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About unprotected oral and its consequences
Jun 21, 2007

Hi Dr. Bob,

First, let me say that, after browsing through your forum, I am deeply impressed and humbled by your courage, fortitude, and optimism in the face of a terrible disease. I especially appreciate your wry sense of humor!

Recently, I performed unprotected oral sex on a guy of unknown HIV status at a club for roughly 30 seconds with no ejaculation. I'm 25 and it was my first sexual experience with anyone (apart from kissing). Since we'd been dancing for a short while before, I'm pretty sure he had some precum on his penis. Since I realized what I was doing was inconsistent with what I personally believe about casual sex, I stopped, awkwardly said goodbye to the stranger, and rinsed my mouth out in a nearby bathroom sink (but didn't gargle all the way to the back of my throat). As far as I know, I have a healthy mouth with no cuts or sores. After leaving the club some minutes later, I kept spitting heavily on the side of the street (something I normally never do). Eventually, my friends and I ended up at a fast food restaurant where I hoped that Sprite would wash down anything that might have been left in my mouth. When I visited my doctor three days later, he examined my mouth and didn't find anything unusual. He took a throat and urine culture for PCR analysis on gonorrhea and chlamydia, which fortunately came back negative. I know you've stressed that oral sex carries a low risk for HIV transmission, but a part of me worries I might be that one unlucky person.

If I do end up testing positive in three months, I might be able to come around to accepting that reality even as I start a rigorous Ph.D. program in History. If I can live long enough to finish a doctorate and teach for a few years, I will be satisfied. My bigger concern, though, is my parents' reaction. They're socially conservative and have already had a hard time coming to terms with the fact that I'm gay. I only came out to them six months ago. They've already vowed to keep my homosexuality a secret from everyone they know and I fear that if I ever told them I'm positive, they would lose their minds. I really hope I never have that conversation and I'm trying to be as optimistic as possible about my test. But I guess my question is: In situations like these, is it better to keep a secret from people who would be devastated or to be honest and deal with the repercussions?

Thank you!

Waiting In Hope

Response from Dr. Frascino

Hello Waiting in Hope,

Your HIV transmission risk from 30 seconds of oral sex without ejaculation is so remote that it's essentially nonexistent. If you remain worried, a single rapid HIV test at the three-month mark will provide you with an accurate definitive answer in as few as 20 minutes. The results will undoubtedly be negative.

Sorry to hear your socially conservative parents have decided their social conservatism is more important than your sexual identity and ultimate happiness. And how thoughtful of them to vow to keep your gay orientation a secret from everyone they know. Their love, affection and understanding just warms my heart. My suggestion is that you sign them up for PFLAG (Parents, Families and Friends of Lesbians and Gays) and advise them you are not ashamed of your sexual orientation. Personally, I would not accept their decision to try to keep your sexuality a secret. Instead I would encourage you to come out to as many friends, relatives, coworkers, neighbors, etc. as possible. You can then enlist the support of those folks in enlightening your parents. I do hope you realize it's your parents, not you, that have a problem!!

To answer your final question, no, I don't believe in secrets. Honesty really is always the best option. It's a lesson apparently your parents have yet to learn.

Be well!

Dr. Bob



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