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Personal and i really hope there will be a response
May 10, 2010

Doctor I sincerely appreciate people like you, who dedicate their lives to enhancing the wellbeing of others and are dedicated to a causes they are passionate for.

My question is personal and is simply looking to be pointed in a good direction overall from someone with your level of expertise. I am a recent college graduate, have no health insurance and am extremely concerned about a medical issue that i am currently faced with: I gave unprotected oral sex MSM to a guy a little less than two years ago. I deepthroated it several times and pulled out befored ejaculation. After this i began to notice some bleeding in my gums when brushing, so there is now obvious reason for concern.

Following the episode i got sick about three to four weeks afterword with a sore throat, headache and a bit of a stuffed up nose. It was bad but no i didn't seek medical attention. By about eight weeks after i broke out with the worst case of oral ulcers that i have ever had. Now at around the year and a half mark i am experiencing what appears to be oral thrush for the past day and a half and what feels like chronic pain in my genital area that may be chronic herpes cause i feel i may have contracted them from a girl i dated long ago!

My question involves direction in where i should turn as an uninsured person who is looking for diagnosis and etc. I live in orlando florida and was hoping to have a plan established before i head in, in order to be prepared for the worst. I know most of your responses involve risk assesment, which usually varies from high risk exposure, to risk, to extremely low risk often accompanied by the odds are on your side. If you could give me some relative understanding of what my risk is- i know performing oral is considered relatively low risk, but bleeding gums can elevate that and am wondering if this elevation is severe enough to put it in the severe risk catagory? I'd like to again reiterate my appreciation for what you do, and simply again reiterate that even if you don't have time or deam my question relavent some suggestions for a plan that could help me confront my status.

Thank you so much!!!!!!!!!!

Response from Dr. Frascino

Hi,

First and foremost I would warn against self diagnosis. What "appears to be oral thrush" or what "feels like chronic pain that may be chronic herpes . . ." in reality may not be thrush or herpes.

You report you "know performing oral (sex) is considered relatively low risk . . . ." I absolutely agree. The "some bleeding in my gums when brushing . . ." would not alter the "relative low risk" classification.

As an uninsured person looking for a diagnosis, the first thing you need to do is be very, very thankful that Obama and the Democrats passed the health care reform legislation. Soon no matter what diagnosis you may or may not have, you'll be able to obtain affordable health insurance! Despite your low HIV-acquisition risk, concern about HIV clearly remains a worry for you. Consequently I recommend you get an HIV-antibody test. You can accomplish this by going to your local health department, an STD clinic or a private doctor or by getting an anonymous test at home using the Home Access Express Test (can be ordered online or purchased in retail pharmacies). The odds are very much in your favor that you did not contract HIV by giving a dude a blowjob. You also need to begin flossing daily and see your dentist for routine care to help with your bleeding gums.

Good luck. Be well.

Dr. Bob



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