phil@wubios.wustl.edu (J. Philip Miller) (10/02/90)
mnemonic@walt.cc.utexas.edu (Mike Godwin) writes: > > Far be it from me to question a professor of biostatistics, but ... > as an assiduous reader of statistics myself, I see no data that > give rise to the inference that a male is at "SIGNIFICANT RISK" > of acquiring HIV from oral or vaginal sex with an HIV+ female. as has been noted before, the African and Hatian data is very convincing about vaginal sex leading to male infection from females infected. Female prostitutes are a major method of the spread of the disease. As I understand the sexual practices in most of the cultures with high rates of HIV infection, oral sex with Females is not a widespread practice. > > In general, it seems, female-to-male transmission is relatively > difficult. Moreover, I've seen little documentation that oral > sex among males is a significant (or SIGNIFICANT) mode of > transmission. > The problem in trying to get good data on oral transmission rates is that one must rely on the truthfulness of a newly diagnosed case when they report that their only sexual contact was oral. some patients will attempt to delude themselves and those around them by admitting to only oral sex in the belief that this is a "less serious sin" some patients may actually be unable to remember significant sexual encounters, especially because of the effects of drugs and alcohol. the number of people who engage in oral sex exclusively is small the patient may be unaware of the infection status of some of their prior, nonoral partners (the partner themselves may be unaware) These problems not withstanding, a number of physicians have reported cases where, in their best judgement, the route of infection was from oral sexual encounters. Most of these have been with an infected male, but cases with females have also been reported. Now perhaps we are going to argue about what is SIGNIFICANT risk. While it is logically possible that some deranged person will intentionally obtain a sample of HIV and come up to me on the street and inject it into me. Now I do not go around worrying about this since it is not very likely to happen. Given the number of cases reported where oral sex was the presumed mechanism, and given the lethality of the consequences of becoming infected, I would not want to take a chance by having oral sex with someone whose HIV status was not known to me confidently to be negative. > If there is statistical data out there addressing these points, > I'd be happy to see the references. is there some level of risk that you find acceptable? 1 chance in 100 encounters of being infected? 1 in 1,000? 1 in 1,000,000? -phil > > --Mike > > Mike Godwin, UT Law School |"If the doors of perception were cleansed > mnemonic@ccwf.cc.utexas.edu | every thing would appear to man as it is, > (512) 346-4190 | infinite." > | --Blake > ----------------- SCI.MED.AIDS ARCHIVE NUMBER 2552 ----------------- > > -- J. Philip Miller, Professor, Division of Biostatistics, Box 8067 Washington University Medical School, St. Louis MO 63110 phil@wubios.WUstl.edu - Internet (314) 362-3617 uunet!wuarchive!wubios!phil - UUCP (314)362-2693(FAX) C90562JM@WUVMD - bitnet