If the estimated "per-act" risk for contracting HIV from an HIV-positive source is 0. Unfortunately population statistics don't work that way. See below. It is indeed possible to contract HIV from a single exposure!
Needless to say, I'm extremely worried, almost resigned. I've been reading about testing statistics and through questions on this forum, and have a few questions. Firstly, I notice that a lot of people have questions about indeterminate results, or results on separate tests that bring back different results.
I notice that in some answers, unless tests are conclusively negative or positive, that diagnosis can include risk assessment. Well, I can pinpoint my exposure, as I had only one sexual encounter within the window period.
The man I was with was rubbing and probing around my anus without a condom, inserted about a quarter of the way in, and then I stopped him and said he needed to use a condom, and we didn't even have oral sex. So, this might be seen as risky as uwerkpartners.netotected anal receptive sex, as I was exposed to his precum, but it did not last long, he did not insert all the way, and did not ejaculate in me.
This is the closest I've had to unsafe sex in years, and at the time, considered it foreplay and didn't worry. Two weeks later, I had classic sero-conversion sickness for 5 days, and five weeks after the exposure, tested preliminary positive. However, the day I got sick was the same day that almost everyone I knew felt feverish and achy due to a sudden drop in temperature perhaps a "bug" that was going around.
As I've read, ELISA tests are But then I read about prevalence at the testing site i. I went to a supposedly low prevalence site, so let's say there will be 20 true positives and 3 false positives out of tests.
And of course, all I've been inundated with in education, HIV campaigns, and even on this site, is that in the risk assessment of my particular case, since I have not had uwerkpartners.netotected sex otherwise.
that I might be considered in a lower risk group. even if you're having risky sex it might take multiple exposures. So I'm confounded by the fact that I may have gotten HIV by a single half-assed literally exposure, despite making such a "successful" effort to stay away from the drug scene, be very healthy, very direct and open in my communication with sexual partners, and vigilant about safe sex.
Obviously, I want to have hope, despite the statistics. I've read about quite a few false positive stories here, and I secretly want to hear the rapid blood test might be unreliable, that I might even have mono or just had a regular flu. I'm not finding my help on the web as I've found mostly outdated articles or answers that are too general. So, if you would be so kind, I have some specific questions.
If HIV is not fully suppressed by effective treatment, anal intercourse without condoms is a high-risk route of sexual HIV transmission for both the insertive and receptive partner. Sexually transmitted infections and the HIV-positive partner being recently infected increase the risk of transmission 22/7/ The risk of HIV through uwerkpartners.netotected anal intercourse is seen to be extremely high, as much 18 times greater than vaginal intercourse. 1 ? The reasons for the increased risk are well known and include such factors as: The fragility of rectal tissues, which allow the virus direct access into the bloodstream through tiny tears or abrasionsEstimated Reading Time: 6 mins Anal sex is a common practice among men who have sex with men, heterosexual men and women, and transgender individuals and is a known risk factor for HIV infection and transmission. Therefore, it is important that education on HIV prevention includes accurate information on the fluids that can transmit HIV through this type of sex
In addition, can an actual positive status be result of "cumulative" exposure? If it's the former, as I think we are lead to believe when reading statistics, then wouldn't my luck just be truly awful and almost defy the statistics?
I know that I just must wait for my Western Blot confirmation results. But in that you've given your assessment based on risk factors, and with your knowledge of testing - would you say I have any reason to hope that my preliminary test is a false positive?
The sensitivity and specificity of a test assume the test is performed properly and free from confounding variables.
The estimated statistical risk assumes uwerkpartners.netotected sex with a partner confirmed to be HIV positive. Please note, however, these general population estimated-risk statistics are useful in assessing relative risk and cannot be applied to a single specific encounter. Yes, there is a distinct possibility your initial rapid test was falsely reactive.
Remember that a reactive positive rapid test is only considered to be "preliminarily" positive. If it is followed by a negative Western Blot, the two tests together are considered a "negative HIV test. Your HIV-transmission risk was low, but not completely nonexistent. Write back with your Western Blot results. We are all rooting for you!
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However, no matter what the outcome, I'm here if you need me, OK? In AIDS conference in Mexico they said that the rates of transmission that the CDC quotes could be way off and actually be much higher than stated. They said some instances of Vaginal sex could be as low as 1 in 10 exposures and anal sex 1 in 3 exposures. I have always followed your advise and use a condom for both these acts wife poz but I am wondering if this were to be true could getting oral maybe turn into the 1 in a We never use condom when I get oral from her and really would just love to here your expert opinion on this.
I know you said getting oral is a extremely low risk theoretical under extenuating circumstances but want to make sure this would not make you change your mind or at least think twice.
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meaning do you think it could also be riskier than everyone has thought THANKS, Here is the article.
Not only am I following what's going on in Mexico City, I'm actually in Mexico City participating in the conference! There have been over 5, presentations, including the one you reference. The take-home message of this study of HIV infectivity is that population based HIV statistical estimates can not be applied as actual risk to one specific sexual action.
