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Canada Loves You!
Jul 6, 2004

Hi Dr. Rob,

Needed to let you know that Canada loves you (especially us guys here in Toronto). This site has been a great source for myself and many of my friends and has certainly helped to keep us calm during those moments of doubt and anxiety. I can't imagine what shape I'd be in without a site like this to help me through some very worrisome times! Plus, you're so funny and add that element of humour that makes it a joy to read ALL the posts! You're educating us and making us laugh at the same time! Keep up the great work!

I'm hoping you'll take a moment to answer my question about oral sex and HIV testing (I'm sure you're rolling your eyes back in your head right now -- saying "not another question about oral sex!!"). I'll keep mine brief -- promise.

Over the past year I've had oral sex with about 20 different guys (most of the encounters were casual), I've swallowed once and try to keep good oral health (no brushing before oral, etc.) -- basically I think I'm doing all the right things in trying to keep the risk level low. But, 20 different guys in 12 months -- that's A LOT isn't it? I had STI tests done in April (all came back neg), but I'm due for an HIV test in August. The Hassle Free Clinic here in Toronto said that with my level of risk (mainly oral and 4 occasions of receptive protected anal) was low and I should test once per year or even once every other year for HIV.

What are your thoughts on HIV/STD testing with low risk encounters? My feeling is with multiple partners I should be tested for STI's every 6 months and HIV testing once a year. I'm sure there are a lot of guys in my shoes -- thinking it's all low risk there's no need for me to test. Sorry -- this was supposed to be brief!?!

In closing, I have 2 questions: 1) In your view, do you agree that my risk for HIV is low (even with 20 guys in 12 months)? 2) How often should one get tested for HIV/STD's if there are in the low risk category?

Any advice/help you can offer would be GREAT!

Lovin' You! 'G' in Toronto

Response from Dr. Frascino

Hey there "G,"

Thanks for your very kind comments. I love Toronto as well. I grew up just across Lake Ontario from you in Rochester. (Toronto was always a hell of a lot more fun.)

OK, now on to your question. Are 20 different guys in 12 months considered "a lot?" Well, some of my friends would indeed consider that figure impressive and oh so lucky; others would consider it a "dry spell." (If you're a QAF fan (filmed in Toronto, by the way), just think of Ted as having the former opinion and Brian, the latter.)

Next, your two specific questions:

1. Number of partners does not really increase or decrease HIV risk. Only the type of sexual activity and level of protection can define the risk of HIV transmission. For you, oral sex and protected receptive anal sex would be considered low risk, assuming the latex condoms were properly used and did not fail.

2. How often should a sexually active gay man get STD and HIV routine screening? Again, this depends on level of risk and if there were any slipups (or slip-offs). Some guidelines suggest every six months. However, the ultimate decision remains a personal one. A number of variables need to be factored into the equation, rather than just putting your STD screening on a routine every-six-month schedule like your dental checkups. The best thing is to know and understand your degree of risk and couple that information with potential HIV exposures. If there were no extenuating circumstances, an every-six-month STD/HIV screen for a sexually active (yes, 20 studs/year qualifies) gay man would be reasonable.

So tell me, are Woody's and Sailor still happening? How about dancing at The Barn/Stables? And has that ferry boat started sailing between Rochester and Toronto? I can just imagine the "ferry" (no matter how it is spelled)traffic will be mostly in Toronto's direction, especially with Folsom Fair North fast approaching.

Stay well, "G." I may be visiting your fair city soon.

Dr. Bob



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