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Know when to hold them and know when to fold them. Help with PEP advice.
May 23, 2007

Hi Doctor Bob,

Ok, Kenny Rogers music is rather out, maybe I should have started with a Justin Timberlake song.

Here is my nightmare: I have been dating a guy for just two weeks and we have had sex. I had protected anal sex with him (start to finish with a condom, no breaking, me as top) gave him oral (I did taste his precum) and rimmed him. We also had frottage, with him rubbing his penis against my anus but not going in. He revealed to me that he was positive after sex. While I always pratice safe sex, and assume my partners are positive, this has freaked me out. I went to my local health clinic to inquire about pep the next day. Well, I got to conflicting opinions. The first person that saw me a nurse said I was a risk since precum contains virus particles and since his viral load was quite high (he told me this as well after sex) my risk increased dramatically. Also, she said precum could have gotten into my anus from the frottage rubbing. I freaked and said give me the PEP. So I see the ID doctor and he said oral sex is such a very low risk it would be such a remote chance and the frottage is not really risky, even if his precum got on the outside of my anus (he said it would be very rare to get hiv from this) He said no pep is needed, he could not recommend PEP. He said don't loose any sleep over this. So now I got two conflicting opinions and am so freaked out I am not sleeping or eating. Now my glands are swollen in my neck (three total). My doctor said its from my sinuses and allergies and post nasal drip. Anyway, I wanted your opinon on the pep, the risk and anything else you can tell me to either lower my anxiety or raise it to the point where I need ativan.

Thank you Doctor, I hope to hear your response.

Freaked out Kenny

Response from Dr. Frascino

Hello Freaked Out Kenny,

If you always practice safe sex and assume your partners are positive, why are you freaking out just because the guy you're dating is indeed and HIVer??? Since this episode did freak you out, I'd suggest you review the HIV risk associated with various sexual activities to be sure your boundaries are set within your no-freak-out comfort zone. That way you'll know when to hold "him" and when to fold "him."

I agree with the ID doctor and not the nurse. PEP is not warranted. I also agree that Justin Timberlake is better than Kenny Rogers, so let's "bring sexy back!" OK?

Dr. Bob



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