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You Have Been Rusty Lately: Medical Textbook ARS symtpoms + Double Donation
Oct 19, 2005

Dear Dr. Bob:

You are getting rusty lately. You answer all these questions about the Vatican, but lately youve gone out of your way to avoid highly technical HIV questions. Double or nothing. Im planning on donating $75 to your fund (Im a graduate assistant). If however, you judge (and you must be fair about this), that my question was not difficult, then Ill make it twice as much = $140 instead of $75.

Here is what happened: September 2, I had protected vaginal sex with a hooker. I have read your Forum; thus, I used a latex condom with water-based lube. Condom did not break. The only mistake, that I fear will cost me my life is: she performed oral sex on me for about 30 to 45 seconds. I feel that this has destroyed my life.

And then the symptoms came, and they are MEDICAL TEXTBOOK ARS SYMPTOMS. You cannot deny that. About 7 to 10 days after the contact, I started feeling slightly achy in my left groin and left pelvic area. It lasted about 10 days, went away, and then came back. I could have sworn that I felt lumps, but I am not sure that they were lymph nodes. They could have been part of normal anatomy. I suspect that they might not have been lymph nodes, because the pain was always worst when I would be sitting down.

Does this sound like ARS to you?

Regarding the unprotected 30-45 seconds blow job, will I become the first person in history to get infected through this? My understanding is that SALIVA is NOT infectious. If so, then it seems that I have unplaced fears. Let me see if I get this right: insertive oral sex is still labeled as extremely low risk, because there may exist rare circumstances where, for example, the person giving the blow may have blood in their mouth. The blood can come from bleeding gums, dental work, or a syphilis sore that just broke. (Well, blood is blood). Thus, because there are people out there who would perform oral sex despite blood in their mouth, then we cannot classify insertive oral as NO RISK.

Im trying to be realistic about my risk from insertive oral, especially since there was NO blood and it was only 30-45 seconds.

My last question: Im not circumsized. With respect to saliva not being infectious, does me not being cut change the non-infectious nature of saliva??

Im scared Dr. Bob. Im 100% sure that I have HIV now.

Response from Dr. Frascino

Hello,

Rusty? Maybe it's because I'm getting old? Maybe I just need more lube?

First off, regarding donations to my foundation, yes, I am the founder and president of The Robert James Frascino AIDS Foundation, a nonprofit charitable tax-exempt organization that provides crucial services for men, women and children living with HIV/AIDS and that also raises awareness of the HIV/AIDS pandemic through advocacy and education. However, donations are absolutely voluntary and not related to my work here at The Body. So, although donations are always appreciated, they have no influence on which questions are selected for posting. Your question is not difficult; however, that should not be a factor upon which to base a donation. Donations should be based only on generosity and compassion. By the way, your question is not only not difficult; it's also been answered many, many times in the past. (Just check the archives!)

Briefly, you had protected vaginal hooker-sex and used a latex condom and water-based lube. However, you're worried about brief (45 seconds) unprotected oral sex, fearing you'll be "the first person in history" to get infected by a blowjob. My response to your fears that you've "destroyed" your life is exactly the same as my response to others who have had similar risks. Protected sex is indeed "protected." If the condom was used properly and didn't fail, your risk is essentially nonexistent. Oral sex carries a very low risk for HIV transmission. If your partner was confirmed to be HIV-positive, which is not the case here, your estimated risk per episode of insertive unprotected oral sex would be 0.5 per 10,000 exposures!

Next, your "medical textbook ARS symptoms . . . ." Hmmm . . . we must have different medical textbooks, because what you describe is not consistent with HIV ARS or HIV disease. Having lived through acute retroviral syndrome symptoms personally, I can assure you that "feeling slightly achy in my left groin and left pelvis area" doesn't qualify. Even with the "I could have sworn that I felt lumps . . . but I am not sure they were lymph nodes . . . ," it still doesn't cut it, O.K.? Consequently, I categorically do deny that what you describe is even remotely consistent with classic ARS.

Finally, the "non-infectious nature of saliva" could care less whether the mohel has visited or not.

You may well be 100% sure you have HIV. From what you've told me, I'm 100% sure you don't.

Final piece of advice: if you're worried, get tested at three months or more. It really is just that simple.

Good luck, even though I doubt you'll need it.

Dr. Bob



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