Female – Male HIV Transmission in the US

John writes:

I scheduled an appointment with my doctor tomorrow, and I am going to ask her to give me an HIV test, maybe also check for other diseases.
I read up on HIV transmission in several countries and on certain cites it says transmission is mainly heterosexual. How is this possible? By this do they mean that it’s mostly men giving it to women? I also read on several websites that the highest concentration of HIV viral cells is in semen, followed by blood, and then vaginal fluids right? Can you get HIV from just exposure to vaginal fluids?
What are the chances (in fractions/ratios/percentages) of getting HIV from one incident of vaginal sex with a woman of unknown status when there are no visible cuts/abrasions, no blood present, and her vagina is naturally wet? The CDC says the risk for insertive vaginal sex is about 2 in 10,000.
I suppose this is reduced greatly since I have had no symptoms of sickness, there were no cuts or abrasions present, and the vagina was wet, also I’m circumcised and I took a piss shortly after the sex and I washed my dick right after in the shower. (I read that non-circumcised men are at greater risk because the virus can get caught under the foreskin and stay there)
How can one even get HIV from vaginal sex with no cuts or abrasions? It would have to travel very far up the urethra in order to get into the bloodstream. Or are the cuts so small (microtears) that they are invisible to the naked eye?
Anyways, taking my test tomorrow (I didn’t specify to the doctor that I was taking a test for STI’s I just made an appointment with plans to tell them there, as there is no specific option for STI test when scheduling online)
What is your verdict Robert?

Those vaginal fluid titers are so low that I am amazed it even transmits. Women -> men HIV transmission is heavily associated with men having diseases like Herpes that cause ulcerating sores. The virus goes in via that opening. It is also associated in vaginal sex with vaginal and/or penile bleeding. Honestly, this is a blood borne illness. Men get it via exposure to blood. If you’re not exposed to blood, you probably will not get it.
Really men get this disease in two different ways.
1. Receptive homosexual anal sex.
2. IV drug use which involves sharing needles.
You can get it other ways, but that is a small percentage of the transmission. As far as heterosexual transmission goes, the disease goes from males to females and then it stops! Women are the end of the line as far as transmission goes.
That CDC figure is really 1/10,000, and that is if she is HIV positive!
A study in the 1980’s (Nancy Padian study) had a number of couples discordant for HIV and followed them for 5 years. By that time the men had had sex with their HIV positive wives ~700 times. Even after screwing them 700 times over 5 years, 80% of the men had still not gotten it yet! 20% had, but there was an association there with associated with penile and/or vaginal bleeding.
You can also get it from having anal sex with a woman because there can be some minor bleeding on her end when you do that, and that would expose your penis to blood.

What are the chances (in fractions/ratios/percentages) of getting HIV from one incident of vaginal sex with a woman of unknown status when there are no visible cuts/abrasions, no blood present, and her vagina is naturally wet?

Incredibly low. Something like 1/1,000,000.

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0 thoughts on “Female – Male HIV Transmission in the US”

  1. Hey there Rob,
    How are you man?
    I’d like to get some feedback if you don’t mind, look, I have this situation where I had protected vaginal sex with an escort on a Business trip to Colombia, I’m a 30 and she was about 33, we met at a bar, and then one thing led to the other, we ended up fucking in my hotel room.
    I received protected oral sex and I also gave her protected vaginal sex, the thing is that at certain point, while fucking her in the shower ( a bit of extreme position) I pulled my dick off, and found I had no condom on, we shortly realized it was inside her ( I guess this situation lasted 1 min max), damn fuck I had a slippage. I was a bit scared and she told she had recently tested negative for hiv.
    Afterwards, I put on a new condom and continued having sex. I’m kinda freaked out at this point.
    What’s the actual likelihood that I had gotten Hiv from this encounter?
    Should I get tested,
    Man, I’d appreciate your objective opinion.
    Best,
    Jay.

  2. Yeah, I tested negative for Hiv about a year ago. And then had a couple of protected encounters with a white girl I know. ( no worries about her)
    Apart from the slippage, in which I didn’t notice any blood or vaginal fluid in my dick, I’d like to add something.
    Well, I’m mostly worried since at one point I noticed there was a bit of blood on the condom ( it didn’t slip off this tome) , I asked her why? And she told me we had been fucking in a kind of rough position for a long time and it had irritated her delicate skin ( plus she somehow suggested that perhaps it was because my dick was a bit bigger than average, I guess she might have also been dry , I am not sure) . Once I saw this, I put on a new condom, then she washed her vagina, we continued to have sex.
    How risky do you think this encounter was?
    How about Hiv in Colombia?
    I am really anxious Rob.
    Any piece of advice.

    1. You can go and do research on HIV in Colombia. Fucking women dry is not cool and women bleeding during sex is not ok. That is the sort of thing that can transmit HIV female-male.
      OTOH, I do not think you got HIV from her. But I get an HIV test once a year. Nowadays when you date women, they ask to see a recent HIV test, say in the past year or so. Interesting.

  3. By the way, do you think Colombia is a Shithole?
    I am kind of evaluating the sort of people ( women) that you would find on a regular basis there?
    As I fucked a CSW I don’t kniow if this changes the situation.
    Regards.

  4. Look, I certainly think you’ve elaborated on rather interesting topics here. ( going off base in terms of the initial question) Pardon my ignorance, but how are colombians classified in terms of race? Are they indigenous?

    1. Not sure, they are mixed race people. Not sure how it all boils down, but the genome is a mix of White, Indian and Black. About 20% are pretty much pure White, and then you have everything in between.

  5. Rob, how do you happen to know so much about such unrelated topics?
    Not only do you seem to have vast knowledge in terms of infectious diseases but also in terms of anthropology, genetics, history, politics and so on…
    I’m really impressed, I think you could easily make it to Harvard as a professor. Did you ever consider becoming a Professor or the like?

    1. Haha, thank you very much! Well everything is getting so specialized nowadays you know. There is not much room for a Renaissance Man or a polymath. Also I have a Masters Degree but not a PhD. Also the academic track nowadays is more of a nightmare than anything else, at least in the US. And then there is the publish or perish thing.
      However, I should have my first publication coming up in 1Q 2015, a book chapter in a book out of Turkey. However, some of my enemies are already tearing me to bits over it, claiming that I know nothing about the subject I am writing about. They have only read the abstract, not the whole piece.
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