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Randon unrelated HIV questions...
Sep 2, 2006

Well I just got my 12 week negative, and needless to say, I'm very relieved. I think a WOO HOO is in order (I wonder if people still say that out loud?). Anyway, now that I am 99.999999% sure of being HIV negative, I feel the need to ask you some questions that, through all my anxious internet browsing, have yet to find the answers.

Ok. Here we go.

1) Does any quantity of the HIV virus entering the bloodstream guarantee infection? For example, if only a small amount of the virus was able to enter the bloodstream (say, some infected precum into an open gum sore), is it possible for the immune system to kill the virus before it multiplies into a fully-fledged infection?

2) We all know the all forms of oral sex carry a low risk of HIV infection, but how come the risk of giving a blowjob is seen to be higher than performing cunnilingus? Presuming the person receiving the blowjob doesn't cum, would it not be the same risk as good ol' cunnilingus? Or is their more HIV in precum than vaginal fluid? I'm confused.

3) On receiving my negative HIV results (by the way, the possible exposure was brief (20 seconds max) unprotected receptive fellatio (no ejaculation) with a gay guy of unknown status) I had a somewhat confusing discussion with the doctor.

Me: Yay, I'm negative. So that's conclusive, corrent?

Doc: No. Nothing in the medical profession is conclusive.

Me: So do I need to test at 6 months?

Doc: No, because even a negative at 6 months will not be conclusive.

Me: ... so ... do I need to test again or not?

Doc: No. You do not need to test again.

Me: (confused)

I'm guessing there is a difference between practical certainty and medical certainty? When you state that a 3 month test is conclusive, are you speaking in practial or medical terms? I'm really confused about it. I dunno, maybe I'm just being paranoid.

PLEASE REPLY ... I have honestly searched high and low for the answers to my questions.

Response from Dr. Frascino

Hello,

Do people still say WOO-HOO out loud??? Oh yes. For instance, it's frequently heard at the Frascino Medical Group! I'd say not a day goes by when someone at the Frascino Medical Group doesn't scream WOO-HOO so loud that it rattles our windows and startles our neighbors.

Now for your questions:

1. "Quantity of inoculum" (amount of HIV) may be one factor in whether infection takes place, but there are many other equally, if not more important, factors at play as well viral strain, host immune response, concurrent infection, etc., etc., etc.

2. We don't rate oral sex risk as with pre-cum, without pre-cum, with ejaculation, without ejaculation, etc., etc., etc. That's way too many variables to sort out. There can always be extenuating circumstances that can increase or decrease the risk of any sexual act. The take-home message is as you said: "all forms of oral sex carry a low risk of HIV infection." To that I would add: the receptive partner is always at more risk than the insertive partner in all forms of sex.

3. Yep, you're being paranoid. A negative HIV test three months after "20 seconds max" of unprotected receptive fellatio is definitive, conclusive and WOO-HOO-able. No further testing is warranted. No need to search for answers anymore, OK? The only thing you need to do is yell WOO-HOO. Go ahead; we all know you want to.

WOOOO-HOOOO! There, doesn't that feel better?

Stay safe. Stay well.

Dr. Bob



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