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Symptoms/Oral Sex Risk
Jan 11, 2008

Hi Dr. Bob!

I have donated a few times through the mail to your wonderful cause and did so with the holiday one you just sent out. I am a heterosexual male that had encounters with two different female escorts. I had unprotected oral sex giving and receiving with both. I used a condom for the penile-vaginal intercourse. About 2 weeks after my last encounter, I experienced a extremely painful sore throat. There were no other symptoms other than a mild headache every now and then, which my doctor claims was caused by the "throat virus". The sore throat has lasted about two weeks and is finally subsiding. I have read through many of your archives and have seen the odds are in my favor and perhaps the "fear of HIV" may be the cause of my worries more than anything. However, it did worry me that I got a sore throat in the window period for HIV. I am planning a 3 month test, but I was wondering if my worries are even warranted? Also, have you ever experienced anyone diagnosed with HIV transmission caused only by oral sex? I have seen many doctors in other forums write that they never have and only certain circumstances can cause the transmission through oral sex. Thanks for your time and go Obama! -Matt

Response from Dr. Frascino

Hey Matt,

Your HIV-acquisition risk is extremely low. Protected vaginal sex is indeed protected, assuming the latex condom was used properly and did not fail. Oral sex carries a very low risk for HIV transmission.

Your isolated symptoms of sore throat and mild headache are not worrisome for or suggestive of HIV ARS (acute retroviral syndrome). Are your worries warranted? No, however, since you are worried, I'd recommend you proceed with the three-month test to permanently put your fears to rest.

Regarding acquiring HIV via oral sex only, there are indeed anecdotal reports in the medical literature. It would be difficult to "document" someone had "only" oral sex without sending the sex police into the bedrooms to monitor blow jobs.

To answer your specific question, yes, I have had a very small number of patients claim "oral sex" as their only potential risk for acquiring the virus. However, remember, it might be difficult for folks to admit they had a lapse in judgment and didn't use a condom when the hot FedEx guy delivered more than a package. (Or the pizza guy, cable guy, pool guy . . . whatever fantasy rocks your boat.) Since everyone is supposed to know unsafe sex is, well, unsafe, they may be reluctant to admit a screw-up while screwing. Also, since many folks feel oral sex is "safe enough", it may be easier for a recently infected person to say "I thought it was 'safe enough,' but unfortunately I got infected."

Finally, Obamamania is here!

Dr. Bob



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