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DOUBTS
Aug 10, 2008

Dear Mr. Frascino,

it looks to me that you have an Italian origin, haven't you? I'm writing from Italy and I have a couple of questions for you. By the way, my compliments for you excellent website!

Here are my questions. I am HIV negative. I recently had insertive oral sex without condom with a woman I don't know her hiv status. I had it twice and I ejaculated both times in her mouth and I also fingered her. I also tried to have protected vaginal sex with condom but I actually didn't come inside her properply cause I couldn't keep erection, I only put my glans into her vagina for 30 seconds with condom on all the time which didn't slip off. We also deep kissed all along. She didnt have any sore or blood in her mouth.

1) do you you think I actually took a risk?

2) do you think I should take the test? Or it would only be for the reason of anxiety and not for having incurred in a real risk?

Actually, here in Italy, anti HIV associations say that insertive oral sex ("fellatio") has no risk, but for the presence of visible blood in the mouth (as in the case of the aftermath of a dentist appointment). The same is actually the view of the Swiss HIV agency, which says that fellatio carry no risk for men, only for women in the case of ejaculation.

What do you think about it? You comments would be really welcomed.

Thank you very much.

Best regards. Massimiliano

Response from Dr. Frascino

Buon giorno Massimiliano,

Yes, I'm Italian. Well, at least all four of my grandparents were.

1. Protected vaginal sex is indeed protected, assuming the latex condom was used properly and did not fail. Oral sex, particularly insertive oral sex, carries an extremely low potential risk for HIV acquisition.

2. The reason to consider HIV testing would primarily be to calm any irrational fears or anxieties. HIV testing is readily available. The decision to test or not is really up to you. In general, I tend to agree with the Italian and Swiss recommendations. However, I would continue to rate oral sex as an extremely low potential risk, primarily due to rare extenuating circumstances.

Ciao,

Dr. Bob



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