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=> All well ends well? (Donation will follow)
Nov 6, 2006

A question from a 24 year old neurotic Belgian boy

In Belgium the prevention organisations changed their prevention standards about oral sex a few years ago. Meaning that it is possible hiv can be transmitted by oral sex. They changed their policy because there were big discussions about the actual oral risk (the one study seems to battle with the other). I believe that discussion is still going on?

To be short: I always practise safe sex (being a top guy) with a condom and I never give oral sex to my sexual partners and I keep my penis as far away as possible from the penis of my sexual partners. But I recieve oral sex (me being the insertive party) unprotected. Due to a few internet stories (urban legends?) and reading several studies about the possible hiv risk by receiving unproteced oral sex I have developed an anxiety disorder and Im now seeing a psychiatrist and will start cognitive behavioural therapy soon.

My last sexual encounter was on 22 august. I had a HIV Antibody test + HIV Antigen test (to rule out the possible window period problem) on 18 october (about 8 weeks after my last sexual encounter in august) and they were both negative. I also had a usual Antibody test + several STD tests in september and another Antibody test in the beginning of october to rule out previous sexual encounters before 22 august. They were all negative.

1. Ofcourse I keep worrying and every head ache, night sweat or cough in the last months freaks me out. I had no fevers, swollen lymph nodes, diahrea, etc. (Im paying for my doctors mansion). Would you suggest another anti-body test at the end of november (after 12 weeks)?

2. Any other advice or suggestion?

I will get my first paycheck next month and then I will donate with my Mastcercard. Thank you.

Response from Dr. Frascino

Hello Neurotic Belgian Boy,

Despite what you may or may not be hearing in Belgium, HIV specialists and AIDS organizations around the globe have not changed their opinions on the potential HIV risk associated with oral sex. The risk of unprotected insertive oral sex remains extremely minimal.

Regarding HIV testing, the general consensus remains: HIV-antibody tests taken prior to the three-month mark are not considered to be definitive or conclusive. Certainly your negative tests to date are very encouraging, but they are not conclusive.

As for other advice, I strongly encourage you to continue seeing your psychiatrist for treatment of anxiety. I also have seen significant results using cognitive behavioral therapy and agree that's definitely worth a try.

Thanks for your tax-deductible gift to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). In return I'm sending you my best good-luck/good-health karma that your definitive HIV test remains negative, as I very strongly believe it will, and that your anxiety-related problem comes quickly under control.

Be well! (That's a doctor's order!)

Dr. Bob



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