Breast Milk - cut on tongue - HIV

[wick704]

Doctors, I am a 35 yr old man. 3 weeks ago I had a sexual encounter with a prostitute, we engaged in condom protected vaginal sex and condom protected oral sex. I am not very much worried about this part,

I am worried mostly about this:

she is lactating and i sucked on her breasts for few minutes, (This is my fantasy and am kicking myself now). I swallowed some of her milk (it tasted sweet, i am sure) I am worried because I have a cut on my tongue, not on the tip though..little deeper..It could be bleeding.

I understand that ingestion of breast milk is not a risk in adults as we have developed immune systems, but my concern of worry is her breast milk coming in contact with the cut/there by blood.

In my head, I am thinking this is a risky behavior as it has chance of two bodily fluids coming together.

Please explain...I am kicking myself for not running to ER to get Prep..would you or any doctor would have recommended prep for this sort of occurrence.

Do you recommend getting tested, if so what kind and how soon?
appreciate you help.

[Edward W Hook, MD]

Welcome to the Forum.  I'll be pleased to comment.  None of the activities you describe, condom protected oral and vaginal sex and ingestion of a partner's breast milk place you at any known risk for HIV.  The  cut on your tongue does not change this in any way.  There is no risk for HIV from ingestion of breast milk or other material containing the virus because the acids and enzymes present in the stomach kill the virus.  The cut on your tongue does not represent a meaningful site of possible entry for the virus either.  Cuts of any sort seal off almost immediately after they occur, preventing access of infected material DEEP into tissue where it might cause infection.

You do not even know that your partner had HIV and, in fact, most commercial sex workers do not.  PEP would not have been recommended for you in the situation you describe.

I hope these comments are helpful. Nothing you have mentioned raises any concerns.  In fact, from wht you say, I see no reason for HIV testing at all EWH

[wick704]

Thank you doctor. you do a great service here.

[Edward W Hook, MD]

Yes, the test you had is a DUO test and the results are conclusive, proving what I told you a month ago.  You need to move on.  EWH

[wick704]

Doctor Hook,

I finally had a test (HIV screen 4rth generation wRfx) from Labcorp at 6 weeks 2 days. The results came out 'non-reactive'.

Is this test the same as antigen/antibody DUO test?

Are my results conclusive at this point?I would like leave this all behind and move on with my life.

I would like to believe this test results.hope there is no twist in the tale.

Thank you so much for your service here.

[wick704]

This Question is more for the informed members than Doctors.

As I am getting closer 6 weeks of this exposure, I would like to get a HIV DUO Test done, for my peace of mind. I am uncomfortable going to a Doctor, all the walk in STD clinics here (Austin,TX,USA) seem to offer standard HIV Test only.

Can I order a HIV DUO Test online myself? if could anyone refer me to such a website.

Thank you very much.

[Edward W Hook, MD]

DUO tests are widely available in the U.S.  They are known as "4th generation tests", DUO tests, or combined HIV p24 antigen/HIV antibody tests.

After 4 weeks the accuracy of the test does not change.  It is conclusive at that time.  

False positives are most uncommon in both DUO and antibody tests.  EWH

[wick704]

Dr.Hook,

While I am significantly less scared after your explanation. I am an anxious person and see myself getting tested eventually. so, please answer some of my concerns.

Are DUO or similar tests (Antigen + antibody) Tests available in the US?

Is a 6 week DUO test more accurate than a 4 DUO week test?

Is a DUO Test more susceptible to a false positive than a Regular Anti-body Test.

Thank you very much Doctor.

[Edward W Hook, MD]

I stated the FACTs earlier, contact of Breast milk with a cut on your tongue is not a isk factor for HIV. There have been thousands, if not millions of such exposures and nothing of the sort has EVER been reported.  Further, it remains unlikely that she was even infected.

No change in my assessment or advice. EWH

[wick704]

Thanks for your reply Doctor.

I am freaking out at the possibility of her breast milk coming in contact with blood from the cut..or entering the cut and entering the blood stream. are you saying the virus doesn't transmit this way?

could you please elaborate on this? Thanks