|"My offer is this........Nothing"
Dec 6, 2005
Dr., Actually I intend to do what I've done before and donate the same $59 I just paid for my home acces test to the foundation. You are my (and scores of others) lifeline.
Kindly consider my questions. 1)I've researched and can't find the actual text on case reports of insertive oral transmision can you illuminate for me. Are there any cases except the one's from Australia with piercings or the senior citizen years ago?
2)Do you think precum moving out of the penis helps "plug" the urethra opening a bit which makes it more difficult for hiv to travel down urethra?
3) In actual seroconversion are nodes painful? Must they be enlarged or just pain painful in lymph areas?
4) In ars what is considered fever? >100F?
Thanks a million Doc- I hope to someday be in a position to donate a Million. PS> If you haven't guessed I'm in window period for insertive oral exposure and NEED you Kosmic Karma!!!!!!!! Love ya
| Response from Dr. Frascino
Welcome back to the Forum!
1. Yes, various "case reports" exist; however, case reports are just that case reports! In other words, they are primarily undocumented anecdotal reports that get published as a "case". They are not really very helpful from a scientific perspective. For instance, there is a certain guilt and stigma associated with seroconverting as a result of unprotected vaginal or anal sex today, because everyone should "know better," right? So, if someone is filling out a questionnaire about potential risks after becoming infected, they might list oral sex, because "the risk is so low that many folks consider it acceptable," but conveniently "forget" that single episode several months ago of barebacking one horned-up night in the backroom after one too many cocktails. This very real scenario might wind up as a "case report" of HIV transmission via oral sex. See the problem? What you really need to look at are large-scale epidemiological studies of risk behavior as well as ongoing longitudinal studies of serodiscordant couples who have chosen to have unprotected oral sex, but protected vaginal or anal sex to really get an idea of the relative risk of HIV transmission via oral sex. What those studies have consistently shown is that the risk of HIV transmission from oral sex is low, much lower than we originally feared early in the epidemic. The risk of HIV transmission is always greater for the receptive partner in all forms of sex, oral included. Even with a low-risk activity, there can always be extenuating circumstances that can modify the degree of risk. If oral sex carried a significant risk of HIV transmission, one would expect rising HIV new-infection rates in places such as San Francisco, where clubs like "Blow Buddies" not only exist, but are extraordinarily popular. Instead we are seeing declining rates of new infections in San Francisco. These facts may be partially explained by social trends, such as sero-sorting, but that's a topic for another day.
2. This hypothesis would be nearly impossible to prove one way or the other and really has no practical implication.
3. No, generally not. Lymphadenopathy associated with ARS is not painful.
4. There is no specific cutoff. The normal body temperature varies naturally in relation to many factors, including ambient environmental temperature. In general, ARS or not, I consider a temperature elevation 100 or above to be significant.
5. Cosmic Karma sent.
Thank you for your donation. My guess is that a WOO-HOO is looming large in your future!
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