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did it again - but this time outside the strip club

Apr 3, 2009

Dear Dr. Frascino,

Let me start by saying I will gladly make a donation for the 2009 tax year as I think the work you are doing for the world is remarkable. Ive done it again and this time, it was not related to alcohol but just some urge which I just had. After my last encounter at this high end strip club in New York which you thoughtfully addressed recently, I kept in touch with this particular stripper. She would text me now and then and last night (March 30, 2009) asked if she could see me. Ive never gone to a prostitute in my life and I have to admit I was thrilled at the possibility especially with one I found insanely beautiful. We got a hotel room in Manhattan and engaged in unprotected oral sex (she on me and me on her) and protected vaginal sex. I did not ejaculate inside her but shortly after coming out via her hand and her saliva (I did not ejaculate in her mouth). Before doing anything of this, I asked her several times if she gets tested for STDs and she told me that she sees a doctor every 2-3 months and always uses protection. She also said she doesnt see that many clients outside the strip club (where she has never engaged in intercourse). What are your thoughts about testing? Im a married man and dont want to tell my wife as, I hope, I wont do this again. Should I look into the p24 test? I dont believe I can wait 3 months without raising suspicion from my wife. Do you feel my exposure warrants testing? Thanks for your help in the past and on this encounter.

Yours truly,

Tribeca Joe

Response from Dr. Frascino

Hi Tribeca Joe,

Regarding your HIV risk, protected sex is indeed protected assuming the latex or polyurethane condom was used properly and did not fail (break). Oral sex carries only a very minimal risk for HIV acquisition.

It is true that the vast majority (but not all) of HIV-infected folks will have detectable levels of HIV antibodies and p24 antigen in their blood within four to six weeks following primary HIV infection. However, when dealing with a disease like HIV, which can result in catastrophic consequences if the diagnosis is missed, the "vast majority" isn't good enough. That is why the published guidelines continue to recommend a test at the three-month mark for a definitive test result.

Do I feel your exposure warrants testing? Well, that's difficult to say because I wasn't there (was I?) to witness if the condom was in fact used properly or to check if you or your Naughty Lady from Shady Lane had any extenuating circumstances that might increase the risks associated with oral sex (gum disease, concurrent oral STDs, etc.). Consequently you'll have to make that decision yourself. I can advise you that from what you told me your overall HIV risk is extremely low.

So what to do???

1. I always recommend leveling with one's spouse, but I know this is not a popular recommendation. It is, however, not only the best way to confront the guilt surrounding an "indiscretion," but it's also the right thing to do. Most solid relationships and good marriages can survive episodes like these. In fact going through a difficult time, such as the HIV window period, together can actually strengthen a relationship. Dishonesty and secrets can often poison a relationship.

2. Since you are obviously in touch with the insanely beautiful Badda Bing Betty, you could offer to escort her to your local rapid HIV test center to check her HIV status. If it's negative, you can breathe a large sigh of relief, as your HIV risk would be dramatically decreased. In fact if she's negative, your only ongoing concern would be that she is still in her window period prior to seroconversion. The chances of this are remote.

Hope that helps Tribeca Joe. Try not to be too hard on yourself. We are all human, which means we all make mistakes, including yours truly. The important thing is to admit our failings, accept responsibility for our actions and learn from our mistakes. I should also point out that the higher powers gave men both a penis and a brain, but only enough blood to run one at a time.

Thanks for your donation to the Robert James Frascino AIDS Foundation ( It's warmly appreciated. I'm flying over Tribeca as I type this response en route to Newark airport to connect to a flight to Washington, D.C. It's cherry blossom time in Obamaland!

Good luck Joe.

Dr. Bob


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