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Just Donated $25, Please Can You Answer My Question?
Dec 12, 2008

Hi Dr Rob,

Good news, I have managed to donate $25 to the brilliant work you do. I did have to put my home address but please can you confirm that will not be used to post any confirmations or newsletters. I live with others and I want to remain private.

I am sure you are really busy but I keep on logging on in the morning to see if you have answered my question. I am such a nervous wreck, I saw I had a red mark on my finger this morning and dreaded it was the start of syphillis or herpes (my fingers had entered a womans vagina but washed immediately after with hot water and soap). The mark had gone in an hour but I am such a nervous wreck, to the extent that I am smoking alot again.

Do you mind if I post my question below, incase it is lost in your many emails? How many emails do you get a day, I think it would be good for everyone to know so that they can remain patient (unlike me!!).

I did visit the clinic on Monday (2 days after this happened). I had a final booster for Hep B, so hopefully if I did come into contact with that then my initial vaccine and then this one will help kill anything?

And also they said that even with my cut in mouth and the unknown fluid they said it was neglible (which I think means so remote it is not worth thinking about, is that right?), and that it was not worth getting tested at the 12 week mark (is it 12 weeks or 3 months, I get confused, or is both ok?). Although for piece of mind I think I should as I am so worried.

But what the advisor did say, was that she had never heard that saliva is known to have things which breaks the hiv virus down? Is it true or not? I am so confused and worried.

**Congratulations on your wedding too! Marvelous news!!***

Here is my question super Dr Bob, please hopefully you can allay my fears and answer it so I can see it tomorrow.

Hi Dr Bob, I hope this email finds you well. I emailed you yesterday, but want to change what I put as I missed out on an important point (please disregard my previous email). Ok, I visited a sex club on Friday night in the UK. An english lady let me insert two fingers into her vagina and these were in and out of her for about 5-8 minutes. I have no cuts on my fingers thank god. The part which is making me sick with worry and unable to sleep is that I sucked one of her nipples and I definitly detected some discharge enter my mouth and am now worried about HIV and Hep B and any other std/sti's. She was around 35-45 and did not look as if she had just had a child. I did read that prolonged breast play can result in fluid oozing out? Anyway, I had it in my mouth and had no where to spit it out, so I waited for more saliva to form in my mouth and then swilled both liquids at the front of my mouth as I read that saliva can kill the virus. I then swallowed it, it had no taste. I woke up the next day very worried as I saw that I had bitten the inside of my cheek and there was an abrasion/cut there...no blood coming out though. I do not know if I did this before or after this horrible situation. But what if the discharge I swallowed contained traces of blood and this mixed with my saliva came into contact with my cut? I do not know if it was breast milk as she did not look as if she had recently given birth and was older than what I would assume a new mum to have been. I did not taste blood and do not know if there was traces there, just fearing the worst. I also could not open my mouth and thus let the virus be airborne to help kill it, I wished I had spat it out. I do not know what was in my mouth. 1) Am I at a high risk? As I had this cut in my closed mouth and fluid directly entered it into my mouth (maybe with traces of blood) and I then swallowed, do I need to seek help and PEP (on Monday morning it will be 55 hours after exposure)? 2) I thought by doing fingering and sucking a nipple would be very low risk....how wrong I was. 3) I called THT Direct in the UK, I did not know about the cut in my mouth at that time and so they said that I should not be worried and no need to get checked, I think the cut in mouth would change this answer? 4) Even if I did not have this cut in my mouth at the time of exposure can the fluids get through intact mucas membranes in the mouth (where are they in the mouth, is it all the skin, and also is it muore durable than the membranes in the genital area? The THT advisor said no, there must be a route of transmission? 5) I am not even thinking about the fingering part of this nightmare as I don't think there was risk, am I right to do so? **Update, but am now worried about syphillis and herpes on my fingers, although did wash them immediately after. I am so worried Doc, please answer and help me, I feel I have ruined everything and am dreading christmas with my family and cannot sleep. Sorry for all the questions but I wanted to write them down whilst they were in my head. ***have donated now!***My finances are in dire straits at the moment and I cannot afford to donate, I am sorry...I will want to remedy this once xmas is over and present buying is finished, sorry again but thanks for the support and love you give. I desperatly want to be able to woo-hoo, do you think I will be able to when I get tested on the 3 month mark. Keep well, Stu

Response from Dr. Frascino

Hello Stu,

Calm down! Your fears are way out of proportion to any real HIV-acquisition risk! Responding to your initial five questions:

1. No. Your risk is extremely remote at best. PEP is definitely not warranted.

2. You were correct.

3. I would agree with the advice you received. The main reason for you to consider testing would be for peace of mind and to put your (unwarranted) worries permanently to rest.

4. HIV can directly permeate intact mucous membranes without there being a cut, abrasion or other "route." The entire inside of your mouth is a mucous membrane.

5. Fingering is not considered to be a risk for HIV, assuming the skin is intact. Your fears of contracting syphilis or herpes on your fingering fingers are unwarranted.

As for your other questions:

1. Literally thousands of e-mails cram their way into my inbox on a continuous basis from throughout the cyber-universe.

2. The immune system really can't distinguish between 12 weeks and three months.

3. Saliva does contain a substance that can partially inhibit HIV.

4. Regarding your wish not to receive an acknowledgement or thank-you letter for your donation, I would suggest you send an e-mail to the foundation (visit www.concertedeffort.org to do so) and specify you want your donation to remain anonymous and that you do not want to receive any formal communication about the gift. The foundation will of course follow your wishes. Since you desire not to receive a formal acknowledgement and thank-you letter, please accept my sincere appreciation here and now. In return for your gift, I'm sending you my good-luck karma that your definitive three-month HIV test will be negative. I'm very confident it will indeed be negative. OK? Spend some time perusing the archives of this forum. You'll find the testimonials both enlightening and reassuring.

Be well. Enjoy the holidays!

Dr. Bob



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