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STRESSED!!!
Apr 22, 2007

Dear Dr. Bob, I am a straight male of 35. I always practiced safe sex and always been in a managamous relationship. I did something really really stupid and had insertive anal protected sex with a prostitute. This was the first time I ever did something like this before. The intercourse lasted about 5 minutes when I got tired and told her to get off me. When she removed the condom and left it in my car I noticed that it was torn right underneath the reservior tip. I am really freaking out because this is the first time I ever had a condom break on me EVER. Second thing that worries me is that I am a uncircumsized man. My penis did not penetrate her deeply but I am still worried. When I took the condom home I noticed that there was no "fecal matter", blood, or semen inside or outside of the condom. I can't seem to sleep as I'm constantly thinking that I'm infected. This has been affecting my home life and my work as I have become "anti social" with even my family. After 4 days of exposure I've had dry mouth and a mild cracked tongue. Please respond. I've called the CDC and they told me that I was at some risk but not a lot. It would be nice to get an answer from someone with experience opposed to talking to someone from the CDC looking up documentation and reading it to me like a telemarketer. PS: I have not found any documentation either here or on the internet stating how much blood is needed for transmission. Please let me know if I owe you anything for your response.

Response from Dr. Frascino

Hello STRESSED!

You have always been in a "managamous" relationship? Managamous??? Would that be managamous, as in monogamous, or managamous, as in magnanimous??? Oh never mind.

So you want to get an answer from "someone with experience." Hmmm . . . what makes you think I have experience with doing the funky-monkey with prostitutes in my car?????

Your risk is broken-condom insertive anal sex with a pro of unknown HIV status. Broken-condom sex carries a risk similar to unprotected sex. Consequently, the estimated statistical per-act risk for acquisition of HIV from unprotected insertive anal sex with a partner known to be HIV positive is 6.5 per 10,000 exposures. Your estimated statistical risk would be less, as we don't know your pro's status.

Next, your symptoms four days post the automotive crotch-rocket-ride would not be caused by HIV. Acute retroviral syndrome symptoms take weeks, not days, to manifest themselves.

STRESSED, it seems to me, as the title of your post so vividly suggests, that your problem is related to stress and guilt over your actions. My advice is simple:

1. Level with your "managamous" partner. It's not only the best way to confront your guilt and take responsibility for your actions, but it's also the right thing to do.

2. Get an HIV test at the three-month mark. The odds are very much in your favor that you did not contract HIV from this one-time lapse in judgment.

3. Realize that STRESSED spelled backward is DESSERTS.

Good luck!

Dr. Bob



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