[sci.med.aids] French kissing - safe or unsafe?

AS.DLH@Forsythe.Stanford.EDU (David Hatt 5-0083) (06/23/91)

I would like someone's expertise on this matter.....

A friend and I had a "disagreement" over whether there is such a
thing as safe sex with someone who is HIV+.  He said that any sex
with an HIV+ individual is inherently unsafe.  I disagreed with him.
I countered that you would take extra steps if a person was
positive and that he would never know that actual HIV status of a
person he slept with.

We did agree on the dangerously unsafe practices and there was one
area where we didn't agree:  Assuming no cuts and sores in the
mouth, is french kissing safe or unsafe?

Survey sez?

Thanks for letting me - and maybe a lot of people - know.

Dave

randi@cis.ohio-state.edu (Randi Pollard) (06/23/91)

In article <1991Jun23.021608.3250@cs.ucla.edu> AS.DLH@Forsythe.Stanford.EDU (David Hatt 5-0083) writes:
>I would like someone's expertise on this matter.....
>
>A friend and I had a "disagreement" over whether there is such a
>thing as safe sex with someone who is HIV+. 
>We did agree on the dangerously unsafe practices and there was one
>area where we didn't agree:  Assuming no cuts and sores in the
>mouth, is french kissing safe or unsafe?
>
>Survey sez?
>
From my understanding.  "the level or ammount of the HIV virus in saliva
is so minimal that if there are no cuts etc. in the mouth French Kissing
is safe.  But the question is, "ARE YOU WILLING TO BET YOUR LIFE ON IT?"

I buried my lover of 4 years in february and I insist on safe sex.  ie
the 4 Ms Movies, Mutual Masturbation, and Massage.  The Safe Way To Go.
>
>Dave

Perhaps, someday our ability to love won't be so limited.
                                         Beverly Crusher, MD, S.T. TNG 
 
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*    Randi Pollard          e-mail to:  sporty!randi@ursa-major.spdcc.com  *
*                                                                          *
*    Data Phone....614-863-0374         Voice Phone....614-863-4801        *
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jfh@netcom.com (Jack Hamilton) (06/24/91)

In article <1991Jun23.021608.3250@cs.ucla.edu> AS.DLH@Forsythe.Stanford.EDU 
(David Hatt 5-0083) writes:
>
>A friend and I had a "disagreement" over whether there is such a
>thing as safe sex with someone who is HIV+.  He said that any sex
>with an HIV+ individual is inherently unsafe.  I disagreed with him.

I'd disagree too.  Phone sex, for example, would be completely and
unquestionably safe.  You may be disagreeing over the definition of "sex".

>I countered that you would take extra steps if a person was
>positive and that he would never know that actual HIV status of a
>person he slept with.

It's probably safe to assume that someone is HIV+ if they tell you they
are.

>We did agree on the dangerously unsafe practices and there was one
>area where we didn't agree:  Assuming no cuts and sores in the
>mouth, is french kissing safe or unsafe?

That's been hotly debated.  I think there were some papers about it at the
conference in Florence.  I think it's reasonable to say that oral
transmission is possible, but highly unlikely.  Gonorrhea and syphillis,
for example, can be transmitted orally, but its not common.  The last I heard, 
there were no reported cases of HIV transmission via oral contact when both
parties had healthy mouths.  There have been some cases of tranmission
through oral sex, but in those cases the recipients had gum problems.

There are lots of safe sex practices that I have no problem with, but
giving up kissing would be really difficult.  It's a good thing that the
risk is so low that it can usually be ignored. 
-- 
Jack Hamilton         jfh@netcom.com         apple!netcom!jfh

jon@turing.acs.virginia.edu (Jon Gefaell) (06/25/91)

In article <1991Jun24.124202.26280@cs.ucla.edu> jfh@netcom.com (Jack Hamilton) writes:
>In article <1991Jun23.021608.3250@cs.ucla.edu> AS.DLH@Forsythe.Stanford.EDU 
>(David Hatt 5-0083) writes:
>>
>>A friend and I had a "disagreement" over whether there is such a
>>thing as safe sex with someone who is HIV+.  He said that any sex
>>with an HIV+ individual is inherently unsafe.  I disagreed with him.

