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ARS or unfortunate coincidence?
Dec 12, 2006

Hello Doctor,

Just last Friday night on the 1st, I gave oral sex to a girl and she gave it back to me where her vaginal fluids entered my mouth. Of course, i didnt know her HIV status. That next Saturday morning i had slight cold symptoms (sore throat and runny nose) that didnt last longer than a matter of hours. Then yesterday (Wednesday the 6th) I got more severe and persistent cold symtoms, stronger sore throat, no runny nose, diarrhea and headache. I'm sure im just being paranoid, but...

1. is there any possibility that I contracted HIV and that these are signs of ARS? Or is it just the common cold...?

2. Whats the earliest you can get ARS symptoms? the symtoms came 4 or 5 days after the encounter. Isnt it common to get cold symtoms like these after an encounter such as this since our fluids were exchanged?

3. If I did have ARS, would medications such as Dayquil and Tylenol have an effect on the symtoms even though its not a real flu?

Thank you so much for what you do. It's all absolutely amazing and Im addicted to this site. I spend so much time on it! This is my second time writing and a donation is overdue, whats your mailing address? Again, I cant thank you enough, take care!

Response from Dr. Frascino

Hello,

The HIV risk from oral sex is extremely low. Take a read through the extensive archives on this topic for additional insights. I'll post a question from the archives related to cunnilingus below.

To address your specific questions:

1. Your HIV risk is remote at best. I'd agree with your "common cold" assessment. If you remain worried and feel you've placed yourself at risk for HIV, get a single HIV test at the three-month mark.

2. There is no "earliest" time. ARS symptoms generally occur several weeks after becoming infected.

As for it being "common to get cold symptoms like these after an encounter such as this . . . ," well, most colds don't require sucking on joy sticks or lunch at the Y, so to speak. Most colds are transmitted by airborne germs from a cough or sneeze.

3. Tylenol and other medications to help with fever, aches and pains, etc. would help somewhat, no matter what the cause of those symptoms might be.

4. The mailing address for The Robert James Frascino AIDS Foundation is:

The Robert James Frascino AIDS Foundation 1000 Fremont Ave., Suite 145 Los Altos, CA 94024

Thanks for your donation. In return, I'm sending you (in addition to my usual Miss Manner's-approved letter of acknowledgement) my good-luck/good-health karma.

Happy Holidays.

Dr. Bob

Elisa Questión & Donation (CUNNILINGUS) Nov 25, 2006

Good Morning Dr Frascino. Im terified. I practice cunilingus to a sex worker in june. ELISA non reactive 15 days after exposure. I have throat pain during the 6th to the 10th week, but I have not presented fever or other symptoms. ELISA non reactive (-) 80 days (11th week) after exposure. Im very worried about mi situation.

Doctor: I need more tests to know if im infected?

Can i have sex with my wife? shes very sad for my stupid behavior

I am going to donate some money to your cause. And i have a great interest to work as a social worker in my country (Colombia) to help people whit HIV. I hope we can speak of this some day.

Thanks for your time.

Adolfo.

Response from Dr. Frascino

Hello Adolofo,

The HIV-transmission risk from cunnilingus is extremely low. (See post from the archives below.) Your 11-week negative ELISA test is extremely encouraging. However, the current guidelines state that ELISA tests taken prior to the three-month mark are not definitive. Consequently, I'd recommend you retest at three months or more following the date of your potential exposure to obtain the assurance your test is indeed conclusive.

I strongly encourage you to pursue your interest in HIV-related social work in Colombia.

Thank you for your donation (www.concertedeffort.org). In return I'm sending you my best good-luck karma that your definitive three-month HIV test remains negative.

Dr. Bob

Tonsils and Oral Sex (CUNNILINGUS) Sep 30, 2006

Dr. Frascino,

You are definitely a person admirable character. I have just donated $50 to your wonderful foundation. I wish I could afford more at this time, but money is very tight on my end with my graduate school studies. Like everyone else, I have a question for you.

