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simple yet urgent [repost from anemia, wrong forum the first time]
May 19, 2006

Dear Dr. Bob,

[sorry posted in the wrong forum the first time...]

Even Ivy Leaguers make mistakes...I have often browsed through the archives to find an answer to my question, but this time I could not find anyhing that resembles my current situation.

A few days ago, I had an encounter with a female of unknown status. I fingered her for a few minutes. Then, I used my hand (with a non-negligible amount of her vaginal secretions on it) to masturbate myelf until ejaculation.

1) Since there was an exchange of bodily fluids of some sort, I assume a theoritical risk does exist?

2) Are there any documented cases of HIV infection through mutual masturbation that involved sharing of bodily fluids (not blood)?

3) If you were to assess my risk, would it be higher than, lower than or comparable to a) receiving unprotected oral sex from a female, without ejaculation? and b) protected vaginal intercourse? I am asking because I do engage in both behaviors, but they do not trigger quite as much anxiety - probably becaue I do know more precisely about the risk involved (btw, I have a diagnosed anxiety disorder)

I know you are very busy, but I haven't slept for three days and we are currently in the middle of exam period. Your answer would certainly alleviate my fears and allow me to successfully complete my second year of studies in this competitive environment.

Thanks again,

Anxious student Harvard College, Clas of 2008

Response from Dr. Frascino

Hello Anxious Ivy Leaguer,

It seems as though I am being inundated with questions from anxious Ivy Leaguers and those attending elite colleges. Once again, I can only point to the profound failure of appropriate sex education in high schools as the primary cause for this phenomenon. Questions such as yours could (and should) have been addressed long before your sophomore year at college, by which time you are obviously sexually active, but even more obviously, are lacking the basic knowledge that would allow you to assess the consequences of your actions. This, as you can see, leads to anxiety and considerable time browsing through archives in search of basic sex education and STD/HIV-prevention information.

To specifically answer your questions:

1. Mutual masturbation is not considered a significant risk for HIV transmission. The fact that HIV does not survive very long outside the body coupled with the fact that a significant amount of infected cervical secretions would have to find their way into the urethra makes this theoretical risk so remote as to be essentially nonexistent.

2. No.

3. There is no way to rank the HIV risk of the three activities you describe because they are all so minute. Certainly no head-to-head-comparison studies have or will ever be done to address such a question. What I can tell you with great certainly is that if you do not worry about unprotected oral and protected vaginal intercourse vis-à-vis HIV transmission, you certainly should not be going bonkers over an episode of masturbation! By the way, these issues have indeed been addressed many times in the archives.

Luckily students at Harvard are bright enough to realize gaps in their knowledge base and how to correct these deficiencies. Unfortunately many other victims of our current inadequate sex education programs do not. I'm counting on you to remember this fact and advocate for the return of age-appropriate, science-based sex education in primary and secondary schools, OK?

Good luck with your studies, your anxiety disorder and your sexual awakening.

Dr. Bob



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