Anonymous
Hi!

Reading some of the answers i find it confusing since it seems its suggested that CSW protect themselves when this is actually misleading. I know the helplines mission is to assess risk but to be realistic in Canada and more in other parts of the world CSW are immigrants and people with scarce resources who cant afford to pay HIV treatments and wont get it for free in a country that is not their country! Even if CSW protect themselves by asking clients to wear condoms etc their job exposes them to lots of cases of condom failure! The chance of getting HIV from sex with a CSW is very high so i would say its not worth even doing it... HIV was spread in Thailand this way! Also CSW dont get tested thats false and if they are positive they are not going to quit and work as engineers the next day! I just want yo say that HIV is riskier in high risk groups. I received oral (inserted my penis) from a CSW 5 weeks ago and im dying of panic now! What if the CSW bit her lip while doing oral to me or what if she had bleeding gums... its all we did but we showered before in warm water which might inflamate my penis mucous membrane and increase transmission risk please help if this might be worth testing. Also please do tell ppl CSW are a high risk group. Thanks s lot!
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Anonymous
Hi there,

Thanks for posting to our website and asking for clarification on this matter. I'm glad we can get the chance to talk about this today. This is a good opportunity to talk about why AIDS Vancouver doesn't base HIV risk on a group of people -- i.e. why we don't marginalize people when figuring out HIV risk.

We at AIDS Vancouver will never tell people that commercial sex workers (CSWs) or any other group of people create a higher risk for HIV transmission. This is because AIDS Vancouver strongly stands behind the substantial research and evidence-based opinion that HIV risk depends on the activity, not the person. Whether your partner is HIV positive or not, the *only* thing determining your risk for HIV transmission is the *activity* you engage in. For example, kissing is a no-risk activity for HIV transmission, regardless of who you're kissing. Even if you're kissing someone who is HIV positive, you will not acquire HIV from that kiss. However, having unprotected sex or sharing needles with someone is a high-risk activity for HIV transmission, again regardless of who you're having sex with/sharing needles with. Just because someone is HIV positive does not mean that you are definitely at risk for HIV transmission yourself. Your risk always goes back to the nature of the *activity, not the person*.

We at AIDS Vancouver encourage people to take ownership of their sexual activities and understand the HIV risk based on *those activities*, and not base their risk on the person they were involved with. Basing your HIV risk on a certain person/group of people (i.e. CSWs) will lead to inaccurate, false, and often hurtful conclusions, especially since CSWs are an already marginalized population. Therefore, we at AIDS Vancouver stand behind the well researched fact that HIV risk depends on the activity and not the person. This is why we tell all our posters that your HIV risk does not change based on the person you're with. HIV does not discriminate against occupation, gender, race/culture, sexuality, age, or any other factor.

As for your sexual activity, let's trace it back to its risk and go from there. It sounds like you're feeling distressed about receiving unprotected oral sex. Receiving unprotected oral sex is a negligible risk activity. That means that even though there's technically a risk since it involves the exchange of body fluids, there has never been a reported case of HIV transmission from this activity. This is mainly because saliva contains enzymes that prevent the growth and transmission of HIV. Therefore, the saliva involved in oral sex acts as a preventative barrier against HIV. In addition, if someone has a significant sore or bleeding gums, their *own* risk for acquiring HIV from someone else goes up. Your risk for HIV transmission largely stays the same. In other words, they become at higher risk of acquiring HIV from you rather than giving you HIV.

Overall, it seems like you're feeling worried about a sexual activity you had, and you are "dying of panic now" because you thought that CSWs create a higher HIV risk for you. This is not true. Your sexual activity was a negligible risk. *The fact that you received oral from a CSW does not increase* HIV risk. While, testing for this activity may not be required, we at AIDS Vancouver still encourage all sexually active people to get tested regularly for HIV and STIs for one's own sexual health.

Finally, in sum: *HIV risk is based on the activity you engaged in, not the person you engaged with.*

Thanks again for giving me the chance to clarify why AIDS Vancouver does not single out specific groups for acquiring HIV.

I hope I have answered all your questions and addressed your concerns, and I wish you the best.

In good health,

Tiina

AIDS Vancouver volunteer
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