The trick here is the inherently unsure matter of HIV infection. Since the
Virus can be present, but not detectable for various periods of time, then
you cannot rely on a negative test as conclusive proof that your partner is
not infected. Additionaly, even if seroconversion had a definate timetable,
you could not know that your partner would/did contract the virus out of
synch with the testing. For these reasons at least, I think that you must
treat EVERY PARTNER as if they were in fact HIV+. This means a singular
approach to 'Safer Sex'.

I'd call 'Safer Sex' the type of sex that involves direct physical contact,
and the presence, though not the exchange of bodily fluids such as saliva,
semen, etc... I'd call 'Safe Sex' phone sex, non mutual masturbation, etc..

So, I suppose I agree with you, Sex with ANY idividual is inherently 'unsafe'
but no more so with a person who's HIV status is confirmed positive, than for
a person who's HIV status is 'assumed' negative as a result of testing.

Do note however, that 'Safe' and 'Safer' Sex practices are NOT HIV exclusive.
There are plenty of diseases that one can contract from sexual activity, and
though HIV/AIDS is uncurable, and deadly, there are plenty of others that are
in the range from deadly to inconvenient... While Oral Sex may not be a  
significant tranmission vector for HIV, it is certainly a well known vector
for other diseases.

A Safe/r Sex strategy must take all this into account.

BTW, I'm getting tested in an hour. My ex-boyfriends wifes girlfriend/lover
(whom he has had unprotected sex with a number of times) just tested HIV+
and so.... To the test I must go. My Safe/r sex strategy allowed oral sex,
but not swallowing (though that seems mostly safe as well, IMHO) but required
a condom for Anal sex. Alas, I broke both these rules.... I've swallowed, and
once allowed him to enter me without a condom. It's too late for regrets, and
guilt will get me no wheres. Scary, but... 

What helps me to think about is that I'm not 'guilty' of anything. I may have
made the wrong decisions a few times... But so have a lot of Brothers and
Sisters. I may have known better, but... Many wonderful people have died a
horrible death from this plague, and I'm no more 'innocent' or 'worthy' or
whatever than they were. This plague takes without hesitation or discrimination.

Oh well, Peace and Happiness be with you all the days of your life!

>
>I'd disagree too.  Phone sex, for example, would be completely and
>unquestionably safe.  You may be disagreeing over the definition of "sex".
>
>>I countered that you would take extra steps if a person was
>>positive and that he would never know that actual HIV status of a
>>person he slept with.
>
>It's probably safe to assume that someone is HIV+ if they tell you they
>are.
>
>>We did agree on the dangerously unsafe practices and there was one
>>area where we didn't agree:  Assuming no cuts and sores in the
>>mouth, is french kissing safe or unsafe?
>
>That's been hotly debated.  I think there were some papers about it at the
>conference in Florence.  I think it's reasonable to say that oral
>transmission is possible, but highly unlikely.  Gonorrhea and syphillis,
>for example, can be transmitted orally, but its not common.  The last I heard, 
>there were no reported cases of HIV transmission via oral contact when both
>parties had healthy mouths.  There have been some cases of tranmission
>through oral sex, but in those cases the recipients had gum problems.
>
>There are lots of safe sex practices that I have no problem with, but
>giving up kissing would be really difficult.  It's a good thing that the
>risk is so low that it can usually be ignored. 
>-- 
>Jack Hamilton         jfh@netcom.com         apple!netcom!jfh

--
_______ 
\ O-> / Mr. Jeffersons Academical Village
 \O->/ Amateur Radio: KD4???
   \/ 38 04 06N / 79 03 53W

jfh@netcom.com (Jack Hamilton) (06/27/91)

In article <1991Jun25.173427.21341@cs.ucla.edu> jon@turing.acs.virginia.edu 
(Jon Gefaell) writes:
>and so.... To the test I must go. My Safe/r sex strategy allowed oral sex,
>but not swallowing (though that seems mostly safe as well, IMHO) but required
>a condom for Anal sex. Alas, I broke both these rules.... I've swallowed, and
>once allowed him to enter me without a condom. It's too late for regrets, and
>guilt will get me no wheres. Scary, but... 

