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Bells Palsy and HIV (CUNNINLIGUS)
Aug 21, 2007

Dear Dr.Bob

I am a happily married man and have been for the last 10 years. My wife has vaginimus (sp). We were seeing a sex therapist for approx 5 years to no avail. Needless to say we havent been able to have "real" sex since we were married...I am not making excuses just simply explaining my mindset.

Stupidily I have seen approx 10 sex workers in the last year bc I could not handle a sexless life anymore...Every encounter I have had has been covered for everything. However on this one occasion approx 3 months ago has prompted this question. I had protected oral and vaginal sex with her, but I performed cunninglus (unprotected) on her. A few days after I had a cold sore or canker sore come up on my tongue and cold like symptoms. Then soon after that I developed bells palsy (facil paralysis). I havent had a fever or the runs or anything else (bells was bad enough). I know that you can also get Bells from HSV1. I am scheduled for my HIV rapid test at the three month mark but I am just dying here b/c the wait is killing me. I feel like I've ruined our lives b/c I could have contracted HIV. I havent touched her since I started seeing the sex workers. I love her dearly and dont want to lose her but now I am afraid of losing everything I have - my healthm my wife, my family and reputation.

Can you please please provide some insight on what you think my chances are like?

Great and informed website BTW...I will certainly make a donation..

Thank you..worried sick!

Response from Dr. Frascino

Hello,

The HIV-transmission risk from unprotected cunnilingus is negligible at best. See below.

I very strongly doubt your Bell's palsy is related to HIV. Please note the vast majority of cases have absolutely nothing to do with HIV!

My advice is to level with your wife. It's not only the best way to confront your guilt over this incident; it's also the right thing to do. A reevaluation by a gynecologist of her vaginismus is warranted. No "real" sex since you were married is indeed a significant problem that requires a mutually agreed upon solution. I also suggest you proceed on with your plan for a three-month definitive HIV test. I'm quite confident the result will be negative.

Thank you for your donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). In return I'm sending you my best good-luck/good-health karma that your conclusive three-month HIV test is negative!

Dr. Bob

unprotected cunnilingus Jun 28, 2007

Yo Bobby!!!

Let me begin by saying how much I love this site. I'm currently working abroad and unfortunately have no peeps I would feel comfortable disclosing my HIV concerns. I plan on making a donation upon my arrival back to home. Ok... on to the good stuff. I'm a 26 year-old heterosexual male living in Japan. I've been tested twice over here for a multiple STI's including HIV and have thankfully tested negative each time. My concern is that recently I had an encounter with a Japanese women. I asked if she had ever been tested and she responded no. A bit worriesome but unfornately not uncommon in Japan. We had sex with limited penetration (Unfortunately she could only stand the the girth of my manhood for a few moments :(). I used multiple condoms provided in the love hotel (for multiple attempts, lol). However, I did perform unprotected cunnilingus on her at least twice and for an extended period of time (1-5) minutues. I didn't notice any sores, there was no blood, my good oral health on my part, and she showered and cleaned her vagina beforehand. It's been 2 weeks since this encounter and I have developed a white tongue with painless white rings and I am freaking out!!!! As a result, I am losing sleep and appetite and I am terrified everytime I get a headache or feel discomfort. Here are my questions - (1) What are the current risks of contracting HIV from a heterosexual women in Japan who is not a sex-worker? (2) Should I be concerned and hence get retested for HIV keeping in mind that I recieved a negative test result 1 month ago and 7 months ago? (3) I'm aware that oral thrush is common in HIV patients but is it a symptom that will show 2-3 weeks after exposure? (4) What is the rate of cunnilingus transmission? (5) What is the rate of unprotected fellatio transmission (for the receiver)? (5) Although I am unaware of the quality of the condoms at the love hotel (there were colored and thin) - they looked like flavoured condoms. The condom did not break or slip off - what are the chances of transmission via flavoured condoms? I have read some horror stories on the internet concerning HIV transmission over here even though from all the statistics the rate is extremely low here (at least reported rate). I've been tested 2 times this year and I am worried if I show up a third time they'll offer me a straight jacket with the free condoms!

Ease my pain!

Big Boy

Response from Dr. Frascino

Hi Big Boy,

Let me guess. You're nickname in college was "beer can," right???

OK, on to your questions:

1. Sorry, a specific HIV-transmission risk statistic for "heterosexual women in Japan who are not sex-workers" doesn't exist any more than a specific statistic for "bisexual cross-dressing Mormon midgets with webbed toes in Salt Lake City".

2. Assuming the latex condoms stayed on the "beer can" and did not break, your HIV risk would be limited to cunnilingus on a partner of unknown serostatus. This carries a negligible risk for HIV transmission. (See below.) HIV testing would be primarily for peace of mind.

