我没有成为世界第一，你们也不会
昨天拿到本市最大三甲医院42天阴单，终于完全放松了。我的行为是WTKJ，但是因为XJ有口腔溃疡，第二周又开始出现一些症状，所以开始恐惧。最恐的是第二到第三周，感觉整个人都垮了。20天开始检测，期间试纸测了9张，县二甲医院测了4此，前天42天本市三甲测最后一次。最后一次检测之前，每次检测都稍微放松，但是不久后又重新恐惧。其中28天自测还出现过隐约红线吓个半死。4周以前基本每天都上论坛浏览，查资料。这个论坛真的很好，各位志愿者，尤其是Q哥，每次提问都不厌其烦的回答，Q哥在我20天自测的时候就结合我的行为判断我排除，也给了我信心。再此感谢各位，言语无法言表，我也将这段时间找到的一些资料共享一下，有些可能本论坛之前已有，稍微整理了一下。由于我的行为是WTKJ（DTXJ不到2分钟，没有意外，我不恐这个，所以没有关心这方面的问题）。有些是国外网站资料，本人英语水平不佳，但是借助Google翻译还是能大概看懂9成，一些问题简单粗暴的翻译一下，勿见笑。
1、国外一个HIV检测网站关于KJ感染几率评估
-----http://i-base.info/guides/testing/oral-sex：
Oral sex is generally a low risk activity. It is likely to be zero or close to zero in most circumstances. This will be higher depending on these factors:· Whether you are receiving or giving oral sex? Receiving oral sex is likely to be zero or near zero risk. Saliva is not linked to HIV transmissions. · Whether you are giving oral sex to a man or a woman? Giving a woman oral sex is likely to be zero or close to zero risk. Cervical/vaginal fluid, even if infectious, is more difficult to get in your mouth compared to semen. · Whether cum or pre-cum or gets in the mouth? If there is no cum or no pre-cum then the risk is zero, but it can sometimes be difficult to know this. · The oral hygiene of the person giving the oral sex? The mouth is generally very resistant to infection, but cuts or sores, bleeding gums, can be a route for infection. · Most cases reporting oral sex as a risk for HIV report mouth problems. Gum problems are common (perhaps in 10-50% of adults). If your gums bleed when you brush your teeth or floss this will be a route for HIV.
口交是低风险行为
口交**方（被动方）风险为0或接近0，唾液不会引起感染。
男性给予方风险接近0，
女性给予方没有接触前列腺液前提下风险为0
给予方存在伤口或溃疡，牙龈出血，可以是一个感染途径。
已报告的口交作为艾滋病感染风险，都存在牙龈问题（也许在10-50％的成年人）。
（注意：这个风险行为分析，除了第一点，被动方，其他的可能存在风险都是主动方，包括提到口腔问题主动方可能存在风险。我也想过，包括其他很多资料，都没有提到主动方有口腔问题，被动方有可能感染，人家既然想到主动方有口腔问题作为一个风险因素，那也应该考虑到主动方口腔问题给被动方带来的风险，只有一个合理解释，他们认为这个不是风险）
2、另一个论坛上翻译的一位专家关于KJ的分析
---http://www.hiv-vct.net/forum/dispbbs.asp?BoardID=29&ID=112286&replyID=&skin=1
f the different sex acts, the one that often causes the greatest amount of confusion in terms of risk – and raises the greatest number of questions – is penile-oral sex. The fact is, most experts agree that fellatio, sometimes referred to as "blow jobs," is not an efficient route of HIV transmission. However, this does not mean that it cannot happen.在不同类型的性jiao中，关于KJ的风险是最容艾滋病生疑惑的。事实上，很多专家同意KJ，有时被称作吹箫，不是一个有效的HIV传播途径。但是，这并不意味着它不能发生。 Research attempting to evaluate the risk of fellatio has often faced important limitations. For starters, very few people participating in studies only engaged in penile-oral sex. Many people also had unprotected vaginal or anal intercourse, making it very difficult to determine if unprotected fellatio is an "independent factor" associated with HIV transmission. There are also people who test positive for HIV and claim that unprotected fellatio was their only risky behavior. However, it's virtually impossible to know if these people are always reporting their sexual behavior accurately. (Study volunteers often have a difficult time admitting the truth about potentially embarrassing behavior to healthcare professionals conducting scientific studies.)研究试图估计KJ风险有很多重要的限制。首先，很有有人只进行了KJ。很多人都还进行了未保护的YJ和GJ，这使得估量无套KJ的独立风险十分困难。有HIV阳性患者声称他们只进行了无套KJ。但事实上，我们不可能知道他们是否真实准确地描述了他们的性行为。