I performed unprotected oral sex on a woman of unknown status about 2 weeks ago. I purposely avoided unprotected intercourse because of its risk. However, I am know concerned about this oral sex episode. I have recently developed enlarged tonsils and my tests for sterp have been negative. I have a sore throat which is understandable, but no other symptoms. I have tried to use your past answers of similar exposures to help ease my anxiety. But there is just something about hearing it directly from you.

Have you ever seen a person with whose only exposure was unprotected oral sex on a woman test positive for HIV?

I hope that your good health will continue to remain. I promise I shall make another donation later on this year.

Thank you,

Kenny

Response from Dr. Frascino

Hello Kenny,

Unprotected cunnilingus on a woman of unknown HIV serostatus carries only a negligible risk for HIV transmission. (See below.)

To answer your specific question, nope!

Thanks for your kind comments and donation.

Stop worrying! If you can't stop worrying, get tested at the three-month mark, but do realize the primary reason to do so would be to put your unwarranted fears permanently to rest, OK?

Good luck. Stay well.

Dr. Bob

Oral Sex and HIV

Feb 18, 2006

i have just stumbled on this site, and would like your opinion, on jan 1st 2006 i had protected vaginal sex with a prostitute, but i performed unprotected oral sex on her, before i performed she whiped her virgina and when performing oral sex i could taste no secretion or menstural blood, immediately afterwards i realised what a rediculous thing i had done and became increasingly paranoid about the possibility of HIV infection, on the 3rd of Jan i started on 28 PEP course, what do you think my chances of having HIV are, alot of other sites i have been on say Cunnilingus is Low risk, some say no risk, quantatively what is this risk? i am due to go for an HIV test at the end of march and am petrified of the result, many thanks

Ben C

Response from Dr. Frascino

Hello Ben,

She "whiped her virgina?" Would that be "whiped" as in whipped or "whiped" as in wiped? And would that be "virgina" as in Virginia or "virgina" as in vagina? I would assume "whipped" and "Virginia" are out, because nothing kinky ever happens in that state. The risk of HIV transmission from cunnilingus is extremely low. I'll post a question from the recent archives that addresses this problem. (See below.)

I do not believe PEP was warranted for your potential exposure. There is no reason to be "petrified" of your HIV test results. I see nothing but good news heading in your direction. I suggest you begin practicing your WOO-HOOs!

Good luck.

Dr. Bob

Cunnilingus - no blood, good oral healt Jan 12, 2006

Dear Dr. Bob,

Just sent a donation of 200 dollares - thanks fo you help - people need it and now i feel i need too

You had answered a number of questions related to the risk of cunnilingus. I was engaged in one 2 months ago but no blood was involved and my oral helth is ok. The experience was with the mistress and when i asked her afterwards she told me she is DD free .What concerns me that you mentioned once that the probability of getting HIV in this case 0.5 per 10000 cases. doest it mean that there is 1 possible transmission in 20000 cases. a number of cunnilinguses given is much more then that and there are no documented cases so far. How do these 2 things reconcile?

I am still concerned although i understand i should not be....you know...

How is it possible generally to get HIV via giving cunnilingus in case when there is no blood and my oral health seems to be in order. Appreciate your reply.

I have another general question re the symptoms...

It seems that in case there are symptoms there are ususally more then one should be present based on the statistics you posted earlier.

Appreciate your reply

Thanks for the help

Response from Dr. Frascino

Hello,

The estimated statistical per-episode risk of 0.5 per 10,000 exposures for unprotected oral intercourse refers to fellatio (oral sex performed on a man), not cunnilingus. The cunnilingus figure would be much less. In fact, it's so small it's difficult to quantitate. There are only very few cases of HIV transmission resulting from performing oral sex on a woman that have been reported to the CDC. Considering we've been monitoring this epidemic for over two decades, that alone is excellent evidence that the HIV-transmission risk through cunnilingus is extremely low. There are a number of scientific hypotheses as to why this is true, but the bottom line remains the same: it's an extremely low-risk activity. (Note: the risk increases if the woman is menstruating and/or the person performing cunnilingus has oral mucous membrane sores, abrasions or inflammation.)

Regarding your second question, ARS can be quite variable in scope, number and severity of symptoms. However, yes, generally more than a single symptom is present.

Thanks for your generous donation!

Stay well.

Dr. Bob



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