3. I doubt you have thrush. It is not common two-three weeks post-exposure.

4. See below.

5. The estimated per-act risk for acquiring HIV from unprotected insertive oral sex with a partner confirmed to be HIV positive is 0.5 per 10,000 exposures.

6. Depends on the flavor! Why not bring your own condoms (the extra girth variety) next time you visit the love shack?

Dude, relax! Your level of worry is way out of proportion to any real risk!

Dr. Bob

Oral Sex question...Pls Pls answer!! (CUNNILINGUS) Apr 24, 2007

Hello Dr. Bob,

About 3 months ago I asked you a question and you responded, which was awesome! I feel like I am talking to a celebrity. I really admire you and all that you do. I know I said I was going to send a donation and I will I promise as soon as I get back to the states next month.

Anyways, my question is regarding HIV and oral sex. I know by reading in the archives that it is a low risk but for some reason I keep on worrying.

Here is what happened. I was with a Romanian sex worker. We had protected intercourse and at the end I performed unprotected oral on her. I didnt notice any open sores or anything unsual down there. After the act I checked my mouth for any open sores and I dont recall seeing any. I also washed my mouth out and when I got back I brushed my teeth. However, I did notice two small canker sores, one on the side of my tongue and the other at the bottom of the inside of my lip. Could any HIV-infected fluids gotten in there?

I assume she was HIV negative. Before and after the act she washed both hers and mine genitals and seemed to be really cautious. As for transmission, is the risk of getting HIV from vaginal fluids lower than from Semen? Does it have to be an open sore in the mouth to get infected? I know blood is the riskiest way as is unprotected anal and vaginal intercourse. Also, does saliva contain agents that help kill the virus?

I would really appreciate it if you could answer this one question for me, I promise this is the last time you will get a question from this worried well. Take care and god bless!

Mikey the Sailor

Response from Dr. Frascino

Hey Sailor-Boy Mikey,

The risk of HIV transmission from cunnilingus is extremely low. (See below.) Even with your two small canker sores, I would put your HIV risk in the remote-to-nonexistent category. Certainly if you're worried, get a rapid HIV test at the three-month mark to put your residual fears permanently to rest. Undoubtedly the result will be negative, but just to be extra sure, I'm sending you my best good-luck karma, OK?

Regarding saliva, yes, there are substances in salivary secretions that inhibit HIV. As for the infectivity of vaginal fluids versus semen, that depends on viral load, viral strain and many other factors.

Be well, Mikey.

Dr. Bob

Tested today. Alone and need some one to talk too. (CUNNILINGUS) Mar 5, 2007

Hey bob, your the best! Well i finally did it, went today and was tested for all sti's including HIV. Im studying in another country and have no one to share the stress of this with. Heres my story...... A few of months ago i performed unprotected cunnilingus. Stupid now i know but i thought this was a safe practice at the time. It lasted for a mere 45 seconds at most. A couple of days later, i came down with chills,which subsided within a day or so. I also had a chesty cough and swollen glands under my chin, which lasted for a week at most. I thought nothing of it at the time as i had just started college and everyone i knew was down with the flu. Then 2 weeks ago (a few months after my exposure) i had some unusual white discharge after urination. This got me worried about gonorrhea and chlamydia, ive been to the toilet several times since and nothing! Anyways today i went to my local clinic in order to put my fears at rest. I honestly didnt think they would test for HIV, but they said i should, so i went along with it. This has got me rather spooked to say the least. My questions are- 1-What do you think my chances of catching HIV from this one off brief exposure? What are my chances of dodging the HIV bullet Dr Bob? Secondly do you think the one episode of discharge indicates gonorrhea or chlamydia? Can symptoms appear month later and only occur the once? Im making a donation to your wonderful cause, will you please send me your goodluck karma in return! Thank you, stay well, Ewan

Response from Dr. Frascino

Hello Ewan,

I'll proceed directly to your specific questions:

1. Negligible (see below).

2. Excellent.

3. Probably not, but you're getting tested anyway, so you'll have a definitive answer very soon.

4. Extremely unlikely.

5. Good luck karma signed, sealed and sent.

Be well. Stay well!

Dr. Bob

Tonsils and Oral Sex (CUNNILINGUS) Sep 30, 2006

Dr. Frascino,

You are definitely a person admirable character. I have just donated $50 to your wonderful foundation. I wish I could afford more at this time, but money is very tight on my end with my graduate school studies. Like everyone else, I have a question for you.

I performed unprotected oral sex on a woman of unknown status about 2 weeks ago. I purposely avoided unprotected intercourse because of its risk. However, I am know concerned about this oral sex episode. I have recently developed enlarged tonsils and my tests for sterp have been negative. I have a sore throat which is understandable, but no other symptoms. I have tried to use your past answers of similar exposures to help ease my anxiety. But there is just something about hearing it directly from you.

Have you ever seen a person with whose only exposure was unprotected oral sex on a woman test positive for HIV?

