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need your input doc...going crazy here
Jun 8, 2005

Dear Doctor BOB You are the greatest man I know and an inspiration to all of us. I'll make it short...... 22 year old gay male with HIV anxiety. I have been reading and re-reading the questions you answer to, and it seems that the pattern I am noticing is that most (almost all) of the people that write to you are worried about a single incident with usually HIV unknown parterns... Therefore that will leave you and and others to advice tham that their risk is negligible since odds are in their favor for a single act.

Mine is diffrent... It's more like 10 acts of receiving and giving oral (all without ejaculation) but all with unknown and high risk status.

I regret that I have done it doc... these risks are just not worth it, even if they are minimal.

I never knew there was such thing as precum... weird ha.. but I just didin't and when I found out I went crazy... suffred extreme stress and anxiety and ofcourse stopped my "high risk" sexual acitivities.

Sure oral sex is considered "lower" but NOT "low risk" (occording to CDC), doesn't that usually refer to receing and only per episode? what about giving and several episodes. sure there was no ejaculate, but then you have to be concered about what if someone had another STD that caused a discharge in my mouth during that particular activity. I never aquired gonhoreah, so I guess I shouldn't be worried about that.

All these ten acts occured throughout the last two years. I have gotton several flu's and sore throats, so I can't say if those were acute HIV, anyways I agree that symptoms don't equal HIV.

I guess I didn't post any questions so I just need your openion and comment on what my risks are? I am scared to get tested, eventually I will, but just need to know what the actual degree of risk is....

Also I read some reports that say that saliva can inactivate or lessens the amount of virus that come in contact with it. Should I rely on that? Since I never heard of precum, it was eventually swallowed right? so what happens then, can it infect my stomach? Is precum proven to contain HIV and is it in the levels of saliva or more? Gues I did ask questions.

Doc,I guess I did not make it short... VERY SORRY... if you got this far. The donation I will make should make you answering it worthwhile as it will add to the help of many.

Thank you doctor for reading this long and annoying story that I hope you will respond to by saying it was worthless to write since the risk is so low even in my "high risk" situation.

Sincerely "positive" guy

Response from Dr. Frascino

Hi "Positive" Guy,

As you have hopefully learned from "reading and rereading" the archives, your "high risk" situation really is not high risk at all. Also, the difference between "lower" and "low" is purely semantics and trying to differentiate between the two is pure mental masturbation.

OK, on to your questions:

1. Some components in saliva can inactivate or weaken the HIV virus. That's true. Should you "rely on" this? No, we don't know enough about it yet.

2. Precum can contain HIV. The amount can vary from person to person, so there is no way to compare levels in precum to levels in saliva. If HIV reaches the stomach, it will be killed by the stomach acids that help you digest your food.

The estimated per-episode risk for HIV transmission from receptive oral intercourse is 1 per 10,000 exposures to a partner confirmed to be HIV positive. Hopefully that number will help you understand why your "high risk" situation is in reality low risk. Please note the risk is exactly the same for each episode. I agree "eventually" you'll need to get tested if you feel you've placed yourself at risk. To calm your anxiety, hopefully "eventually" will be sooner rather than later. What are you waiting for? Isn't it time for "Positive" Guy to realize he's in reality just being "negative" about the whole situation?

Thanks for your donation. Write back with your test results. With luck, we'll be celebrating you're becoming a "low risk," "negative" guy, OK?

Good luck!

Dr. Bob



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