（研究志愿者也总是会有对研究科学家不好承认潜在的其他性行为的真相的时候。） Because unprotected fellatio can mean that body fluids from one person can (and do) come into contact with the mucosal tissues or open cuts, sores, or breaks in the skin of another person, there is a "theoretical risk" of HIV transmission. "Theoretical risk" means that passing an infection from one person to another is considered possible, even though there haven't been any (or only a few) documented cases. This term can be used to differentiate from documented risks. Having unprotected receptive anal or vaginal intercourse with an HIV-positive partner is a documented risk, as they have been shown in numerous studies to be an independent risk factor for HIV infection. Having unprotected oral sex is a theoretical risk, as it is considered possible, but has never been shown to be an independent risk factor for HIV infection.因为无保护的KJ意味着能且确实通过粘膜组织、新鲜割伤、伤处或皮肤裂缝处与其他人的体液进行接触，这使得存在理论上的HIV风险。理论风险意味着即使从未有过或者只有极少数备有文件证明的例子，通过这种途径感染HIV也是可能的。然后理论风险与实际风险是不同的！同HIV阳性患者进行无保护的接受性GJ或者YJ是被实践证实的，因为他们作为独立的风险因素出现在很多的研究中。进行无保护KJ是存在理论风险的，这意味着它是可能的，但从未被仍定为一个感染HIV的独立风险因素。 Here's a good way to think about theoretical risk: In theory, it is possible that while walking down the street, a meteor will fall on your head and kill you instantly. This is because meteors do occasionally fall to earth. People live their lives above ground, so there is a theoretical risk of being hit be a meteor. In fact, there have been reports of a few people being hit by meteors. But because the risk is so small, given that few meteors fall to earth and the large number of inhabitants of this planet, the risk is purely theoretical. The same principle holds true with oral sex – millions of people all over the world are believed to engage in unprotected oral sex and there have only been a handful of documented cases of HIV transmission. In turn, fellatio, and other types of oral sex (see below), remains a theoretical risk for HIV infection.这有一个很形象生动的方式去了解理论风险：理论上，当你走在街上，一颗流星坠落砸在你脑袋上，并导致你立即死亡时可能的。这是因为流星确实偶尔坠落到地球上，而人们居住在地球表面，所以确实会有理论风险被流星砸中。但因为这个风险可能性太小，即使这么多的人居住在地表，而且确实有一些流星坠落到地表。同理，对KJ而言，全世界数百万人都进行过KJ，但只有少数被证实感染的例子。继而考虑，吮吸YJ及以下的其他KJ，仍只是存在这理论上的HIV感染风险。 There have been a number of studies that have closely followed MSM and heterosexual couples, in which one partner was HIV positive and the other partner was HIV negative. In all of the studies, couples that used condoms consistently and correctly during every experience of vaginal or anal sex – but didn't use condoms during oral sex – did not see HIV spread from the HIV positive partner to the HIV negative partner.有很多针对男同性恋和异性恋夫妇的研究，他们通常是一方是HIV阳性，另一方是HIV阴性。在所有的研究中，每次YD或GM性体验夫妇坚持且正确地使用避孕套，但KJ过程中不使用避孕套，没有发生一起感染例子。 There have been three case reports and a few studies suggesting that some people have been infected with HIV as a result of unprotected oral sex. However, these case reports and studies all involved MSM – men who were the receptive partners (the person doing the "sucking") during unprotected oral sex with another HIV-positive man. There haven't been any case reports or studies documenting HIV infection among female receptive partners during unprotected oral sex. Even more importantly, there hasn't been a single documented case of HIV transmission to an insertive partner (the person being "sucked") during unprotected oral sex, either among MSM or heterosexuals.确实有三个实例和一些研究提到一些人通过无保护的KJ感染了HIV。但，这些报导和研究全部出现在男同性恋中——男男主动KJ方（吮吸的一方）给HIV阳性患者KJ。至今为止，在女性主动KJ方中，没有任何一例感染报道。更加重要的是，没有任何一个例子报道出现在无保护KJ插入方中，无论是男同性恋群体还是异性恋。 Is insertive oral sex a possible route of HIV transmission? Yes. But is it a documented risk? Absolutely not.插入KJ时HIV感染的可能途径吗？是的，但有事实证明吗？当然没有！
3、HIV的真相- Medhelp
这个好像本论坛上有，我在Medhilp上也查到原文。关于KJ部分的节选：
The Great ORAL Debate.This is probably our most common question.Unprotected oral sex.Is it a risk?The short answer: NO.The long answer....