I don't think it's the swallowing that matters, it's having the cum in your
mouth that matters.  Anything that makes it to the stomach will die pretty
fast, but the gums can be a point of entry.  You'd probably be better off
swallowing it quickly than rinsing it around in your mouth and then
spitting it out.  Better yet, use a condom.  Whatever happened to those
"natural-flavor" condoms someone mentioned a while back? 

I hope your test comes out OK. 

-- 
Jack Hamilton         jfh@netcom.com         apple!netcom!jfh

James.Graham@Eng.Sun.COM (Jim Graham) (06/27/91)

jfh@netcom.com (Jack Hamilton) writes:

|> I don't think it's the swallowing that matters, it's having the cum in your
|> mouth that matters.  Anything that makes it to the stomach will die pretty
|> fast, but the gums can be a point of entry.  You'd probably be better off
|> swallowing it quickly than rinsing it around in your mouth and then
|> spitting it out.

How much of a difference is there here?  In particular, if you are in
the situation where someone has just ejaculated in your mouth, would
it be better to:

	1) Spit it out as quickly as possible.

	2) Swallow if this will clear your mouth quicker than #1.

	3) It depends on how certain you are of the current state
		of your gums.

What other factors might be involved?  If you are prone to ulcers does
that make a big difference.  Is saliva hostile to the virus and to what
degree compared to the stomach acids?

I imagine that #1 would be the answer since that minimizes total exposure
unless you are in a position that makes it difficult to comply (for
example, maybe being tied down wasn't the best idea, but it is too late
to worry at this point...) in which case the difference in danger between
oral exposure and stomach exposure would play a big role.

|> Better yet, use a condom.  Whatever happened to those
|> "natural-flavor" condoms someone mentioned a while back? 

Of course, the best answer is not to be in this position in the first
place, but the information is still helpful just in case.

|> I hope your [Jon's] test comes out OK.

Me too.

				...jim

tim@ucbvax.Berkeley.EDU (Tim Wood) (06/28/91)

In article <1991Jun25.173427.21341@cs.ucla.edu> jon@turing.acs.virginia.edu (Jon Gefaell) writes:
>The trick here is the inherently unsure matter of HIV infection. Since the
>Virus can be present, but not detectable for various periods of time, then
>you cannot rely on a negative test as conclusive proof that your partner is
>not infected. Additionaly, even if seroconversion had a definate timetable,
>you could not know that your partner would/did contract the virus out of
>synch with the testing. For these reasons at least, I think that you must
>treat EVERY PARTNER as if they were in fact HIV+. This means a singular
>approach to 'Safer Sex'.
>...
>So, I suppose I agree with you, Sex with ANY idividual is inherently 'unsafe'
>but no more so with a person who's HIV status is confirmed positive, than for
>a person who's HIV status is 'assumed' negative as a result of testing.

Does this mean that all single people who commit to a monogamous
relationship in the future must nevertheless exclusively practice "dry"
sex indefinitely?  (My just-made-up term; it seems more precise than
"safe/r sex" in that it means *no* contact with any liquid-borne
substance from your partner's body.  It also lends an ironic tone which
helps me communicate my point.  Please feel free to correct me on 
technical points.)

