Hey Dr. Bob, I'm twenty one years old, have been sexually active for three years now, and in line with what I've read here and elsewhere, I've done my level best to practice safe, or at least safer, sex. I always use condoms for vaginal sex (I've never had anal sex) and try and not mix alcohol and sex! I've found your forum to be so helpful and so insightful and I love the quotations that you post. You are an inspiration to me and I need your guidance.

23 days ago I performed unprotected cunnilingus on a female of unknown status. We'd never met before; she's a thirty five year old divorcee from the UK (I know, I should be high fiving myself hee hee) and, having followed up with her, she has told me I have nothing to worry about from an STI point of view. Having read here and elswhere about the remote to non-existent possibility of HIV transmission via performing oral sex on a woman, I went for it, and both of us got great pleasure out of the few minutes I was down there (my oral health is relatively good, and I saw no bood).

HIV never really crossed my mind - it never does when I've performed oral sex and I test twice yearly for all STIs - until this evening. I had been feeling a searing pain in my left upper quadrant all weekend and visited my GP who diagnosed an enlarged spleen. That in itself is enough to be going on with, but I've read before that such a condition can be linked with ARS, and of course the goblins that usually sit quiet in my mind sprung to life.

I'm quietly terrified. I've done my best to be responsible in terms of sexual health, and now I have this concern. I genuinely believed that going down on a woman was but a theoretical risk for HIV, and now I don't really know what to do.

I have some questions

1. You seem to place performing cunnilingus in the remote to non-existent category. Does my diagnosis change your opinion on my risk?

2. Should I test over this incident?

3. Is Dubya really useless at being effective or really effective at being useless?

4. Am I overreacting? As I said, HIV never entered my mind until my visit to the DOC.

I'm a PhD student, so funds are low but whenever I manage to get some dollars together I promise to donate. I respect you for what you do here - and, no doubt, everywhere else - and I hope you can find it in your heart to answer this.

With sincerest gratitude and respect from a long time reader who thinks your wonderful

Hi PhD student,

Thanks for your kind comments. Your HIV concerns are completely unwarranted! As for addressing your specific questions:

1. No, not at all. The vast majority of cases of enlarged spleens have absolutely nothing to do with HIV. Your HIV risk remains remote to nonexistent.

2. Personally I do not feel additional testing is necessary. However, if it will help put your residual worries permanently to rest, go ahead and get a single three-month rapid HIV test. The result will undoubtedly be negative.

3. Both. Dubya is really useless at being effective and really effective at being useless.

4. Yep!

PhD student, continue to play safe and you'll stay safe (and well), OK? By the way, I think both you and the 35-year-old divorcee should be high-fiving themselves!

Be well. Stay well.

Dr. Bob