Sore Spot

Syphilis vs. AIDS

Does your provider have the “AAHIVS” letters after his or her name?

Sore Spot

I suppose you’ve answered this question many times, but I don’t know the answer, so here it is… If a person does not have sores or lesions anyplace in their mouth or throat, can one get HIV from swallowing semen?

Bill

Overall the risk of HIV transmission from an infected partner through oral sex is very minimal as the mouth usually is an inhospitable environment for HIV. Saliva appears to contain an enzyme that breaks down HIV, and the skin of the mouth is hardier than the anal or vaginal regions. Furthermore, it is difficult to measure the exact rate of HIV transmission through oral sex, as sometimes persons are engaging in other unsafe practices.

However, there have been documented cases of HIV transmission through oral sex. For instance, in the Options Study in San Francisco among men who have sex with men, 7.8% were found to be infected through oral sex. Increased rate of transmission due to oral sex is not only increased with oral trauma/lesions but also with overall inflammation, other STIs, and an overall immune suppression.

Therefore, while the risk of transmission is significantly lower in the hierarchy of risks, the risk still exists.

Sara Back, FNP, MPH, AAHIVS
New York, NY

Back to top

Syphilis vs. AIDS

What is your take on neurosyphilis being AIDS?

William

Neurosyphilis, a late complication of untreated syphilis infection, can involve the brain and other parts of the central nervous system. People with neurosyphilis and HIV can have a variety of symptoms, anything from almost no symptoms at all to headaches to dementia. While syphilis in persons with HIV may be more likely to progress to neurosyphilis and over a shorter period of time than an HIV-negative person with syphilis, it is not an AIDS-defining diagnosis by CDC definitions. It is important for people living with HIV to be tested for syphilis (preferably once a year) with a blood test to detect infection. This strategy will make sure that people with HIV and syphilis are treated long before they can develop neurosyphilis.

Aimee Maree Wilkin, MD, MPH, AAHIVS Wake Forest University, School of Medicine, Winston-Salem, NC

Back to top

Does your provider have the “AAHIVS” letters after his or her name?

Those six letters indicate that your physician, nurse practitioner or physician assistant has met rigorous requirements to ensure the highest quality HIV care for you.

Are you getting the best possible care? Is your provider an HIV Specialist™ credentialed by the American Academy of HIV Medicine (AAHIVM)?
The American Academy of HIV Medicine (AAHIVM)’s HIV Specialist™ credentialing program is the first and only clinical credentialing program offered domestically and internationally to physicians (MDs and DOs), nurse practitioners and physician assistants specializing in HIV care. HIV care providers become designated HIV Specialists™ (AAHIVS) after meeting experience and education requirements, and successfully completing a rigorous exam on HIV-specialized medical care.

Due to the space limitations, all submitted questions cannot be answered in this column but we are making every effort to ensure you receive the information you have requested from the HIV Specialist™. For more information about AAHIVM, visit www.aahivm.org or call 202-659-0699

Back to top

E-mail your questions to aahivm@tpan.com, or send a letter in care of “Ask the HIV Specialist,” TPAN, 5537 N. Broadway St., Chicago, IL 60640.

The American Academy of HIV Medicine (AAHIVM) is an independent organization of physicians, nurse practitioners, physician assistants and others dedicated to advancing excellence in HIV care through the HIV Specialist™ credentialing program, advocacy work and continuing education opportunities. E-mail your questions to aahivm@tpan.com.