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Lost Virginity In Thailand
Apr 16, 2009

Hello Dr. Francisco,

I recently lost my virginity (in Thailand) of all places. I am 23 years old. I was the insertive partner with this act. I feel really lousy (emotionally) about what happen. It totally took me by surprise. The sex was unprotected unfortunately, but I didn't even think about it because the Thai guy was so good-looking. And, he was a guy not a ladyboy.

So here are some questions: 1. What are the statistics for HIV transmission per act concerning anal sex? 2. Is insertive or receptive at more of risk? 3. How long do I have to wait until I am certain I am clean? 6 months? 1 year? 10 years? 4. Does no symptoms mean no virus?

I still can't wrap my mind around what happened. I never would have thought it would happen to me. I guess maybe because I am not out of the closet, and I just never bothered contemplating such a thing.

I am not sure if I will continue with this lifestyle. Not for moral reasons. Only because I can't really deal with the fact that every ache, cough, sneeze (in my mind) is the virus replicating itself. I have new sympathy on all levels for cancer patients and mothers-wanting to-be. Waiting is horrible.

Help for a Traveler in Thailand

Response from Dr. Frascino

Hello Closeted Traveler in Thailand,

First, I'll make a few salient points and then respond to your specific questions:

1. Closets are health hazards!

2. Homosexuality and heterosexuality are not lifestyles. They are innate sexual orientations! Choosing to be a rightwing religious zealot wingnut is a lifestyle. Being gay is not!

3. "I didn't even think about (the risk of unprotected sex) because the Thai guy was so good looking." What??? Are you making the assumption that all HIVers are monkey-butt ugly??? I take personal offense at that assumption! What about Rock Hudson, frevinsakes?!

OK, on to your questions:

1. The estimated per-act statistical risk for acquiring HIV from unprotected insertive anal sex with a partner confirmed to be HIV infected is 6.5 per 10,000 exposures. Your estimated risk would be less, because we don't know the HIV status of your handsome Thai-guy stud during your "one night in Bangkok" sexperience.

2. Being the receptive partner of any type of penetrative sex is always considered to carry more of an HIV-acquisition risk than being the insertive partner. It's just common sense and simple biology. If an HIV-infected top gun pops his cork inside an HIV negative bottom, he shoots a whole wad of baby batter directly into a waiting cavity lined with a mucous membrane (mouth, vagina, anal canal). These mucous membranes can directly absorb HIV. Consequently the increased risk of being an HIV-negative receptive partner with an HIV-positive top guy stud should be obvious when compared to that of being an HIV-negative top gun shagging an HIV-positive bottom boy (or gal). In this case the HIV negative insertive partner would need to get infectious fluids from an HIVpositive bottom into the urethra (pee hole), which is also linked with a mucous membrane.

3. The guidelines recommend an HIV-antibody test at the three-month mark for a definitive result. HIV-antibody tests taken prior to the three-month mark are not considered to be conclusive.

4. Absolutely not! A number of HIVers have seroconversion reactions that are so mild that they don't even notice them (or perhaps chalk them up to a transient cold or routine day of the "blahs"). Of course others may experience symptoms so severe they wind up in the hospital. The rule of thumb is that your HIV-risk exposure, not symptoms or lack of symptoms, is what counts!

As for not being able to wrap your mind around what happened, I think you're being too hard on yourself. You were a 23-year-old virgin. No doubt you were more than ready for your first horizontal mattress mambo experience! What's unfortunate is not your getting your cock banged in Bangkok (so to speak), but rather that you chose to do so without appropriate protection. Add to that your equally unfortunate and absolutely unwarranted feelings of guilt over finally expressing and consummating your innate sexual orientation and you can perhaps see why you are feeling "emotionally really lousy." Just because you are gay does not mean you have to freak out over "every ache, cough and sneeze"!!! And visa-versa! Leading a heterosexual life does not protect you from HIV. The virus could care less whether you're straight as a lawn dart or gay enough to bottom for Liberace.

My advice is that in addition to getting HIV tested, you get counseling to explore issues related to your sexual orientation, your inaccurate impression that being gay is a "lifestyle" rather than an innate sexual orientation, your guilt over your lapse in judgment (having unprotected sex), coping with the anxiety of waiting through the three-month window period and a variety of other related issues.

Good luck. I'm here if you need me, OK?

Dr. Bob



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