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Why do you ignore people from Mongolia? (Kidding, Dr. Bob!)
Jul 3, 2003

Dear Dr. Bob,

I apologize in advance for this rather detailed historia sexualis, as Aristotle might say, and subsequent lengthy missive, but I'm quite nervous and can't seem to get myself thinking about my situation rationally. A word of two of counsel from you would really help put me at ease - your humor and intelligence always put a smile on my face, even as I've combed nervously through the archive looking for answers.

For the past two years of high school, I was involved exclusively with a girl my same age. Before our relationship, she was a virgin and without any sexual experience (no mutual masturbation, oral sex, etc), and I was a virgin, though had engaged once in both giving and receiving oral sex. We lost our virginity to one another, and had quite frequent (unprotected) oral sex throughout the course of our relationship. The relationship, sadly, ended sometime late this year.

I'm not one to wallow, I suppose, and on June 1st, I received oral sex from a girl whom I know, and engaged in quite a heavy-handed and dexterous (puns intended) session of mutual masturbation and fingering with her. The young lady in question is also allowed to wear white at her wedding, according to Victorian rules of etiquette (i.e., a virgin), though has engaged in various acts of oral copulation with perhaps seven or eight young gentlemen. I also know that when younger and slightly depressed, she would engage in self-cutting (though fortunately, that has most certainly stopped).

It seems to me that her chances of having HIV are fairly small, but I am concerned because during our session of fingering etc., one of my fingers that spent a great deal of time probing the innermost crevices of the pudenda had a fingernail trimmed back fairly far, so that the skin was not bleeding or red, but certainly sensitive to the touch.

Then, exactly two weeks later, I had another sexual encounter with my long-time girlfriend, after several months of no sexual contact with each other. We both gave oral sex to one another, though I had a small cut on my inner lip from accidentally biting it several hours earlier. In the interim period, I know, she had no significant sexual contact with anyone else, save for a short make-out session.

Well, Dr. Bob, I suppose you're used to dealing with those irrationally worried about HIV infection, and it seems to me that I may just fit that profile. And yet, I've two voices speaking in my head (well, not literally; I realize this is not a schizophrenia forum). One is the rational voice, telling me that my HIV chances are very small, and that I should, bluntly speaking, shut the hell up and stop worrying. I'm able to listen to that voice for a little bit, until the more powerful, paranoid voice drowns it out and convinces me that I should be very scared. Could I have contracted HIV from the fingering/receiving oral sex encounter? And perhaps even worse, should I be worried about having given it to my subsequent (oral) sex partner? And to be truly paranoid, could I have contracted it from my ex-girlfriend? (That last question I can realize is pretty crazy, but I'd love to hear it from you)

Adding to my worry is the fact that two days after the fingering encounter on the 1st, I came down with a one-day low-grade fever (around 99 degrees or so), and since then, I've had a great deal of itching on my chest and torso, colorless unless I scratch it, but fairly significant itching, anyway (it seems to be exacerbated by sun exposure, I think). Do I have a chance of HIV infection? Should I get tested or save resources needed elsewhere?

Merci en avance, as the French say. You are a compassionate and wonderful human being doing great work - and sometimes you remind me of the Beatles' song "Doctor Robert," though I'm sure you get that a lot. Thanks again!

Response from Dr. Frascino

Hello,

"Dr. Robert?" Who's that? Gosh, you're too young to even know that song, aren't you?

OK, you've got 2 conflicting voices in your head. Now add a third -- mine (or Doctor Robert's if you wish). I agree totally with Mr. Rational Voice: No matter how loud Mr. Paranoid is blabbering away, I think your chances of HIV are essentially nonexistent. By the way, 99 degrees does not qualify as a significant fever, and your itching is not suggestive of HIV.

Should you get tested? That's up to you. Unprotected sex can carry some risk for STD's, including HIV; however, your specific history (despite all the details) is quite unimpressive to me as far as "risk" is concerned. If you do test, and I'm not saying you should, make sure you wait until 3 months after your last possible exposure, so you're not writing a 30-page treatise to me about whether or not a 4 or 6-week test is "accurate enough."

And also as the French would say "Il n'y a pas de quoi"

"Doctor Robert"



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