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Please dont retire !!!!!!!!!
Dec 17, 2003

Dear dr.Bob,

I noticed that you get more and more unpolite letters of rude people last days!!

And I see that this hurts you rightly so. Please dont think that all of us reading this forum think the same as those who write such letters. Some people think that this is their private forum and that all thier questions should be answered automatically. That is stupid. One has a chance for his question to be answered either if it is interesting to a wider audience or if it is original.

This is a free forum and you get to choose the questions that you are going to answer and we are allowed to try asking questions and hoping that you will answer them but we dont have the right to be angry if you dont.

Now just a brief question from me, with hope you will answer it. But if you dont I still like you very much:) and please dont retire!!!

I had receptive oral with no ejaculation but I have a gingivitis ( ok I promise I will brush more often:)) and when I brush sometimes I have a minimal bleeding from my gums. Since you said that extenuating circumstances can facilitate virus transmission thru oral sex , 1.is this gum disease itself making the transmission facilitated or the gums are just more prone to bleed and if they bleed than it is riskier? 2. Am I still at low risk,with this gum disease ( I didnt brush but 4 hours prior to oral sex) or am I at high risk (like genital sex)? I am very worried but you now the rest....

Much thanks and all the best to you

Marco

Response from Dr. Frascino

Hello Marco,

Thanks for your support! "Impolite letters from rude people" will not make me retire. Their comments primarily reflect how incredibly miserable their lives are. Sure, some of it may be mean-spirited, but most is just ignorance and/or anxiety. In any case, I often just feel sorry for them.

OK, on to your questions:

1. Gum disease may facilitate HIV transmission by allowing the virus to get directly into the blood stream. It's the inflammation and bleeding that increase the risk.

2. I can't really quantify your risk accurately, because I can't accurately assess the severity of your gingivitis. In general, oral sex carries an extremely low risk of HIV transmission. That you were not actively bleeding, hadn't brushed your teeth to induce bleeding for at least four hours, and there was no ejaculation would all lead me to surmise your risk remains extremely low. Should you decide to get HIV tested, remember to wait at least three months.

Finally, and perhaps most importantly, don't forget you promised to brush more often. And equally important, don't forget to floss!

Stay well.

Dr. Bob



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