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Dr. Frascino's Sistuation Vs. Unprotected Oral
Mar 27, 2010

Dr. Frascino, I was reading your bio and I wanna applaud your great work that you have done in the medical and scientific fields. I also wanna ask a question comparing your situation of obtaining HIV in 1991 to unprotected oral if you don't mind. It was mentioned that you contacted HIV while doing a normal procedure on an HIV + patient, in which you got stuck by a hollow-tubed needle and lacerated. If you contacted it with this single exposure, and the odds are usually low, can't someone that receives a single exposure of unprotected oral also contact HIV in the same way you did. I recieved unprotected oral from a sex worker a little over a year ago, and I am concerned that this could be the case. Is a needle stick and getting unprotected oral sex similar risks, or does one outweigh the other? IF so, how?

Response from Dr. Frascino

Hi,

Thanks for your kind comments. Regarding the relative risk of acquiring HIV, the CDC has published statistical estimates of risk that provide a reasonable reference point for evaluating risk associated with various routes of exposure to HIV.

The estimated per-act risk for acquiring HIV from unprotected insertive oral sex with a partner confirmed to be HIV infected is 0.5 per 10,000 exposures.

The estimated per-episode risk for acquiring HIV from a percutaneous needle stick from a patient confirmed to be HIV infected is 30 per 10,000 exposures.

As you can see, the risk is quite different. Your HIV-acquisition risk is extremely low. I should also mention that HIV transmission is influenced by many potentially confounding variables involving both the virus (viral strain, viral load, etc.) and the host (immune integrity, concurrent illnesses, etc.). As always, the bottom line is if you've placed yourself at risk for HIV, you need to get an HIV-antibody test three months or more after the potential exposure.

You can read much more about this topic in the archives of this forum. We have chapters devoted to HIV sexual transmission, oral sex, sex workers and many other related topics. Check it out!

Good luck. Be well.

Dr. Bob



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