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Nov 24, 2006

Hi Doc, I am writing to you because I figure you are one of the most knowledgable and honest experts around. I am a married male who has been involved in a few incidents with other males over the last 3 months or so. The first involved light kissing, until he put his tongue in my mouth and I backed off. The second was I performed "protected" felatio(about a minute) on another male. He was only semi-erect and did not ejaculate.I highlighted the word protected because I used a thin plastic food bag (the kind you put sandwhiches in etc.- I don't know whether to laugh or cry about that). I have checked and the bags are water tight. The third incident involved me performing insertive anal sex with another guy. I used a latex condom and kept my eye on the rolled out end all the time.(it did not slip). This lasted for about two minutes. Afterwards I was so shocked at what I had done that I wrapped the condom in tissue paper and took it home.I dried the outside, filled it with water and to my intense gratification it did not leak .The sexual health advisor at my local clinic says I was protected and had no risk of HIV from these incidents. I have got so worked up about all of this (sleepless nights,not eating etc. that I went to My G.P. They put me on a course of valium (up to 8mg daily)For a month. I have read that valium can cause Leukopenia and this can cause lowered immune function. Please Doc. 1)What are my risks? 2)I really do not want to go for a test, But if I did would the valium have extended the window period? Things like this really make you appreciate what you have in life (Great wife and kid) and all I want to do is draw a line under this and move on.

Response from Dr. Frascino


First I'll address your specific questions:

1. Risks.

a. Kissing (with or without the tongue-tonsil hockey) is not considered to be a significant risk for HIV transmission.

b. Regarding the tasty salami in a Ziploc bag incident, oral sex is considered to have a very low risk for HIV transmission. Ziploc baggies have not been clinically tested for their ability to prevent STDs; consequently, I can't comment on this other than to recommend that their use be reserved for the kind of salamis you buy at the grocery stores, rather than the ones dangling from a Mr. McSteamy.

c. The HIV risk from latex condom-protected insertive anal sex would be considered essentially nonexistent, if the latex condom was used properly and did not fail.

2. Valium will not affect the duration of the window period, the ability of your body to produce anti-HIV antibodies or the results of any HIV-related tests.

My advice:

1. Level with your wife. It's not only the best way to confront your guilt; it's also the right thing to do.

2. If you are concerned about HIV, a single HIV-antibody test at the three-month mark will give you a definitive result. Your overall risk from your recent "boys nights out" remains extremely low at best.

3. Consider getting some counseling to better understand your recent "incidences." A better understanding of your sexuality will not negate the fact you have a "great wife and kid."

Good luck. Stay safe.

Dr. Bob

Atripla and testing period

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