There is often a difference in the answers given by the docs in the expert forum vs us.People have to understand that medical professionals and the CDC have a responsibility to be ULTRA conservative when discussing risks.Therefore, there is a MINUTE "theoretical" risk assigned to oral sex.If oral sex was TRULY a "real" risk, there would be new cases all the time of HIV being transmitted in this manner.There absolutely is NOT.And a "theoretical" risk is VERY different from an actual risk.The docs have BOTH said time and time again in the expert forum that neither of them, in their combined DECADES of being specialists dealing with HIV have EVER seen a case of HIV as a result of oral sex, nor have they READ any convincing cases.There is a physiological reason for that.First, the virus isn't present in the saliva, making infection impossible for the receptive partner (the person receiving oral sex).Secondly, for the person GIVING oral sex, THEIR saliva contains enzymes that inhibit the virus, should they be exposed to infected genital secretions.Secondly, again, the virus has been exposed to the air and elements, rendering it inactive in an oral situation.This debate will continue, but again, for anyone worrying about an oral "exposure"...think of the facts.If it was truly a risk, there would be newly reported cases ALL the time. 关于口交的大讨论。这可能是我们最常见的题目。无保护的口交。有风险吗？简单回答：没有。拆开来说…通常我们的回答和专家论坛的答案有所不同。大家要明白一点，医学专家和CDC在讨论行为风险的时候有必要保持过度的守旧。所以，口交是有一个极小的所谓的“理论”风险。假如口交真有“事实”的风险的话，那么应该总能发现一些通过这种行为感染的新病例。但是绝对没有。同时“理论”的风险和实际的风险有很大的不同。专家版块的两位专家（译注：Dr.HHH和Dr.Hook）经常说，在他们两个作为HIV专家几十年从来没见过一例通过口交感染的例子，和没有看到过任何可信的报道。这里有一个生理学的原因。首先，口水中是没有病毒的（译注：不足以感染的病毒含量）所以口交的接受方是不可能感染的。其次，对以口交的主动方，他们的口水中有多种酶可以抑制病毒，假如他们暴露于感染性的生殖器分泌液。再次，在口交的过程中，病毒已经暴露于外部环境中，已经失活。这个争论还会继续，但是再说一次，假如谁担心口交的风险，那么请想想这些事实。假如真是个有风险的行为，那应该总有新的案例报道。
4、MEDHELP上一位医生Dr. Jose Gonzalez-Garcia对KJ的分析，大家上MEDHELP论坛HIV分坛首页就可以找到：
Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD Can I get HIV through oral sex?Jan 20, 2010 - 52 comments
Tags: oral sex sexual health vaginal sex HIV HIV infection Oral Anal Sex Can I get HIV through oral sex? is probably one of the most frequent questions we get asked at Freedomhealth either in person or via our Sexual Health Forum. The answer is yes, possibly, but it is exceptionally unlikely.
There has been a great deal of interest and many research papers written about the HIV risks associated with oral sex and similarly many studies to try to determine why the risk of oral sex with an HIV positive person might be less than that associated with unprotected penetrative vaginal or anal sex.
Romero and others, in their article describing an excellent and diligent long term study failed to identify any risk at all in transfer of HIV from an HIV positive to an HIV negative partner through oral sex. In total 19000 episodes of oral sex were documented amongst 135 heterosexual couples over ten years and in 34% of these episodes the HIV positive male ejaculated into the HIV negative females' mouth. (Romero J et al. Evaluating the risk of HIV transmission through unprotected orogential sex. AIDS 16:9:1269-97, 2002.)
Baggaley and others, in their article Systematic review of orogenital HIV-1 transmission probabilities. International Journal of Epidemiology 37 : 1255-65, 2008 have reviewed the major articles to date and conclude that the risks of HIV transmission via oral sex are low.
To reach their conclusions they conducted a systematic review of the available literature. Ten studies from North America and Europe were identified as meeting the required criteria.
The authors noted some difficulties with the methodology of the studies. These were mainly the common ones of:-
- People rarely confining their sexual activity to oral sex alone
- where people have had other sorts of sex including unprotected anal or vaginal penetration it is assumed that the higher risk activity will have given them HIV
- exact details of the sexual activity have been missed out - ie whether or not ejaculation into the mouth etc
- Studies where one partner is known to be HIV positive and the other HIV negative are likely to be slightly skewed because the HIV positive person is likely to be on anti-retroviral medications and consequently probably less infectious anyway.
The overall conclusion was that:-
- Chances of acquiring HIV through oral sex with an HIV infected partner are very low. The majority of the studies reporting zero to miniscule risk.
- Very large, very expensive, well controlled studies would be needed to define the question exactly.
The results of a study due to appear shortly in AIDS seem to show that HIV negative gay males in sero-discordant ( a relationship where one of the partners is HIV positive and the other HIV negative) relationships have saliva which has an HIV neutralising capacity. Consequently one of the conclusions drawn is that repeated exposure to low levels of HIV may produce a level of resistance to HIV in this population.
Posted by Freedomhealth
文章提到一项研究，针对135名异性恋夫妻一方阳性的10年19000次WTKJ追踪，没有人感染。
最后得出结论，KJ风险极低，大部分的研究认定其没有风险。
期间还看到本论坛有些帖子引用MEDhelp上专家关于KJ的回答和观点，为了印证，我也上去查了，那些话基本上能从MEDhelp上面找到，几个医生可能对这个问题回答的太多了，每次回答样式也基本固定，无非就是我没有见过一个例子/从事这方面研究的专家不认为这是一个风险/风险极低和无风险一个意思等之类的话。
最后，还是要谢谢论坛，谢谢志愿者，谢谢QQ哥。感受什么的就不写了，一个粗人，不过期间确实想了很多，也下决心，如果上天眷顾，逃过一劫后以后要做些什么。
我走了，以后不会再来，不会复高，回家好好陪家人过日子
兄弟我就是wtkj,心理压力好大！祝你以后幸福
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