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Real Risk - Please Respond - Transmission via parasite?
Nov 4, 2004

Hi Dr. Frascino,

I am the Italian guy in NYC who sent you a long, angst-filled e-mail about a week ago - don't know if you ever saw/read it (it didn't get posted), but I'm sorry if I unburdened myself on you - I guess it really wasn't suitable for posting - 60 days ago, I had a one time (first time) experience with another guy involving mutual unprotected oral sex, rimming, and fingering. He also pressed his penis (hard) against my anus, but no inner penetration, however I have a hemorrhoid (outside) that bleeds on occasion - don't know if it was bleeding at the time, but don't think so -no ejaculation in any of these events, but certain there was pre-cum. Afterwards, he gave me the indication that he is HIV positive - I will be getting tested within the next month and from reading the archives, I know I am at real risk. I got very sick about 9 days after exposure which doctor diagnosed as parasitic infection (giardia). I did not tell the doctor how I got it because I'm too ashamed. Can HIV be transmitted as well via the parasite? I know this may sound stupid, but I also know what I did was stupid, so there you go. It's hard to distinguish whether all the symptoms I had were due to the giardia or whether it was ARS. At the onset of the giardia, I had a mild sore throat and a cold sore in mouth (both for one day only) and doctor said I had an elevated white blood cell count, but I had no fever or swollen glands. I still have a lot of joint pain/muscle aches (mostly the legs but also pain in my ribcage bones - it's weird) as well as mild sweating at night. I know, I know, you can't go by the symptoms, but I can't help but think that the reason I'm still not back to normal is because I have HIV. I'm having a hard time dealing with all this as well as with my sexuality and since all my family and friends think I'm straight, I really can't expose this to anyone - there's really no one I can go to about this so I hope you don't mind my venting this to you - I'm just hoping and praying for the best, but expecting the worst - I don't want you to think I'm feeling sorry for myself - I know what I did is my own fault and my responsibility and that despite everything, given what's going on in the world today and what other people have to endure, I'm still luckier than most - it's just hard to go it alone sometimes, you know? - I want you to know how much I admire what you do and the valiant way you have dealt with your own situation. May God Bless you and Steve and continue to keep you both in good health. You Italian pal in NYC. P.S., Go Kerry!!!!

Response from Dr. Frascino

Hi Italian Guy in NYC,

First off, if you've really been reading the archives, why would you conclude you are "at real risk?" From what you've written, I would say your HIV risk is really quite low. Maybe it's time to reread those archives, OK? One important point to note, and I've written this many, many times, is that HIV is not easy to get from any kind of oral sex. However, other STDs, like parasites, hepatitis A, and herpes, can be easily transmitted through rimming. Consequently, your situation is not uncommon.

Next, just to be clear HIV is not transmitted by parasites. Parasites however can be readily transmitted by rimming without protection.

Next, I think you diagnosed your own very real problem. In your words: "I'm having a hard time dealing with all this as well as with my sexuality . . . ." that's the problem that needs prompt attention. I would suggest you seek counseling. The doctor-patient relationship is confidential and you definitely need help in coming to grips with these issues. Yes, get HIV tested three months or more after your sexcapade. But realize that the odds are all in your favor that you did not contract HIV from this potential exposure.

Good luck. We'll all be sending you our best cosmic karma. Don't delay in seeking counseling. I'm certain you'll find it extremely beneficial.

Dr. Bob



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