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What I should know before I become sexually active.
Oct 24, 2004

Hello Dr. Bob: First, I want to thank you for all the contributions you have made to the fight against HIV. Your humanity and generosity has inspired me to join the fight.

I am a gay/bixsual, whatever people want to call it, male. I've only been with one female, and after the relationship ended, I was tested - negative.

I am now beginning to explore my sexuality and, if I meet the right guy, am willing to have sex. What hinders my exploration is that I'm deathly afraid of contracting a disease from a guy. I guess what I want to know is the level of risk involved in the following forms of sex.

1) Deep prolonged kissing. 2) Oral sex. 3) Sexual play - mutual masturbation, etc. 4) Anal sex with and without a condom.

If I knew the risk involved with the above acts, I think I would be in a much better sitution when negotiating how far I am willing to go with a partner. I know there is information on the internet about the above, but it is very conflicting and most doctors do not convey their answers in your eloquent and concise fashion.

Again, thank you for doing what you do. I wish you the best in your personal fight with HIV.

Your Friend in Toronto, Canada (one of them at least).

Response from Dr. Frascino

Hi Toronto-Guy,

Thanks for your kind comments, and welcome to the fight!

Regarding safer sex information, try the HIV InSite Knowledge Base Chapter (Dec. 2003), which can be found at http://hivinsite.ucsf.edu/InSite?page=kb-07-02-02.

I'll give my personal opinion as well:

1. Deep prolonged kissing. As the song goes, "A kiss is just a kiss, as time goes by . . . ." I do not consider kissing a risk for HIV, unless there are some very strange extenuating circumstances.

2. Oral sex. Recent clinical studies indicate HIV is not easy to get from any kind of oral sex; however, there are some isolated cases of contracting HIV from sucking ("giving head"). Certainly bleeding gums, gum disease and sores in the mouth can make it easier to get infected. There have not been any well documented cases of getting HIV from getting sucked.

3. Sexual play-mutual masturbation, etc. Well, I don't know about the etc., but mutual masturbation is considered safe from an HIV perspective. Frottage is also considered safe.

4. Anal sex with and without a condom. If a latex or polyurethane condom is used properly and doesn't fail, there should be essentially no HIV risk. Anal sex without a condom carries the highest HIV transmission risk, that being estimated at 0.1% to 3% per episode of unprotected receptive penile-anal sexual exposure with a partner confirmed to be HIV positive.

I have limited my comments to HIV. Of course there are other STDs to consider as well, but explaining each one in great detail is beyond the scope of this brief question-answer format. You should be able to easily locate information about specific diseases and specific sexual practices using the archives. If after reviewing that information you have additional questions, don't hesitate to write back, OK?

Give my best to Young Street!

Stay safe and you'll stay well.

Dr. Bob



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