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Stopped in to smoke a cigar and ended up getting mine smoked
Sep 1, 2009

Hi Dr. Bob,

I am a long time fan of you and this site. Thanks for everything you do. Just made a $100 donation. I stopped in at our local cigar shop near closing time, picked out one of my favorites ended up getting a unprotected BJ from the young girl behind the counter ( she locked up the shop and went at it ),yes I was smoking the cigar while she was smoking me, figured your naughty mind would want to know. I always use condoms for intercourse (no exceptions)but pretty much don't for oral. I have also been tested for HIV at least 10 times over the course of the last 5 years. All a result of oral sex. I am struggling with whether it is necessary to get tested after unprotected insertive oral sex. I guess the easy answer is why not. Well here is my why not. I am hung up on getting a false positive, which would probably put me over the edge. So, my question is.... what is statistically a greater risk, getting hiv from unprotected oral sex or getting a false positive Oraquick. Basically my logic is if the chance of getting a false positive is greater, then why the heck do it. I think allot of people struggle with this question (to get tested after unprotected bj)this probably falls into the category of QTND but I think that the reason allot of people continue to ask is that they can't put the risk in perspective. I mean what does 0.5 per 10,000 exposures to a HIV+ person really mean. I think people need analogies to understand better. If they did it might reduce the amount of QTND. Would this be an accurate analogy ( I will use the receptive oral sex statistic of 1 per 10,000 to make it more straight forward). There is a roulette wheel and it has 10,000 numbers on it. Every time you have unprotected receptive oral sex you are spinning the wheel. There is only one number it can fall on for you to get infected. Everytime you have unprotected receptive oral sex you spin the wheel again. Is this an accurate analogy? By the way, my 19 year old daughter just sat me down to tell me she is gay. She was a bit worried about my reaction ( although I really already knew, figured she would tell me when she was ready). I gave her a hug and told here I loved her the day she was born and I will still love her the day I die. I feel closer to her now more than ever.

Peace ( go Obama !!!)

Response from Dr. Frascino

Hi,

I hope you realize your post probably just sent hundreds of readers out to their local cigar shops at closing time hoping for a similar experience.

Your roulette analogy is a good one in that it emphasizes that each spin of the wheel gives exactly the same odds of "winning." However, it must also be pointed out that even with 10,000 numbers on the wheel, it's possible to "win" on the first spin! Your analogy does not take into consideration extenuating circumstances, such as local trauma (from a toothy sucker, for instance) or concurrent STDs, which could increase the odds.

As for comparing the statistical risks of getting HIV from unprotected sex and the risk of getting a false-positive OraQuick, unfortunately that would be comparing apples to oranges and therefore not valid. The best I can offer is that the statistical risk of false-positive HIV-antibody tests and the statistical risk of getting HIV from unprotected insertive oral sex with a smoking hot cigar-shop gal are both extremely low. The difference would be in potential consequences. If you were to get a false-positive OraQuick, follow-up tests would immediately reveal your true HIV-negative status. If you happen to be the sexual roulette player who "wins," despite the long odds, you might not realize it for quite some time, which could put your health (and perhaps the health of others) in jeopardy. Basically, what I'm trying to convey is that you shouldn't fear inaccurate HIV test results but there would be cause for concern if an HIV diagnosis was missed.

Regarding your response to your gay daughter coming out, all I can say is BRAVO and that every gay son and daughter in the universe wishes they had a dad like you.

Finally, yes, go Obama!

Dr. Bob



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