I've made this point many times in the forum see below. The presentation from the group at North Carolina focused on the effect of co-factors that can affect the risk of heterosexual HIV transmission circumcision, genital ulcer disease, anal rather than vaginal sex and other biological cofactors.
I'll reprint the article you reference below. Hello Doc. Hopefully you can help me with my fears. Eight days ago I had protected anal sex with another gay male of unknown HIV status. I was the top. After completion, which lasted less than five minutes, I pulled out and noticed the condom i was wearing had broke.
I immediately went into a panic.
I checked my penis and there was no sign of blood or anything else. I do not know at what point the condom broke. Accordingly, the purpose of this study is to compile and organize available data from the medical literature and the Centers for Disease Control and Prevention CDC on the high risk of HIV transmission via RAI so as to place into perspective the significance of this high-risk behavior.
Since the beginning of the U. HIV epidemic in the early s, more cases of HIV infection have been attributed to the transmission route of AI than to any other route of transmission.
From through in the U. Nevertheless, the number of new cases attributed to men who have sex with men MSM has remained stable . In the total number of new HIV cases in the U. Seventy percent of all new HIV infections occurred among MSM including MSM and IDU.
In this heterosexual category, vaginal intercourse VI and AI are the major transmission routes .
Six percent of the HIV infections were acquired by equipment sharing e. HIV infection predominantly occurs among young persons. HIV infection is now considered a chronic disease, but it still carries for the young a lifetime requirement of medication and an increased morbidity and mortality, especially for the many who are not retained in care  .
From throughthe all-cause mortality among HIV-infected persons with stage 3 AIDS in the U. was 66, Among newly infected persons in in the U. The role of receptive anal intercourse RAI in this epidemic will be examined using the following approach:.
Sexual Health - HIV
The three major routes of HIV transmission are: AI, VI, and IDU. In the CDC published an estimated per act probability of acquiring HIV from an infected source by exposure route based on studies from published medical journals . The risk per 10, exposures to an infected source for the three major routes of transmission was: RAI: 50; insertive AI: 6. Comparing exposure risks, the estimated risk of uwerkpartners.netotected RAI was 5 times that of uwerkpartners.netotected receptive VI and 8 times the risk of insertive AI.
Rather strikingly, the risk of RAI approached that of needle-sharing during IDU. In Junethe CDC ated the risks of HIV transmission by routes of exposure based upon a systematic review published in the journal, AIDS . According to this investigation the estimated per act probability of acquiring HIV from an infected source by exposure route follows: risk per 10, exposures to an infected source RAI: ; insertive AI: 11; receptive penile VI: 8; insertive penile VI: 4; and needle-sharing during IDU: 63  .
These results now show that RAI has the highest exposure risk for the transmission of HIV Figure 1  17 times that of uwerkpartners.netotected receptive VI, 13 times the risk of insertive AI, and twice the risk of needle-sharing during IDU.
Pre-exposure prophylaxis PrEPa daily medication used by. Figure 1. Estimated per-act probability of acquiring HIV from an infected source by exposure act. Derived from: Centers for Disease Control and Prevention. HIV Risk Behaviors.
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Using PrEP plus a condom provides even greater protection . This may explain, in part, why the high rates of HIV infection among MSM have persisted . Table 1  derived from the Tool, illustrates very high risks for HIV transmission via RAI as compared to insertive AI and receptive VI in both asymptomatic chronic HIV infection and in the acute retroviral syndrome new infection, high viral load.
Specifically, when the inserter is HIV-positive and the receptor is HIV-negative, the estimated per act probability of acquiring HIV via RAI with a condom is 39 risk per 10, exposures to an infected source .
This is a higher risk than insertive AI without a condom risk: RAI with a condom plus PrEP reduces the risk to 3 per 10, exposures. However, if the insertive partner has acute HIV infection high viral load the risk for RAI with a condom isand with a condom and PrEP it is 22 . Thus, despite risk reduction with a condom and PrEP, the RAI HIV-negative partner remains at risk. Again, that risk is higher than having insertive AI without a condom. It has been long known that ulcerative and non-ulcerative sexually transmitted diseases STDs increase the risk of HIV transmission  .
However, it has been more recently realized that there is a very high risk of HIV transmission via RAI among persons infected with an STD, even with condom use. If either partner has an STD, or if both have an STD, the risk can escalate to extreme risk especially if exposed to acute HIV. Without a condom, the risks range from chronic to acute With a condom the risks range from chronic to acute Again, these risks can be reduced with the added option of PrEP.
However, the risks still range from chronic 8 to acute A risk of. Table 1.
Risk per 10, exposures to an infected source. The CDC also advises choosing less risky behaviors than AI . The estimated probability per act via RAI is reduced from to 6 risk per 10, exposures to an infected source . Treated individuals who use condoms further reduce the risk of HIV transmission to 2. Diagnosis and treatment is an ongoing part of the U. HIV prevention strategy .
Its efficacy in prevention depends on linkage to HIV medical care, retention in care, and suppression of viral load with ART   .
