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Cold Sores and HIV Infection
Jan 5, 2007

Hey Dr. Rob- I"m a huge fan of You and your organization, and I want to start off by saying "thank-you" for all that you do. I'll be sending my semi annual donation very soon! :)

Okay-here is my concern. I recently went to a bath house (sex club), and participated in oral sex (both giving and receiving). I gave oral sex very briefly but I did have an outbreak of oral herpes at the time on my lip. It wasn't actively bleeding nor did I take ejaculate into my mouth, but I"m still highly concerned given the circumstances. No, it wasnt the best decision i've made, but I'm just trying to access my risk before getting tested in 3 months.

I know that the risk for contracting hiv through oral sex is low, but does having a cold sore increase your risk exponentially? Does the HIV virus "cling" onto the white blood cells that are present during a cold sore? I'm a bit scared, Doc, but I want to start out 2007 with a clean slate by getting tested.

Any information that you could provide would be greatly appreciated.

Best to you- Concerned Gay Male

Response from Dr. Frascino

Hello CGM (Concerned Gay Male),

You are correct: the overall risk of HIV transmission from oral sex is low. Can having an active herpes outbreak increase your chances of acquiring HIV? Yes, it is possible, particularly if you had open herpes sores or blisters, as this could provide an easy way for HIV to enter the body. White blood cells at the site of herpes sores or blisters may increase susceptibility to HIV as well. That your outbreak was not "bleeding" and that you did not allow ejaculation into your mouth may have decreased the overall risk somewhat. The bottom line is that a test at the three-month mark is warranted and, overall, your HIV risk remains reasonably low.

I should also point out there was one other risk in your story. The risk you could transmit herpes to your partners. Sores and blisters (usually on the lips, genitals or anus) are extremely infectious. Herpes is easily passed by sucking, getting sucked, rimming or being rimmed. In many cases, the herpes virus can be transmitted even when no symptoms are present.

Finally, thanks for your thanks and for your donation! Both are warmly appreciated. In return, I'm sending you my very best good-luck/good-health karma for 2007 and hopes that your definitive three-month HIV test is negative.

Be well.

Dr. Bob



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