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The bottom line Is rectal mucus a source of HIV transmission? by Chuck Osborne rectal mucus a source of HIV transmission? There have Isbeen few studies conducted on rectal secretions and HIV plasma load, but the limited data does point to the probability that rectal mucus has a higher concentration of HIV than other bodily fluids such as blood or semen. Rectal mucus is a natural-forming substance that occurs when the bowels contract to allow smooth passage of stool. In most people, this only happens in small amounts. Most rectal mucus discharges are benign, but there are many conditions that can cause abnormal or excessive discharge. Amongst these could be hemorrhoids, anal fissures, prolapses, and warts. Crohn’s disease, colitis, rectal ulcers, anal tuberculosis, or any number of sexually transmitted infections (STIs), as well as some AIDS-defining illnesses, could also be responsible. It’s also normal that rectal mucus can consist of a litany of fluids, the most evident being blood. The US Centers for Disease Control and Prevention do not specifically list rectal mucus as a source of HIV transmission, and very few other agencies mention this fluid by name; however, the general reference to vaginal or anal fluids presumably includes anal mucus. The US Centers for Disease Control and Prevention do not specifically list rectal mucus as a source of HIV transmission, and very few other agencies mention this fluid by name. Nevertheless, scientists have been aware that rectal fluids can be a source of infection since Dennis Osmond’s report from the University of California, San Francisco, in 1998. There appear to be only two studies of note that have attempted to measure levels of viral load in rectal mucus. The first, conducted in 2000 by investigators at the Center for AIDS & STD at the University of Washington in Seattle, found only one man out of 54 participants with blood plasma viral loads below 50 copies/mL who had detectable HIV virus in rectal secretions. The other study, conducted in 2004 by Zuckerman et al, again at the University of Washington, compared viral loads in the blood, semen, and mucosal lining of the rectum in 64 gay men in the US and Peru. Viral loads tended to be higher in rectal mucus. Bodily fluids and their risk factor in HIV transmission HIV is not present in: • Urine • Feces • Vomit • Sweat HIV is present in negligible (non-infectious) quantities in: • Saliva (only detected in a very small number of people) • Tears • Blister fluid HIV is present in sufficient (infectious) quantities in: • Rectal lubricating secretions (in very high concentrations) • Blood and blood products • Semen and pre-ejaculate (pre-cum) • Vaginal/cervical secretions or juices • Breast milk Zuckerman’s study fails to note that of 63 patients, only 27 were on antiretroviral therapy and only 18 had undetectable viral loads. The study also doesn’t address how long the viral load was non-detectable before biopsy, or the type of antiretrovirals participants were taking. We know from many other studies that some people can have undetectable viral load in their blood but detectable viral loads in either genital secretions or sperm. Scientists believe that this may be more likely to happen in people who have STIs or even asymptomatic herpes (that is, herpes with no visible symptoms). The bottom line is that when engaging in anal sex, it’s always wise to use precautions. 5 Chuck Osborne is a volunteer with BCPWA’s Prevention and Treatment Information Programs. 8 living5 MayqJune 2010
Cover Story BCPWA is changing with the times by Adam Reibin Changes are afoot here at BCPWA. If you’re a regular participant in our programs, services, and events, you’ve no doubt noticed several changes in our methods of operation over the past two years. If you connect to us only through our external communications resources, recent enhancements to our published content and graphic style should make the new trends in our Society’s direction just as obvious to you. If this issue of Living Positive is your first introduction to BCPWA, welcome; you couldn’t have chosen a more exciting time to get involved. New audiences are at the core of BCPWA’s efforts to transform. Why? Because we’re committed, by our mission, to “enable persons living with AIDS and HIV to empower themselves through mutual support and collective action.” This statement is no less relevant to our community today than when BCPWA members crafted it in 1990. continued on next page MayqJune 2010 living5 9
Page 1 and 2: inside 333 features q treatment inf
Page 3 and 4: Canada cuts funding to internationa
Page 5 and 6: The FIGHTING WORDS Fighting back Th
Page 7: Jennifer Evin Jones For the past 15
Page 11 and 12: Cover Story just some of the progra
Page 13 and 14: HIV-positive status to his partners
Page 15 and 16: Pain and anguish—and bliss One HI
Page 17 and 18: treatment *nformation TREATMENT INF
Page 20 and 21: Feature Story When old is new The i
Page 22 and 23: Feature Story and notes that future
Page 24 and 25: Antiretrovirals Whatever happened t
Page 26 and 27: Please phone 604.893.2239 or email
Page 28 and 29: Nutrition Nutrition and HIV, revisi
Page 30 and 31: Wednesdays • 5:30 PM • Training
Page 32 and 33: Let’s clinical! get Clinical tria
Page 35 and 36: New BCPWA AGM voting procedure Now
Page 37 and 38: Volunteering at BCPWA Profile of a
Page 39 and 40: If you are a member of the BC Perso

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