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I think i need professional help

Aug 25, 2011

Dear Sir, i think i m not ok, and need a professional help. I m male, 36 years old, and since i was 18 i only visited a sex worker. At the beginning i had always protected (vaginal) sex, and protected oral. But after this as i was 22 i received a first blowhjob without condome. I didnt make any HIV-Test. in 1998 (as i was 23) i slept with a female sex worker and a condome broke. I didnt get a test. I started to visit more sex worker- a few times a blowjos without condome happened (1999-2006) However 2007 i was in STD-ambulance and took a lues and HIV test. Negative. After 2007 i started to visite a shemales. Anal protectes, few times i was givinga blow job, but only for few seconds, without any cums. I was worried after this shemale-experiences... Yesterday i wisited a female prostitute and she geve me a blowjob without condome. I actually can not explain you why. i really dont know. I will always use a condom, and tell to myself: i will 100% make it saef, but it is not the case. This girl is comon to make oral without condome, and do this about 3 months in a legal house (ok i know she is controlled, but... the cums of previous people...and maybe bleeding gums...). Should i actually take PEP after unprotected oral sex or pre-expostion prophylaxe (i think this is a new strategy)? Should i get againa hiv-test? Do you think i m infected ? Waht do you think, should i go to psychiatrist and tell him i need a therapy, which can help me to use always condomes.... It is terrible, cause i will stop with risks, and i cant. I cant. I m afraid, psychiatrist will not be able to help me. I m pationate sex worker visitor. I feel testosterone is too strong.I also tried to find a stable girlfriend 8 i think this could help me), but i was not sucessful. I will you donate for your willingness to read this and answer my questions (Risko or not, PEP or not, pre-expso.prophyl or not? Therapy suggestion?...Your analysis..) about 300-400 Eur and next month again the same sum. THANK YOU Respectfully Thomas

Response from Dr. Frascino


I'll answer your specific questions first.

1. PEP would not be warranted for unprotected insertive oral sex with a sex worker of unknown HIV status.

2. Routine STD screening, including an HIV test, is recommended every 6 to 12 months for sexually active folks with multiple partners.

3. Do I think you are HIV infected? No, I do not. The statistical odds are very much against the possibility you acquired HIV from your various sexcapades.

4. Pre-exposure prophylaxis (PrEP) is not recommended for situations like yours. It's being evaluated for use in magnetic couples (one poz, one negative) in addition to condoms and other harm-reduction techniques. PrEP is not a substitute for condoms!

5. Regarding your risk behaviors, don't be too hard on yourself. You are not alone! Many folks struggle with adhering to the safer sex guidelines for "sexy-time" each and every time. Someone once made the comment that the Higher Powers gave men both a brain and a penis, but only enough blood to run one at a time! You clearly understand the safer sex recommendations and the potential catastrophic consequences of unsafe sex. That's half the battle. As I mentioned adhering to safer sex recommendations can be difficult in the heat of passion. Support groups for HIV-negative men struggling to stay safe(r) are available in some parts of the country. One-on-one counseling can also be helpful in delving into issues that might be underlying some of your risky behaviors. When visiting sex workers you might try arriving with condoms in hand and advising your partner of your wish to use condoms for all penetrative sex well before the pants hit the floor. You could even set these guidelines up over the phone in advance of the hookup. Give it a try. Sex is way more fun when it's not connected with so much guilt and/or anxiety. Really, it is!

Thanks for your support of The Robert James Frascino AIDS Foundation ( It's warmly appreciated and urgently needed. In return I'm sending you my good-luck/good-health karma that you are now and will forever be HIV free.

Good luck. I'm here if you need me, okay? Stay safe(r).

Dr. Bob

Weird fingernail question
re re: doing things properly

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