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make your mind up!!

May 13, 2003

hi dr i seem to be coNfused hear ive read many posts on hear saying you canot CANOT GET HIV FROM RECEVING ORAL SEX!!! THEN THE POST IVE JUST READ YOU STATE YOU CAN !!!!! Dr. Frascino I took a poll Posted: May 8, 2003


I asked all of my friends about recieving not giving oral sex and all of them said they do NOT use a condem for this I am with them by the way. We are all guys if that makes a difference. Even if any of us had ars symtoms should I tell them they should be tested? Everyone is under the assumsion that you dont get hiv that way but I am not positive even after reading your answers because an extremely small risk is still a risk and if you have hiv symptoms after maybe you should be concerned. My friends call me nuts and they are college educated but I am still not sure. If this is your only real risk as a doctor would you say to get tested with or without the CLASSIC ARS SYMPTOMS?


As with all things in life, we weigh the risk versus the benefit, and then decide what to do. You see a traffic light change from green to yellow as you approach it in your car and decide if its worth the risk to proceed through the intersection or better to slam on the breaks. Well, sex isnt exactly like driving (its a whole lot more fun), but the same principle applies. Everyone needs to understand the potential risk of what they are doing, and then decide if they are willing to accept that degree of risk.

Is a small or even "extremely small" risk still a risk? Absolutely.

Does oral sex have a theoretical risk? Yes, it does.

Is that risk extremely, extremely small? Well, yes it appears it is.

So what do I recommend for guys who choose to have unprotected oral sex? I remind them there is a theoretical risk, and suggest HIV testing every 6 months or so, with or without classic ARS symptoms.

Hope that helps.

Dr. Bob

Response from Dr. Frascino


Make up my mind? I have made up my mind. Perhaps it is you who now must make up yours. Please read my responses carefully; they are all very consistent. I never said, "You cannot, get HIV from receiving oral sex." What I have said over and over and over again is that the risk of acquiring HIV from oral sex is extremely low. The most recent studies have shown that this "extremely low risk" is most likely even lower than previously estimated. I always add the caveat that despite the "extremely, extremely low risk", that does not mean there is absolutely no risk. The theoretical risk remains, and there may also be extenuating circumstances for instance, blood in the mouth from recent trauma coupled with cuts or open sores on the penis, etc. Yes, I do believe the insertive partner is at lower risk than the receptive partner. Again, thats just common sense.

Please note I try to respond to each question based on the information provided. Consequently, the person who writes in saying a sex partner of unknown serostatus "licked my penis for 10 seconds 15 years ago" and is now worried that the pimple on his butt that appeared last night might be HIV resulting from his indiscretion 15 years ago is far, far different from the questions I receive from very sexually active men who enjoy the pleasures of sex with multiple casual partners on a regular basis. The risk of contracting HIV from insertive oral sex per episode for both these questioners remains exactly the same extremely, extremely low. However, I would advise the first gentleman his theoretical risk is so incredibly small that its essentially off the radar screen. In other words, the pimple on his butt should not be a worry for HIV. My response to the second questioner is that sexually active folks, who have unprotected sex, including oral sex, should have periodic screening for STDs. I usually recommend every 6 months. The HIV risk for unprotected insertive oral sex remains extremely, extremely low; however, other STDs are more easily transmitted as demonstrated by the recent rise in syphilis and gonorrhea. As part of this periodic STD screening, I would advise HIV screening as well. Certainly number of partners and extenuating circumstances can change overall "risk." However, in spite of this, the overall risk remains extremely, extremely low, but we cannot say that it doesnt exist. Many folks write to me wanting me to proclaim oral sex has absolutely no risk under any circumstances. I cannot do that. I can only give you the scientific facts and advise you of relative risks. After that, its you who must make up your mind.

I hope that clears up any lingering confusion.

Stay well; stay informed.

Dr. Bob

Thank you for your help!
Dr. Bob....truly a Saint!

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