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guilty bareback sex
Sep 30, 2005

Dear Doc Bob

It has been a little bit more than a week since I had unprotected receptive anal sex with a guy while on drugs. He did not cum in me. Two days later I told the story to a close friend, because I was really scared. And guess what: This friend told me that he got infected by this man a couple of years ago. To make things short: I started with PEP 55 hours after the incident. I feel terrible. The worst for me right now is not even the fact that I could be infected, but the feeling of guilt and shame! I mean: How could I get empathy and understanding in the year 2005 for fucking without a condom while on drugs? Until now I thought: How stupid must someone be to become infected nowadays (expept for condom breaking and occupational exposure)! I even asked myself: How did Dr. Bob get infected in the year 1991? I mean, this was not the beginning of AIDS ... After I read that it happened by occupational exposure it changed somewhat my feelings for you. Meaning: I felt even more empathy for you. Isn't that crazy? And now I am in the situation of possible infection by sexual exposure. I am scared to death by the virus itself, but even more scared of being alone without empathy and understanding from others because it was my fault and stupidity. How can I deal with this feeling of guilt and shame? What is wrong with me that I feel like there are poor pos. people and stupid, guilty pos. people? Keep up your work without prejudice!

Response from Dr. Frascino

Hello Guilty Guy,

I categorically disagree that there are innocent victims versus those who deserve to be HIV positive. I am no more guilty or innocent than any of the 43,000,000 folks currently cohabitating with the virus. None of us wanted it.

I believe you are being way too hard on yourself. We are all human. That means we all make mistakes. Recognizing our mistakes, confronting our weaknesses, accepting the consequences of our actions and learning from our experiences, be they good or bad, are what is most important.

The number of new HIV infections in the U.S. is rising. It had been steady at 40,000 per year for a number of years, but recent estimates indicate it may be as high as 60,000 per year now. Drugs do play a role. After all, the reason people take drugs or have a martini is to reduce their inhibitions and alter their senses (sometimes they alter their "common sense" as well!). You clearly realize you had a lapse in judgment and I believe this scare and having to take PEP have reinforced the lesson you have learned. I doubt you'll make the same mistake again. Remember life only goes in only one direction forward! We can't undo the past (or we wouldn't have that numb nuts inhabiting the White House). I suggest you focus on the realities of today and how things will be different in the future (no sex without condoms, no Bush, etc.).

It's also important for you to know that not every HIV exposure leads to HIV transmission. The estimated per-act risk for acquiring HIV from unprotected receptive anal sex with an HIV-positive partner is 50 per 10,000 exposures. That you began PEP within the 72-hour post-exposure period will reduce your estimated risk significantly. Whatever happens, please do not feel you are alone. I'm here. OK?

Good luck.

Dr. Bob



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