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Please clarify (or hypothesize) re: tonsillitis . . . please

Jul 7, 2009

Thank you for answering my previous question. I've been searching hard for a doctor I can talk with about these things, but it's been a real challenge so far. I hope you will take a moment to clarify this follow-up question. Since with tonsillitis there *are* small sores and infection *is* present, to what degree (theoretically) would you say that the risk is increased? Would you say it's still a small theoretic increase, because it's still in the category of lower-risk oral sex? Or does the risk theoretically spike, to the level of having receptive, unprotected anal sex? Any thoughts you have on this would be greatly appreciated. Of course I'll get tested over the next several weeks/months, but in the meantime, it really, really helps to get feedback. I really appreciate your help.

Getting really scard - please answer - 4th try - made $100 donation Jun 28, 2009

Hi Dr. F ~

I appreciate this website and I've read the postings on oral sex extensively over the last couple of months! My donation confirmation number is EPCE3EC1DF26.

I know you say that in general, oral sex is very low risk. A lot of people have asked about their specific circumstances, and I'd like to ask about mine. I have had a chronic, low-grade tonsillitis for about a month; it's minor, it doesn't hurt, and I've forgotten it's there a few times, but there *are* small sores and white spots on my tonsils. During this time period, over the last month, I've given oral sex to about four guys, to completion, with swallowing. The last time was about two weeks ago. I know about when to test, etc. What I'd like to know is if you think the tonsillitis I describe increases exposure risk significantly, in the same way that having an oral STD would. Without the tonsillitis, I would *know* that receptive oral sex is considered very low risk. But what about with the tonsillitis? Please, please, please take pity on my and send me your answer specifically talking about tonsillitis and oral hiv risk. Thank you.

Advertisement > Every 9 minutes someone in the US is infected with HIV. Act Against AIDS. Response from Dr. Frascino


There are many different types of tonsillitis with varying degrees of severity and associated amounts of inflammation, from a severe bout of strep throat where it is painful to swallow (let alone think about deep-throating a throbbing tallywhacker) to low-grade cryptic tonsillitis (low-grade chronic inflammation). Consequently I'll only be able to address theoretical risk. Certainly if your tonsils are inflamed or actively infected, there would be a theoretical increased risk for the inflamed area to come into contact with HIV-infected fluids, such as spunk. This can be analogous to having an active STD in the mouth (gonorrhea, syphilis, herpes, etc.). However, it's the degree of inflammation and the presence or absence of open sores or lesions that determines the level of HIV risk.

I'd suggest:

1. Get a single HIV-antibody test at the three-month mark to put your worries permanently to rest.

2. Get your chronic tonsillitis treated so you won't have this

concern the next time "something cums up" (so to speak).

Thanks again for your donation to The Robert James Frascino AIDS Foundation (

Be well.

Dr. Bob

Response from Dr. Frascino


You are overanalyzing these hypothetical/theoretical situations. I'd suggest keeping things simple. If you've had a potential HIV exposure, get an HIV-antibody test at the three-month mark. Mentally masturbating about slight differences in levels of risk, confounding variables, nonspecific symptoms or other "stuff" won't change the results of your test. And that's really the only thing that counts!

As I mentioned previously "tonsillitis" can vary greatly in severity. Consequently the level of inflammation can vary as well. Because of this variability I cannot accurately quantify the exact degree of increased risk. What I can say is that it certainly would not approach the risk of unprotected anal receptive sex! OK? Now stop overanalyzing!

Good luck.

Dr. Bob

I did something horribly foolish and scary
Worried from India (mumbai)

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