there has been no outbreak really worries me. My concern is that her saliva and some little blood came in contact with the base of my penis and scrotum (while she was sucking it) and HIV(1/2) came in contact with the skin (tears and cuts that I could not see) and infected me. Reading more on this, HSV2 creates an environment of high concentration of cells that HIV can infect.

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H. Hunter Handsfield, MD
77 months ago
You're contiuing to seriously over think this. There is no risk at all. On quick scan of the article you provided, it is entirely about HIV1 and doesn't mention HIV2 that I can see. I find nothing that says HIV2 is less inhibited by saliva than HIV1. And from my understanding of both viruses, I cannot think of a biologically plausible reason that type would not be equally inhibited by saliva.

I have nothing more to say about HSV2 and HIV transmission. Re-read my comments in the other thread.

Nobody in the world ever caught HIV of either type from an exposure like yours. Believe it, suck it up, and move on. And for goodness sake stop searching the internet on this. Like many anxious persons, you're being drawn to (and probably actively looking for) information that hightens your fears and missing (and probably not looking for) the reassuring information that actually is there is you try for it. The famous statististian Nate Silver (https://fivethirtyeight.com) wrote a book titled The Signal and the Noise about data and statistics, in which he describes your problem like this (approximate quote):  "Give an anxious person a computer with an internet connection in a dark room and soon he'll think his common cold is the bubonic plague." Lay off. And please no more questions that duplicate these or the ones discussed in your other thread.
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77 months ago
If you do a CTRL+F with HIV-2, you will find two clear references to it. Please take a look at it and comment.

I appreciate your help
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77 months ago
Final question. The scrotal skin, how susceptible is it to infection? I mean how much damage is needed for it to be open to infection? If my scrotal skin was to come in contact with blood contaminated saliva, how risky would it be given that I have herpes 2?
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H. Hunter Handsfield, MD
77 months ago
Scrotal skin is no more susceptible than skin anywhere on the body. You are too obsessed about HSV2 -- re-read my comments above about HSV2 and HIV risk. And the chance that your HSV2 infection invovles the scrotum is low, if you have not had visible herpes outbreaks there.

The study cited looked at several physiologic mechansisms that suppress or kill HIV. That one of thoes mechansisms may be less active against HIV2 vs HIV1 does not necessarily translate into increated risk through oral sex. The killing of HIV by saliva is not necessarily important at all in the low risk of oral sex. The virtual absence of proved HIV infection by mouth to penis exposure, ever, is much more powerful evidence than the lab studies reported in that paper.

It's time for you to stop paying so much attention to the trees and pay attention to the forest of evidence that you were not at sigificant risk. If you continue to obsess about it, get tested. It seem clear that a negative test will do a better job of convincing you than even the most expert, reasoned, science based professional advice.
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