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Since when is protected sex with prostitutes risky?
Jan 19, 2002

I am writing to you about your response posted on Jan 13, 2002 when someone wrote about protected vaginal sex with a prostitute. He wrote to you for advice regarding his sore inguinal nodes. Why did you tell this person he was at risk? According to the Hopkins site and the transmission forum on this site protected vaginal sex and receiving oral sex with or without a condom does not lead to HIV infection and testing is not even needed. Do you think that recieving oral sex is a risk even though there have been no reported cases in 20 years and if so I guess you also believe that deep kissing would also be a risk then. Or do you think that vaginal sex with a condom is a risk? I am a little confused.

Response from Dr. Dezube

Your question is a fair one. Protected vaginal sex and unprotected oral sex with a prostitute is probably not a traditional risk factor in the way that unprotected anal sex is. HOWEVER, there are associated risk factors. For example, alcohol is a risk factor for HIV in gay men (HIV- negative) who drink to the point of excess since such men are at risk of having unprotected sex without even knowing it. In this forum, I give my best opinion which in many cases is based on hard data, and in other cases is based on soft data. I stand by my initial comment that a man who frequents prostitutes is putting himself and his HIV-negative girlfriend at risk. The condoms diminish his risk, but certainly do not eliminate risk. I appreciate that you brought up your concern with my response.


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