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Big Complaint. Why don't you answer questions from the third world??
Mar 20, 2006

Hi Dr. Bob.

Let me crib to you first a bit. How come most of the questions you answer are either from people in USA or Europe?

In fact we in India need much more of your help and counseling since the counseling system in India is virtually non existent. Also testing HIV+ in India carries a huge stigma (you would not even to begin to imagine the way people are treated, one patient in a a hospital had a sign AIDS infected put on his head). So I would really appreciate if you could take more questions from the third world countries. Anyway probably my crib comes from the fact that I have posted my message nearly 15-16 times without it getting answered. I genuinely feel you are a beacon of hope and the light hearted answers to serious issues really provides succor to a lot of people. Just as a token of appreciation I am donating $ 100 to your organization. I know this is a small amount but I think my funds would be better utilized in my own country. Please please please keep up the good work.

After much beating about the bush let me come to my question. Around 6 weeks back I had been to a massage parlor in Phuket . Unfortunately I had an open sore on my shoulder which I had not noticed (Can u believe it; some stupid fish stung me while snorkeling couple of hours earlier??). During this massage session, I was laid out on this rubber mat. Water was poured onto me and then the masseuse applied soap on her hands and applied it all over my body. Then she used her hands and her entire body to massage my body. She was also continuously using a bucket of water to wash away the soap. Only thing I am certain of is that she did not have any open wound on her body and her genital region never came into direct contact with my sore. I am not sure whether her finger touched my sore but seems unlikely. Since she had soap on her hand always and was continuously using water to wash the body, is there a possibility of HIV+ transmission??? I searched your archives for this reply but I could not find anything.

That was just a trailer of the horror story. Next we moved to the bed and the lady in all her wisdom decided to give me a blow job. Of course she decided to put on a condom and went about her job. However 15-20 seconds into the session, she looked up and gave me a grimace as if something had gone into her mouth. At that point of time I did not really think too much of it except that I saw the condom was still on and had not fallen off. I asked her what the problem was but she smiled and went back to her business. Anyway I asked her to remove me from her mouth and asked her to remove the condom and finish me off by hand. I would not have been in her mouth for more than 1 to2 minutes

No problems paid her a good tip, came back to hotel and then it hit me with the force of a sledgehammer. What if the condom had leaked/ ruptured and what she got in her mouth was my semen. It could very well have been some soap from the massage or more like a pubic hair, but what if? If it is of any help at least I did not have any sores in my penis/ pubic region. I nowhere went anywhere near her genital region in the whole episode .Also she being a professional would she have gone back to sucking a ruptured condom ??

And hence started my misery. I became a mental wreck. Came back home to India, confessed to wife (who blew me away with her understanding, I really never knew I had such a great wife) and then hit the internet and became a further wreck.

As things stand now, I am into the 6th week. Thank god, no real symptoms except a very mild fever which keeps coming and going (between 98.4 Fahrenheit and 99 Fahrenheit). My doctor says this is entirely my anxiety and anything below 99 is no fever. A pulled muscle under my left armpit keeps causing me some pain. Are these symptoms to worry over?

I know the statistics doctor. They are astronomically in my favor (or so I would like to believe). But we Hindus believe in Karma. Can some bad Karma somewhere make me that 1 in 20000 person to get HIV+ ( ok unknown HIV status , but after all she was a sex worker so lets keep it at 50% chance, so it still makes one in 40000)from this encounter???? Doctor I scoured the net and did not come across any person who knows any person firsthand who got HIV+ infection from oral sex. I do not want to become that person, doctor.

My HIV+ specialist (he is a great guy, definitely the best in India, your site featured an interview with him) feels it is all a mental thing for me. Chances of HIV infection are so miniscule ,he wants me to forget about the whole thing and just get one ELISA test done after 6 months.

What in your honest opinion doctor are the chances of getting HIV+ infection from this episode? Do I really need to get an ELISA test done or just forget about the whole episode??

And please please do remember to send me the good luck karma by fed ex. You can even send it payment on delivery from my side but I need that good luck karma of yours.

And please please reply

Thanks & Regards

An ardent admirer

Response from Dr. Frascino

Hello Ardent Admirer,

"How come most of the questions you answer are either form people in the USA or Europe?" Would you like to try to answer your own question, Ardent Admirer??? The answer is really self evident. Most of the questions I answer are from folks in the USA or Europe, because most of the questioners writing in are from, you guessed it, the USA and Europe! I do not discriminate based on local! The reason I did not respond to your question the last 15 or 16 times is that similar questions have already been posted and I really don't have much more to add.

Your HIV risk is minimal to nonexistent. A Phuket massage may sound sexy, but your rub-a-dub-dub soapy slip-and-slide session carries no risk for HIV transmission, even though the stupid fish stung your shoulder. Next, protected oral sex carries essentially no risk for HIV transmission, even if she grimaced. Your "what ifs" make no sense whatsoever and would not increase your risk of HIV.

The one bright spot in your story of unwarranted doom and gloom is that you leveled with your wife and she was understanding. Please give her a big hug and kiss from me!

As for the "force of a sledgehammer" misery making you a mental wreck as you hit the Internet, what can I say? Other than it's completely unwarranted. I absolutely agree with your "great guy" HIV specialist. Your chances of HIV infection are essentially nonexistent. Your problem is anxiety and irrational fear. You should get psychological counseling to help with those very real problems, rather than worrying about and perseverating on a disease you do not have. I would recommend a single ELISA at three months is all that you need for a definitive and conclusive result. (It will be negative.)

I'm more than happy to send my finest good-luck karma to you; however, in all reality, I strongly doubt you'll need it! Thank you for your donation. When it arrives, I'll instruct my foundation to use it to help AIDS awareness and education programs. Hopefully that way it will help to fight against the stigma and ignorance, which remain so prevalent in your country.

Stay well, Admirer. (Yes, I do believe from an HIV perspective you are indeed well.)

Dr. Bob



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