At some point, all we have to go on is the numbers.  A negative antibody
test a minimum of six months after one's last non-dry sex act gives 
better than 99.3% assurance that one is actually virus-free (at least I 
remember reading in a responsible publication.)  To get assurance that
both in a new relationship are HIV-, they have only "dry" sex for at
least six months, then both partners get tested.  If the tests are
negative, both are as safe (practically) as they can be, no?  If the
partners can truthfully and trustably say that they have been "dry" for
some periods of time before becoming involved, then the 6 month wait
could be shortened by the minimum of those two periods.  I am for the
moment assuming no other diseases.

I see this regimen as an upper bound; people may depend on condoms and other
barriers for varying degrees of "damp" sex.  Of course, any non-dry contact
with someone outside the relationship might "break the seal", and the
clock must start over again.  (I'm also assuming that detection-by-PCR
is not used; while very expensive, that tests presence of the HIV virus 
itself, so gives a virtually certain (P(true result) ~= 1.0) answer,
within a short time of when the virus might have entered the body.)

Of course, the assurance one eventually wants here is the assurance that it's
OK to have "wet" sex.  I just can't see being in a committed relationship
and using condoms for other than birth control (again, ignoring other
diseases: eg male jock itch can cause a vaginal yeast infection.)

Implicit to the relationship is trust.  If I couldn't ultimately trust 
my partner way more than the likelihood of condom failure, I wouldn't stay.

Good luck with your test, and getting free of guilt.
-TW
Sybase, Inc. / 6475 Christie Ave. / Emeryville, CA / 94608	  415-596-3500
WORK:tim@sybase.com     {pacbell,pyramid,sun,{uunet,ucbvax}!mtxinu}!sybase!tim
PLAY:axolotl!tim@toad.com		       {sun,uunet}!hoptoad!axolotl!tim
Dis claim er dat claim, what's da difference?  I'm da one doin da talkin' hea.

jfh@netcom.com (Jack Hamilton) (06/29/91)

In article <1991Jun28.172317.129@cs.ucla.edu> 
mtxinu!ohday.sybase.com!tim@ucbvax.Berkeley.EDU (Tim Wood) writes:
>Does this mean that all single people who commit to a monogamous
>relationship in the future must nevertheless exclusively practice "dry"
>sex indefinitely?  

Why not?  Is it really that important to have high-risk sex when low risk
sex is easy, as pleasurable, and safer? 

>(My just-made-up term; it seems more precise than
>"safe/r sex" in that it means *no* contact with any liquid-borne
>substance from your partner's body.  

You're excluding kissing; I wouldn't, unless I'd just flossed my teeth. 

>It also lends an ironic tone which
>helps me communicate my point.  

And also biases the argument.

>To get assurance that
>both in a new relationship are HIV-, they have only "dry" sex for at
>least six months, then both partners get tested.  If the tests are
>negative, both are as safe (practically) as they can be, no?  

If you're taking the PCR virus test rather than the antibody test, and you
have it done twice at different labs, then maybe.  

>I am for the moment assuming no other diseases.

A dubious assumption. There are lots of viruses out there, and we don't
know to test for them, even if we could.  HIV was spread by people having
what we know call unsafe sex, back before people had thought of that
concept.  Why run the risk?  I'm not saying that we have to live in a
sterile bubble - I'm saying that although the risk of some unknown disease
is pretty low, the consequences of catching one might be catastrophic, and
prevention is easy.   Use your imagination and play safe.

>Of course, the assurance one eventually wants here is the assurance that it's
>OK to have "wet" sex.  I just can't see being in a committed relationship
>and using condoms for other than birth control (again, ignoring other
>diseases: eg male jock itch can cause a vaginal yeast infection.)

It's your life. 

>Implicit to the relationship is trust.  If I couldn't ultimately trust 
>my partner way more than the likelihood of condom failure, I wouldn't stay.

People have been cheating in marriages for thousands of years, and for
thousands of years people have been saying that they'd never do such a
thing.  Yeah, I know, this time it's different.

-- 
Jack Hamilton         jfh@netcom.com         apple!netcom!jfh