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Unprotected hetero oral - need of peace of mind
Nov 23, 2009

Hello Dr. Frascino,

I know you are busy but I have been in quite a mental state for 43 days now, so I will try to be brief but totally factual:

1. Had a brief unprotected oral encounter one night with a woman I met in a bar that same night on Oct 10, 2009.

2. She briefly performed oral on me (no ejaculation) and I performed oral on her clitoral area if I remember correctly.

3. She was an older woman maybe late 30's or early 40's so I was surprised that she got "wet." Maybe this was cervical mucus (which I have read is more "dangerous").

4. I also rubbed her vaginal area with my left hand which is how I know she got "wet." I don't remember if I inserted my fingers into her vagina. I also inserted the fingers of my right hand into her anus.

5. I have absolute certainty that this woman (who came into the bar alone and who is also a "biker" and who I no doubt will never run into again) stole my wallet while my shorts were pulled down and I was on my back. This has been part of what has set my mind into craziness (perhaps she is infected). The other part of my craziness is due to the fact that I lied to my girlfriend (who lives in Kentucky) about what happened that night.

6. Within about 5 days after the encounter I developed a slight irratation on the skin right above my upper lip (which has now more or less gone away).

7. About 30 days after this encounter, I developed post nasal drip and a severe dry mouth with odd taste in the mouth (which seems to still be going on).

8. Got HIV tested on day 32, which came back negative last week (I realize I should get tested at the 3 month and 6 month mark).

9. At the end of the fifth week (day 34), I began to experience loss of appetite as well as insomnia (during week 5 and 6).

10. During the sixth week (36-42 days after the encounter), I have lost some weight (about 5-8 pounds).

11. On day 40, I had an appt with my general practitioner. The nurse took my weight (which was down) and my blood pressure (which was high to her surprise) as well as my temperature. I told the doctor the whole story. His opinion was that I was going to be fine, but I should get tested in about two months (February). He did say I could come back in about 3 weeks in mid December to get retested (at about 8.5 weeks after the encounter).

12. He also prescribed temazepam for me, which does not seem to be working.

13. I have also developed diarrhea on day 41 (two instances very close together in timing in the early evening) and then again on day 42 (one instance in late morning), and then on day 43 (Nov 22, 2009) I had a small bowel movement of dark, solid, soft, broken up stool. Also, during week six, I also had several very loose bowel movements and only 1 "normal" one. I have taken Pepto Bismal twice today, so I am afraid of having more diarrhea. It feels like it is going to happen again.

Sir, I know that you are very busy and get hammered with these types of emails by the thousands, but I really would appreciate your professional opinion on what I have described above. How badly have I put myself at risk? Does it sound as if I have ARS symptoms by what I have described above?

I had an uncle who died 18 years ago this Thanksgiving as a result of complications from AIDS, so I hope you can imagine the hell and insanity I am going through right now, and the hell that I could potentially put my entire family through again.

I have been reading your responses every day for the past 11 days and have been praying and hoping to put my fears to rest.

I made a donation to www.concertedeffort.org due to your great work in helping people with HIV/AIDS and also to honor the memory of my late uncle.

I thank you for your time and I pray and hope you are able to answer my email.

Thank you again.

Response from Dr. Frascino

Hi,

First, a few comments:

1. The virus really doesn't care if the unprotected sex was gay, straight, bi-curious or closeted Mormon Republican.

2. Late 30's or early 40's really doesn't qualify as an "older" to most of us. As for your "surprise" that she got "wet," did you think late-30- or early-40-year-olds were all dried up shriveled has-been grannies and grandpas?

Now on to your questions:

1. Your HIV risk is very low to negligible. Unprotected oral sex and fingering the front and back doors carry only a very slight risk for HIV transmission/acquisition.

2. "Symptoms" are notoriously unreliable in predicting who is and is not HIV infected. Your symptoms are not worrisome for HIV ARS. Your negative 32-day HIV test is encouraging, but not yet conclusive.

My advice:

1. Level with your girlfriend. It's not only the best way to confront your guilt; it's also the right thing to do.

2. Get a single HIV-antibody test at the three-month mark.

3. Don't refer to late 30's or early 40's as "older."

Thank you for your donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. I'm sorry to hear about your uncle. One way to respect his memory is to become very well informed about HIV and help spread the message of HIV awareness and prevention to your family, friends, colleagues, and acquaintances. Your donation will be used to help provide crucial services to men, women and children living with the virus. In return for your donation, I'm sending you my good-luck karma that your definitive three-month test will remain negative. I'm very confident it will.

Good luck.

Dr. Bob



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