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Congratulations. I will donate $250. Please help (2nd email with + info.)
Jul 20, 2010

Dear Dr. Bob,

Congratulations for your outstanding forum and excellent work. I will donate $250 for your foundation. Please help:

Two weeks ago, I French kissed and had unprotected insertive oral sex (no trauma or bleeding) for some time (I couldn't have an erection) with a female sex worker of unknown status. Although I remember using a condom for vaginal sex, I am afraid now I that might have had brief unprotected vaginal sex, since I was drunk at the time.

Two weeks after the event, I am having joint and muscle pain (mostly in my legs and arms) and I have herpes simplex on my lip. My brief questions are: 1. Could any of these symptoms indicate ARS?

2. If she had herpes in her mouth (I did not notice) would it be an extenuating circumstance for oral sex? I had herpes simplex before but all the previous times on my lower lip and this time it is on my upper lip.

Congratulations once more for your fantastic work. I will donate for your foundation. Thank you so much.

Response from Dr. Frascino

Hello,

1. "Symptoms" are notoriously unreliable in predicting who is or is not HIV-infected. Consequently the answer to "could any of these symptoms indicate ARS?" is that it's a moot point. Whether they could or could not carries no predictive value as to whether you are infected with HIV. ARS symptoms may be so mild that they go completely unnoticed. You need to be concerned about your level of HIV risk, not whether you have symptoms. Your HIV-acquisition risk is exceedingly low. However, since you were drunk and aren't sure if you had "brief unprotected vaginal sex" or not, a simple HIV-antibody test at the three-month mark is warranted.

2. Yes, if your partner had open herpes sores/blisters, white blood cells at the site may increase the risk of HIV transmission/acquisition.

Increased risk of HIV transmission is more of a problem if the HIV-negative person has the herpetic outbreak with open sores and blisters. If these sore/blisters are exposed to infected bodily fluids HIV susceptibility would be increased.

Thank you for your generous donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. Your one gift will touch many lives in desperate need. On behalf of those lives please accept my heartfelt thanks. In return I'm sending you my good-luck/good-health karma that you are now and will always be HIV free.

Good luck. The odds are all in your favor that you did not acquire HIV from this incident.

Dr. Bob



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