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Transmission Confusion in Texas
Sep 1, 2005

Happy Sept 1, Doctor!

Yes, I am from Texas, and yes, I did vote for George Bush, but I hope you won't hold that against me. We Texan do love YOU.

I have two questions on transmission, and I'm confused:

1. I keep everyone always saying that HIV is not an easy virus to get, and that other STDs are easier to get. Is that really true? For example, assume a male having unprotected vaginal sex with a female (e.g., 1 minute of passion). Now assume the woman has HIV, Herpes, Gonno & Chylamidia, nd Hepatitis, and Syphillis. Is the chance of the man becoming infect with all of these exactly the same?

2. I'm an "uncut" man. How is it that the risk is higher for "uncut" men. Is it statistically significant? Is is the foreskin at risk or the glans?

You're doing a great job. Keep it up (no pun intended).

Response from Dr. Frascino

Hello Confused Texan,

You voted for Dubya???? You really are confused, now aren't you?

O.K., on to your questions:

1. True. HIV is not all that easy to acquire. And true, many STDs other than HIV are much more readily transmitted and acquired. Next, you want me to assume some poor chick has HIV, herpes, gonorrhea, chlamydia, hepatitis and syphilis???? I would normally say that would be rather unlikely, except for the fact you are from Texas and so I suppose this unlucky wench could be a product of a Dubya abstinence-only sex education program, which, of course, leads to all kinds of confusion and loads of STDs, because folks are never taught how to protect themselves, so . . . . You wonder if the chance of contacting each of these STDs during one minute of unprotected vaginal sex is exactly the same. No, of course not! Didn't I just say HIV is not all that easy to acquire and that many STDs are much more readily transmitted and acquired???

2. Yes, there are some epidemiological studies suggesting uncut men who have unprotected vaginal sex with HIV-positive partners are at a significantly increased risk for acquiring the virus. Since both cut and uncut men have glans, we can, by using our keen sense for the obvious, conclude it's the foreskin that's making the difference. What's important to remember is that the cut versus uncut risk data pertained to unprotected sex. You can and should level the playing field by using latex condoms and water-based lubricants, not by calling in a mohel.

O.K., Texan, I love y'all, too. Except that Bush dude. It seems to me he if he were any more stupid, he'd have to be watered twice a week.

Stay well, Cowboy.

Dr. Bob



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