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Brazilian Needs your Help !!!PLease!!!!!!!
Jan 10, 2007

Dear Doctor Frascino, first of all I would like to wish you a bright 2007 with lots of happiness. I also want to beg your pardon for my poor english, so I will try to explain my big concerns, which are driving me crazy and bringing me a lot of stress ! I am a man who dates men. I met a guy very recently and I allowed him to make oral sex in me without condom. Besides I know that this is not a risky action, I am concerned because I let him doing this, just some hours after my doctor took out the "thread" ( is that right?) he used to sew my penis 3 weeks ago, when he made a circuncision.This guy is a young doctor, who had an accident at the hospital, where he works, with a needle, used for sewing. He was hit by this needle, while he was sewing an HIV + person. The hospital told him that once he was wearing gloves and the needle has not a hole inside, his risk was minimal and did not prescribe him PEP. He made 1 HIV test when it occured ( 1 month ago)and must repeat it in 2 months from now ! My big concern is to know my risk of being infected by this scenario that I told you ( Insertive oral sex and deep kissing under all these circunstances !!!!!!!!)!!!!!!. Please doctor, I do know that you are a very busy man, but I would not ask you a question if I would not be sooooo stressed as I am now...This situation is really driving me crazy !!! Anytime you wish to visit S.Paulo/Brazil, please let me know and I will arrange everything to you, ok? Many, many, many thanks in advance !!! Brazilian friend

Response from Dr. Frascino

Hey Brazilian friend,

I think I have the facts of your situation sorted out, but just in case I don't, let me reiterate my understanding of them. You had a circumcision (OUCHAMAGOUCHA!) three weeks ago. Three hours after the suture removal, you had sex with a young doctor (was he the same one who removed the sutures????) who had had an occupational HIV exposure one month ago that consisted of being "hit" by a solid-bore needle while wearing gloves. He did not receive PEP, because it was felt his risk didn't warrant it. He had one negative HIV test at the time of the incident and is scheduled for his next test at the three-month mark. Do I have all that straight or, ahem "gaily correct?"

You are correct: the HIV risk of oral sex in general is indeed very low. Whether this risk is significantly increased by your recent suture removal and the fact your Dr. McDreamy has had a recent occupational exposure is difficult to state with any certainty. I would characterize the "occupational exposure" factor as negligible in terms of your overall risk. The importance of the "suture removal" factor would depend on how well healed the incision suture tracks were. Again, I would assign this a minimal or, at best, small theoretical increase in your overall risk.

I see no reason this should "drive you crazy," but I would suggest you get a single HIV test at the three-month mark to put any residual fears permanently to rest, OK?

I've been to Sao Paulo before and enjoyed my visit immensely. If I come for another visit, will you give me some samba lessons?

Be well, Brazilian friend.

Dr. Bob



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