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Thanks (RE:Worried about brief encounter with african prostitute)
Sep 19, 2010

Hi again Dr Frascino,

I know you've a lot of questions to get through so I'll try and keep it to the point, its not really a question so you don't have to reply.

I just want to thank you for your advice and analysis of my situation. Once I got home from holiday and had time and privacy to properly browse this site on a real computer, I found past questions you've answered that went some way to addressing my fears, so I was starting to feel a bit better about the situation, even if it was going to turn out that you never had the time to answer me individually. Obviously your response has been very re-assuring to me, and I appreciate it a lot.

This incident actually made me realise how ill informed I was about the ins and outs of HIV/AIDS, a subject I had previously assumed I knew enough about.

For example I didn't know that there was such a varied level of risk between different types of exposure, and in all cases I didn't realise that the actual risk per exposure was as low as it is (relatively speaking). Not that it isn't significant, just that for all I've been taught about HIV in sex education, I thought "exposure to HIV equals HIV". Maybe overestimating the risk isn't a bad thing when you're trying to teach people safe practices, but it was reassuring to discover that my own risk had been fairly small. Which isn't to say I'll be putting myself at risk that way again, you'll be glad to know I've learnt my lesson!

I also didn't know about PEP - not that it would have necessarily been appropriate in my situation (well, almost certainly not). And I didn't know (or it hadn't stuck in my mind if I'd been told before) that there was an accute stage of HIV after transmission, I thought it just went without any symptoms for many years (which I believe it does after the accute stage).

Anyway, I'd like to consider myself a fairly well educated individual (if occasionally prone to doing things that aren't so smart, like washing my fellow minty fresh with Listerine - ouch) and there's a lot I've had to learn in the last few weeks about HIV/AIDS, so the need for better awareness on this subject throughout society is pretty clear. I was pleased to be able to make a donation to your foundation today, I know it will be put to good use.

Thanks once again for your time, you provide a vital service here on The Body, and the non-judgemental and often humourous responses you give make it a lot easier to deal with the stressful scenario most of the people that come to you are in, whether their worries prove to be founded or not.

Good luck with all of your ongoing work, and I send you good karma back, if I have any :)

Much Less Worried British Guy

PS: Hope your trip to the UK was an enjoyable one, I'd heard the weather wasn't the best in Scotland that week, and on my return that appeared to be the truth. Home sweet home :D

Response from Dr. Frascino

Hi Much Less Worried British Guy,

Thanks for your thanks and the update. I'm delighted you found the information here enlightening and reassuring. Thanks also for your donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated.

The cruise through the British Isles was spectacular. The two days I spent in Edinburgh were brilliantly sunny and warm. I had a marvelous time.

Be well. Stay well. I look forward to WOO-HOO-ing with you following your definitive three-month HIV-antibody test.

Good luck.

Dr. Bob

Worried about brief encounter with african prostitute Sep 18, 2010

Hi Dr Frascino,

I hope you have enjoyed your vacation, when you read this i will have returned from mine in Majorca, Spain. Unfortunately, in a state of intoxication i've done something regrettable.

Returning from a night out, i was approached by a dark skinned woman that i suspect was of african origin who offered me oral sex. Frustrated at the time, i said yes. I provided the condom which she rolled on before i was properly erect (although it seemed to grip ok) and gave oral for about 30 secs. Then she asked if i wanted sex, and again i said yes, probably the single most regrettable action. There was then brief penetration with me behind, both standing and then with me sitting. This was also as brief, i wasnt feeling it much and again not terribly stiff so i stopped her. I then masturbated with condom still on until i was ready then she finished with oral which took literally about 5 seconds. She then removed the condom and wiped my penis with a paper tissue which i have to hope was new.

Because of my drunken state, i didnt properly start to worry until i was back in my bed maybe about 15 mins later. I had both put my penis away and later touched it with unwashed hands and as i said i made hand contact with the outside of the condom when masturbating, after it had been in her. I got up again and washed my penis at the sink (i should have mentioned im british uncircumsized) and used a bit of antiseptic mouthwash, thinking that was a great idea. I did it again an unknown time later, maybe an hour (washed i mean).

The things that worry me most are that on reflection this woman must have been at the high end of the scale for HIV probability because of her probable origin and the line of work she finds herself in (which i now feel very guilty about). Im fairly sure that the head of my penis was covered by the condom if it wasnt perfectly in place - all of slightly hazy memory, darkness and general lack of understanding about acceptable condom placement make me less than 100 percent sure i can declare it safe. The fact that i later touched the tip of my slightly moist penis with unwashed hands is probably what is of greatest concern to me.

As im still here in majorca i am limited to my old cell phone for net access. The research ive managed to do is both reassuring and worrying at the same time - reassuring that a 1 time exposure to vaginal fluids (if this did even happen) does not carry a particularly high probability of transmission, but worrying that this womans job increases the likelihood of hiv presence (and i assume other risks associated with short intervals between partners and cleanliness - she was back in position on the street in a few minutes and wasnt using accomodation). Also worrying is that i had chlamydia treated about 9 months ago, thought i had it again at the start of last month (and was treated for it again because of symptoms and possible visually abnormal swab) but all tests came back negative a week ago, including HIV.

My plan is to get tested in 3 months but obviously i would appreciate any support and informed opinion you can give in the mean time, because i am a worrier by nature. I frequently get symptoms like sore neck lymph nodes and headaches in my day to day life but knowing me im sure in 2 weeks ill be convincing myself its accute HIV. In a worst case scenario, what would you estimate my risk to be?

Thank you very much for your time, i will look into a donation to your charitable organization when im home safe and sound, and have a keyboard and mouse in front of me instead of a cell phone!

(Sorry if there is a duplicate question, it can be hard to know when a web form has submitted correctly on this phone.)

Response from Dr. Frascino

Hi Worried British Guy,

Even in "a worst case scenario" your HIV-acquisition risk from your drunken tryst with the Naughty Lady from Shady Lane is extremely remote at best. The chances of becoming HIV infected by putting your trouser snake away and touching his head with unwashed hands that may have had contact with vaginal secretions on a condom are so extremely remote they are essentially nonexistent.

As for giving Mr. Happy several baths in Listerine, I can only assume you thought he may have had bad breath??? It's certainly not a recommended harm-reduction strategy for preventing HIV infection!

Thanks for your interest in making a charitable donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. In return I'm sending you my good-luck karma that you are now and will always be HIV free! I agree with your plan to get a single HIV test at the three-month mark.

Good luck Mate!

Dr. Bob



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