Essential to the prevention of human immunodeficiency virus (HIV) is the public knowing that receptive anal intercourse (RAI) is a key transmission route of the HIV epidemic in the United States (U.S.). Receptive anal intercourse (RAI) carries the highest risk for the transmission of HIV compared to all other major HIV transmission behaviors Receptive anal intercourse (RAI) carries a greater per-act risk of HIV acquisition than receptive vaginal intercourse (RVI) and may influence HIV epidemics driven by heterosexual sex. This systematic review explores the association between RAI and incident HIV among women, globally 9/1/ If the estimated "per-act" risk for contracting HIV (from an HIV-positive source) is to percent for receptive anal sex, does that mean that 97of people wont contract HIV from a one-time
HIV infection among MSM youth has been rising among all the major races. In the U. From through HIV infections attributed to MSM among adolescents 13 - 19 years decreased, but among young adults 20 - 24 years it increased . The behavior of heterosexual AI among males often starts in adolescence. A National Survey of Family Growth NSFG study of adolescent males documented that by age 15, 4.
It has been known for many years that receptive anal intercourse RAI also places women at high risk for HIV infection.
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The European Study Group on Heterosexual Transmission of HIV, published indemonstrated that uwerkpartners.netotected RAI was five-fold more likely to transmit HIV than uwerkpartners.netotected receptive VI  .
Now RAI is known to be 17 times more likely to transmit HIV than receptive VI  . Again, the behavior of heterosexual AI among females often starts in adolescence.
A National Survey of Family Growth NSFG study of adolescent and young adult females documented that by age 15, 2. Figure 2. Figure 3.
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National Survey of Family Growth U. Heterosexual Vaginal and Anal Intercourse Reported by Young Men. Mosher WD, Chandra A, Jones J. Sexual behavior and selected health measures: men and women 15 - 44 years of age, United States, Adv Data. opposite gender, and by age 24 the percentage had risen to Among adolescent and adult women, the behaviors of heterosexual VI and AI play major roles in the transmission of HIV infection when there is a higher prevalence of HIV infection in a community.
Background: The human immunodeficiency virus (HIV) infectiousness of anal intercourse (AI) has not been systematically reviewed, despite its role driving HIV epidemics among men who have sex with men (MSM) and its potential contribution to heterosexual werkpartners.net by: Among the HIV-positive MSM, (79%) had had anal intercourse in the year before interview, and (29%) reported at least 1 episode of UAI. The proportion of men engaging in UAI varied greatly according to the participant's knowledge of his HIV serostatus during the year before interview 20/1/ There is a significant risk a negative top could contract HIV by having uwerkpartners.netotected anal (or vaginal) sex with a positive bottom. The estimated per-act risk for acquiring HIV form uwerkpartners.netotected
In in the U. Inthe annual HIV diagnosis rate perpopulation for black women Therefore, the higher prevalence rates of HIV and the apparent common practice of RAI nationally, could explain, in part, why the HIV diagnosis rates are high for Hispanic women and higher for black women. However, the significance of the contribution of RAI in the transmission of HIV infection remains undetermined since national VI and AI data on women who have acquired HIV infection heterosexual category are not available.
Overall, receptive anal intercourse RAI is a key transmitter of HIV infection. The complicated epidemiology of the role of RAI in HIV infections has become better understood with advances in risk-factor analysis. For example, in the risk of transmission of HIV via receptive anal intercourse RAI was believed to have been lower than that of needle-sharing during IDU, and five times that of receptive VI. RAI is now known to be twice the risk of needle-sharing during IDU and 17 times the risk of receptive VI.
Another example is the change in condom risk-factor analysis. Today it is acknowledged that having RAI with an HIV-infected partner using a condom carries a substantial transmission risk: 39 per 10, exposures this. Figure 4. Heterosexual Vaginal and Anal Intercourse Reported by Young Women. risk is three and one-half times higher than having uwerkpartners.netotected, insertive AI with an HIV-infected person: With the addition of PrEP, the risk is further reduced: 3.
However, the Table shows that the other risks of acquiring HIV infection via RAI are higher, and at times extreme, the range being 8 to These risks are clearly much higher than insertive AI and receptive VI. Furthermore, among MSM, a recent long-term study revealed that consistent condom use during AI was low Consequently, some of the factors above may in part explain the increase of HIV infection among young MSM from and their persistent high HIV infection rates from That AI starts in adolescence and increases with age in both sexes reveals that this high-risk behavior is not unique to gender or lifestyle.
Both sexes are at risk, especially in areas of high HIV prevalence. Moreover, health outcomes often are driven by risk behaviors established during adolescence. Preventing their initiation through education has lifelong health benefits .
Thus informing young people of the potentially harmful risks of RAI may likely result in a downward trend of new HIV infections and contribute to ending the epidemic. In the past, the public was made aware that needle-sharing during IDU carried the highest risk for the transmission of HIV. The public responded and either decreased injecting drugs or decreased sharing needles e.
A similar strategy to alert the public that receptive anal intercourse RAI is an even greater risk than needle-sharing appears to be warranted. html [ 2 ] Patel, P.
and Mermin, J. AIDS, 28, MMWR Surveillance Summaries, 55, Cities, United States, MMWR Surveillance Summaries, 60,