I hope that your good health will continue to remain. I promise I shall make another donation later on this year.

Thank you,

Kenny

Response from Dr. Frascino

Hello Kenny,

Unprotected cunnilingus on a woman of unknown HIV serostatus carries only a negligible risk for HIV transmission. (See below.)

To answer your specific question, nope!

Thanks for your kind comments and donation.

Stop worrying! If you can't stop worrying, get tested at the three-month mark, but do realize the primary reason to do so would be to put your unwarranted fears permanently to rest, OK?

Good luck. Stay well.

Dr. Bob

Oral Sex and HIV

Feb 18, 2006

i have just stumbled on this site, and would like your opinion, on jan 1st 2006 i had protected vaginal sex with a prostitute, but i performed unprotected oral sex on her, before i performed she whiped her virgina and when performing oral sex i could taste no secretion or menstural blood, immediately afterwards i realised what a rediculous thing i had done and became increasingly paranoid about the possibility of HIV infection, on the 3rd of Jan i started on 28 PEP course, what do you think my chances of having HIV are, alot of other sites i have been on say Cunnilingus is Low risk, some say no risk, quantatively what is this risk? i am due to go for an HIV test at the end of march and am petrified of the result, many thanks

Ben C

Response from Dr. Frascino

Hello Ben,

She "whiped her virgina?" Would that be "whiped" as in whipped or "whiped" as in wiped? And would that be "virgina" as in Virginia or "virgina" as in vagina? I would assume "whipped" and "Virginia" are out, because nothing kinky ever happens in that state. The risk of HIV transmission from cunnilingus is extremely low. I'll post a question from the recent archives that addresses this problem. (See below.)

I do not believe PEP was warranted for your potential exposure. There is no reason to be "petrified" of your HIV test results. I see nothing but good news heading in your direction. I suggest you begin practicing your WOO-HOOs!

Good luck.

Dr. Bob

Cunnilingus - no blood, good oral healt Jan 12, 2006

Dear Dr. Bob,

Just sent a donation of 200 dollares - thanks fo you help - people need it and now i feel i need too

You had answered a number of questions related to the risk of cunnilingus. I was engaged in one 2 months ago but no blood was involved and my oral helth is ok. The experience was with the mistress and when i asked her afterwards she told me she is DD free .What concerns me that you mentioned once that the probability of getting HIV in this case 0.5 per 10000 cases. doest it mean that there is 1 possible transmission in 20000 cases. a number of cunnilinguses given is much more then that and there are no documented cases so far. How do these 2 things reconcile?

I am still concerned although i understand i should not be....you know...

How is it possible generally to get HIV via giving cunnilingus in case when there is no blood and my oral health seems to be in order. Appreciate your reply.

I have another general question re the symptoms...

It seems that in case there are symptoms there are ususally more then one should be present based on the statistics you posted earlier.

Appreciate your reply

Thanks for the help

Response from Dr. Frascino

Hello,

The estimated statistical per-episode risk of 0.5 per 10,000 exposures for unprotected oral intercourse refers to fellatio (oral sex performed on a man), not cunnilingus. The cunnilingus figure would be much less. In fact, it's so small it's difficult to quantitate. There are only very few cases of HIV transmission resulting from performing oral sex on a woman that have been reported to the CDC. Considering we've been monitoring this epidemic for over two decades, that alone is excellent evidence that the HIV-transmission risk through cunnilingus is extremely low. There are a number of scientific hypotheses as to why this is true, but the bottom line remains the same: it's an extremely low-risk activity. (Note: the risk increases if the woman is menstruating and/or the person performing cunnilingus has oral mucous membrane sores, abrasions or inflammation.)

Regarding your second question, ARS can be quite variable in scope, number and severity of symptoms. However, yes, generally more than a single symptom is present.

Thanks for your generous donation!

Stay well.

Dr. Bob

Update from Tonsils and Oral Sex (Cunnilingus) Dec 14, 2006

Dr. Bob,

Thanks for responding to my previous question entitled Tonsils and Oral Sex (CUNNILINGUS). May I woohoo based on the following tests and events:

Week 2: Oraquick Negative Week 7: Oraquick Negative Week 9: Oraquick Negative Night after test, fever of 101.3 and horrible earache Week 12 (86 days): Oraquick Negative

I have not had any other exposures since my unprotected cunnilingus episode. So I will ask again. Do I have your blessing on woohooing?

Happy Holidays!!!

Kenny

P.S. I plan on sending a donation to your organization once I get paid at the end of this week.

Response from Dr. Frascino

Hey Kenny,

Your week 2, 7 and 9 tests were encouraging, but not WOO-HOOable. However, your negative week-12 OraQuick allows you a full-throated, ferociously committed, screaming-banshee-type WOOOOO-HOOOOO!

Thanks for your donation (www.concertedeffort.org).

Happy WOO-HOOing Holidays to you, too!

Dr. Bob



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