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situation in thailand... please help... I PLAN TO MAKE A DONATION
Oct 9, 2009

Dr. Frascino: I am abroad (in Thailand) and last night I had sex with a girl I met at a bar. She gave no indication of being a prostitute until after we finished having protected vaginal sex at which point she asked me for money. I immediately asked her to leave. However, given the risk factors of sex workers, I have played back everything we did. Below, I have documented the things that I am concerned about.

I am most concerned about this first issue>>

1. In the middle of protected vaginal sex, I removed my penis and she performed oral sex on me over the condom. I subsequently kissed her on the mouth when we returned to vaginal sex. (Her vaginal secretions were on the condom and then we engaged in French kissing after we returned to vaginal sex)

Do I have any risk of transmission of HIV or any other STD from this?

2. Before engaging in vaginal sex, I was lying on top of her. (we were both in our underwear), It is possible, though not likely that some secretions could have gotten through our underwear. Does this pose any risk for STDs including HIV?

3. After she left, I immediately used a hand sanitizer (like purell) and then brushed my teeth. Is it possible that this was not enough to get any of her vaginal fluid off of my hands or sterilize them properly before brushing my teeth. (I used my fingers to open her slightly before initial vaginal penetration) The reason I ask about the brushing the teeth issue is that I splashed water in my mouth with my hands to rinse the toothpaste out. Does this pose any risk?

4. I noticed that there may have been one small bump near her lip that was covered with makeup. Given that there was french kissing happening throughout the night, should I be concerned about herpes or anything else from this?

5. I used a Trojan Ultra thin condom that had been in my pocket for some time. There was no break in the condom but I'm wondering if given that it had been in my pocket (think heat, bouncing around over several weeks not in the box) that there could have been any possibility of a breakdown in the integrity of the condom itself that I wouldn't have noticed but could have allowed trace amounts of fluid to pass through?

Under normal circumstances, I would never have analyzed a situation so carefully or had so many doubts (I realize the potential absurdity of the teeth brushing example/the condom integrity issue) but given the nature of what happened, I can't get these things out of my mind. I am most concerned about issue number 1.

Thank you in advance! I would appreciate any advice you have about what STD tests are necessary. I WILL BE MAKING A DONATION.

Response from Dr. Frascino

Hi,

1. The STD/HIV risk is negligible at best. If you remain worried, a simple STD screen now and a single HIV-antibody test at the three-month mark should put your residual fears permanently to rest. I'm confident the tests will be negative.

2. No risk.

3. No risk.

4. Without examining the "one small bump near her lip," I would have absolutely no way to evaluate this. (Herpes would be the most likely STD-related possibility.)

5. The Trojan Ultra Thin condom would not be harmed by the activity described or by your body heat.

Thank you for your donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. In return I'm sending my good-luck karma that you are and remain HIV negative! Try not to worry. You adhered to safer sexual practices and this should indeed keep you both safe and well no matter who you do the "dance with no pants" with.

Be well.

Dr. Bob



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