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no documented cases?
Oct 16, 2008

Hi Doc, I have two questions - 1) Is the song 'A certain smile' by Johanny Mathis about you? - I think it is! 2) Some American based websites say insertive fellatio carries a zero risk as there has never been a documented case of anyone being infected this way and say the this is epidemilogical and scientific fact. I see your views are more conservative. Are these websites not being irresponsible by disseminating information that people will base there behaviours on? Stay beautiful, your fan.

Response from Dr. Frascino

Hello Fan,

1. "A certain smile" was not written for me. Someone did write a song for me once; however, it concerned a body part other than my smile. (No, I can't publish the lyrics; they wouldn't make it through the censors.)

2. I believe there is a difference between "no documented cases" and "zero risk." There certainly are "reported cases" of HIV acquisition from oral sex (both insertive and receptive). Scientifically, "documenting" such cases would be difficult to do without inviting the sex police into the bedroom to assure the only potential HIV risk was indeed insertive oral sex. There is also the problem of extenuating circumstances and confounding variables. For instance, if someone has certain concurrent STDs, that significantly increases the risk of HIV transmission via oral sex. Likewise, if the oral sex involves vigorous deep-throating and trauma occurs to either the probing tallywhacker or the talented sucker who has no gag reflex, this, too, could increase HIV-transmission/acquisition risk. The important take-home message remains that oral sex carries a very low risk for HIV transmission/acquisition and that, as with all forms of penetrative sex, the insertive partner faces less risk than the receptive partner. I don't believe this is a conservative view, but rather an accurate assessment of the scientific realities surrounding the risk of HIV transmission related to oral sex. Hope that helps!

Dr. Bob



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