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CDC says anal warts and oral sex mean HIV. PLEASE HELP DR. BOB!
Oct 6, 2003

Dr Bob:

Im a 24 year old gay man. Please help me with this situation! I am scared to death!

My doctor recently diagnosed me with some anal warts. He told me that they are very common and that I should see a dermatologist to have them removed. We discussed my sexual past and I told him that I ALWAYS USE PROTECTION for anal sex (insertive partner 4 times), and tried to receive anal sex 3 times with protection but with minor insertion (it hurt too much- OUCH!). I'm assuming I contracted these warts through frottage (dry humping). I have performed unprotected oral on lots of guys with faint precum a couple of times, but never with ejaculation! I also make sure to maintain good oral health. He told me that my risk is low.

I've made an appointment with a dermatologist to have the warts removed but I've become more curious about HPV. I called the CDC hotline and the counselor told me that the HPV outbreak is most likely due to a compromised immune system. She said that because I have had unprotected oral that it is very likely that I have HIV, and that the warts may not have shown up for some time until I became infected with HIV. She also said that it is estimated that roughly 100 of people infected with HIV are also infected with HPV. I am so confused. I've read the archives and done major research on the oral sex question, and I know the risk is extremely low. I just don't know if what this counselor told me is indeed true and if I should be worrying about HIV now. I called my doctor and he said that testing for HIV is not warranted because my potential exposures are minimal, especially because Ive never had a guy cum in my mouth.

I really need your expert advice. Is testing for HIV warranted in this case? Does this HPV outbreak mean that I also have HIV? I am so scared and it's affecting my job. I thought Ive been putting myself at low risk by not having cum in my mouth and always using condoms for the few times I've had anal sex. I don't know what to do. All these conflicting views are confusing the beejesus out of me and I'm convinced that I have HIV! Am I freaking out over nothing? I have a history of OCD and am on Celexa for my anxiety disorder. I tend to catastrophize everything. Is all this worrying just in my head? Please help me!

Thanks, Jake

P.S. You are such an inspiration to the world and I admire your persistence in helping to combat HIV! Steve is one lucky guy!

Response from Dr. Frascino

Hi Jake,

Let me get this straight. The CDC hotline counselor told you:

1.An HPV outbreak is most likely due to a compromised immune system?

2.Because you had unprotected oral, you very likely have HIV?

3.Warts may not have shown up until you became infected with HIV?

4.100% of HIV-positive folks have HPV too?

Jake, you are not the one that's confused. It's that idiot counselor. What she told you is pure crap (and that's putting it mildly). Don't worry about "castastrophizing" (is that even a word?). The only catastrophe I see here is having that moron at the CDC giving "advice!"

HPV is a very common STD. Yes it can be transmitted by frottage or other types of skin-to-skin contact. No, having HPV does not mean you have HIV. You have adhered to safer sex guidelines by using latex condoms for sex. Yes, oral sex has an extremely low risk for HIV transmission. So whether or not you've got "beejesus" in you or out of you, don't be confused by what that poor excuse for a counselor told you!

Steve and I are here if you have other questions or concerns. Stay well.

Dr. Bob



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