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How Do You Reconcile This?
Jul 2, 2006

Hi Bob,

Please help me understand something. You assign a small HIV risk to the negative party receiving unprotected oral, presumably because the party giving oral may be HIV poz and his or her virus-infected saliva may pass through the urethra wall, which is considered a mucus membrane?

On the other hand, if these same parties engage in any kind of kissing, and the poz partner's saliva enters the neg partner's mouth, wouldn't there be a comparable risk that the virus would pass through the mucous membrane of the mouth. After all, some oral medications are used sub-lingually and enter the blood in this manner. Yet, you suggest that for all intents and purposes, the chance of acquiring the HIV virus through kissing in which saliva is exchanged is zero.

How do we reconcile this: with passive oral being assigned a definite risk and kissing none at all?

Also, since I'm over here in Palo Alto, could I call your clinic and make an appointment to have an _anonymous_ HIV test, or do you only ofter the onfidential version?

As you can probably guess, I've been kissing someone who's in a high risk group (a very cute hispanic tgirl) and would very much like to continue.

btw, saw your recent notice in the SJ Mercury's story on leaders in the HIV community. IMHO, richly deserved.

Keep up the good work; having written a weekly health column, I know how time-intensive your contribution to this forum is.

Sam

Response from Dr. Frascino

Hello,

The estimated-risk statistics that I quote were generated and published by the Centers for Disease Control (CDC). They do not publish estimated-risk statistics for kissing, presumably because the risk would be so low as to be essentially nonexistent. Consequently, I'm not sure exactly what you want me to reconcile!?! I will mention the presumably obvious fact that kissing and blowjobs are two very different activities. There is a much higher risk of potential trauma when throat plunging than with smooching. At any rate, the take-home message should be these are both extremely low risk activities, and if HIV transmission were to occur, it would most likely be due to extenuating circumstances, such as recent dental work, sky high viral loads, trauma, etc. OK?

Next, regarding the Frascino Medical Group, yes, we do offer completely anonymous HIV testing and yes, you are more than welcome to call for an appointment at 650-917-1357.

Thank you for your kind comments about the recent newspaper articles.

Finally, regarding that Hispanic hottie, yes, by all means, continue to kiss away!

Stay well.

Dr. Bob



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