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Realistic Concern?
Mar 9, 2008

Dear Doc

I thoroughly enjoy your posts and the info you provide to the "gazillions" of concerned persons out there.

I did post my situation a few days back. The short and sweet of it is that I received oral sex and then approximately 20 seconds of "safe-sex" using a condom.

I am not aware of anything having been wrong with the condom and was therefore presumably not exposed to any vaginal fluids.

Reading your posts it becomes clear quite quickly that 1. vaginal sex carries a limited risk, 2. receptive oral sex carries virtually no risk, and 3. vaginal sex with a condom (properly used) carries no risk. The set of facts as I describe them appear to be a gross over reaction if one considers this general advice.

My Doc has placed me on PEP as a precaution (approx 60hours post exposure) and my baseline test came back negative (as expected). I think she saw the state I was in and would have prescribed the treatment no matter what the facts were.

The only side effective i've had to the meds is that I'm rather fatigued but then who minds getting extra sleep:-)

Doc, am I overreacting due to irrational fear? Should I calm my racing heart down and carry on with life knowning that I acted "responsibly"?

According to CDC and other stats, I have a one in approximately 200 000 chance of becoming infected. What kind of odds is that?! Is my threat of HIV infection of academic interest only?

I'll stick with the PEP and the 6week, 3 month and 6 month tests, but it would be nice to hear from you whether I should spend the coming weeks preparing for the bad news or the Woohoo!

I imagine you're flooded with questions and emails and cant answer them all. But I would like to let you know that your life story is an inspiration and that there are millions (not gazillions - unfortunately) of people who are eternally grateful for the work you do.

Thanks again J

Response from Dr. Frascino

Hi J,

My assessment and advice related to your situation remain unchanged. See below.

Dr. Bob

Once-off Exposure Mar 8, 2008

Hi Doc

I managed to get into an unfortunate situation with two "local girls" whilst overseas on a business trip. I allowed them to perform oral sex for about 30 seconds and protected vaginal sex for about 20 seconds. At that point I freaked out and called an end to the whole thing.

My doc has recommended PEP, which I started at about 58-60 post the incident. I have stuck to my routine for three days now and obviously intend doing so until my course is complete.

Whilst not married or with any children, I am a wreck about the fact that I was willing to risk so much for so little.

I would appreciate it if you let me know what my risk of exposure/infection is, the possible success of the PEP treatment and any other advice that may be of use.

Thanks in advance.

J

Response from Dr. Frascino

Hello J,

Without extenuating circumstances, PEP would not be recommended for "oral sex for about 30 seconds and protected vaginal sex for about 20 seconds with two 'local girls'."

PEP is recommended for significant HIV exposures. Your brief interlude with the dynamic duo doesn't qualify, particularly if the latex condom was used properly and did not break.

My advice would be to stop PEP and get a single rapid HIV test three months from the potential exposure. It will undoubtedly be negative. You should then yell "WOO-HOO." (It's kind of a custom around here.)

Dr. Bob



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