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re: Is oral sex riskier than everyone thinks?
Mar 31, 2008

Something doesn't quite add up with that statement.

Dr. says you recently seroconverted, but you still test antibody negative ("still in window period?") The very definition of "seroconversion" requires being antibody positive. If you test antibody negative, you obviously haven't seroconverted. You may or may not be infected (thus safer sex is a moral obligation), but BY DEFINITION you are still HIV negative and HAVE NOT seroconverted.

In short form, READ the CONFIRMED test results BEFORE you panic. To console your fears in the meantime, do a risk assessment. If oral sex (other than in the dentists office or STD clinic) is truly your biggest risk, ask your Dr. what insurance he is selling.

The question here... Speaking for YOURSELF, Dr. Bob, what is the "up side" of suggesting HIV infection w/o a positive test? There must be one, or it wouldn't happen.

Response from Dr. Frascino

Hello,

You are correct: One cannot continue to test HIV-antibody negative yet claim to have "seroconverted!" Certainly the questioner and, perhaps even more worrisome, his doctor are confused and/or misinformed. (See below.) I hope the questioner follows my advice and get a more competent second opinion!

As for an "up side" of suggesting someone is HIV infected without a positive test, there is none. This happens primarily out of incompetence.

Dr. Bob

Is oral sex riskier than everyone thinks? Mar 30, 2008

Having survived the 80s when there were no hiv drugs, I abstained entirely from anal sex. Its 26 years later, and my doctor just told me I have just seroconverted. EVen though my hiv antibody tests keep coming back negative, my viral load test came in at 25,000. When I asked my doc how I could have converted when all I do is oral his response was, "Oral sex is complerely risky. HIV is tenacious and can attach to vocal chords and tonsils and get into the system that way." Now, for years and years, every HIV doctor I have talked to (including this one) has been answering that question with "HIV is EXTREMELY difficult to acquire orally. Its considered very low risk. And confidentially, there's been no actual evidence to support that HIV can be spread through oral sex". So, if all I have had for 26 years is oral sex, how is it that I have seroconverted? If seroconversion is so likely should't doctors be making patients more awate of that fact? Everyone I know is of the opinion that anal sex is high risk and oral sex is complerely safe. Its too late for me, but maybe you could help others now by elaborating on just what the truth is in this matter?

Response from Dr. Frascino

Hello,

"Oral sex is 'complerely' risky." What does that mean? "HIV is tenancious and can attach to vocal cords . . . ." What??? That's certainly news to me.

If you have multiple negative HIV-antibody tests, you are HIV negative. Viral load tests should not be ordered if the HIV-antibody tests are repeatedly negative. It is entirely possible your positive viral load is a false positive! I'm a bit concerned about the competency of your current doctor and would urge you to seek a second opinion from a certified HIV specialist. You can locate certified HIV specialists by checking the American Academy of HIV Medicine's Web site at www.aahivm.org. There you will find a roster of HIV specialists listed by locale.

Oral sex continues to carry an extremely low risk for HIV transmission. Period.

Good luck.

Dr. Bob



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