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great work Dr. Cohen

Jul 18, 2001

I just wanted to say I love your optimistic approach to answering questions. You do a great job in injecting the perfect combo of excellent medical advice and encouragement.

My question to you is the following: I am a male who was sexually assualted by two males (who appeared to be homeless ie. concern for poor oral hygeine,bleeding gums perhaps). The one male pinned me against the wall while the other pulled my pants down and put my penis into his mouth for approx. 2 minutes before I was able to break free and run to the police station. The next day I got a sore throat followed by sore glands (groin next day, armpits a week later, neck the next day)and later dizziness. I went to several doctors who assured me that the incident poses no risk for HIV and that my symptoms are due to anxiety or possibly a bug I picked up. Since I'm a big fan of your answers and I love your forum, I thought I would ask you for your opinion. It was a pretty scary event and I have never had any kind of sex before and at this point I don't know if I ever will. I was also wondering if I could have gotten anything else through the incident, ie. HTLV, CMV, HBV, HCV etc?

Thank you very much DR. Cohen. I apologize for asking this in the treatment forum, but unfortunatley for alot of us you don't post anywhere else.

Thanks again Dr. Cohen

Response from Dr. Cohen

Thanks for the support.

As for your sad encounter - it just doesn't seem at all likely that you would acquire HIV this way. Our skin is a very very effective barrier against acquiring most viruses. And saliva, even if blood tinged, on the outside skin, usually leads to no transmission.

Based on work from Africa, one issue that may be somewhat relevant as well is the issue of circumcision. It seems that when men are circumsized, then the remaining "epithelialized" skin that grows is very good at protecting us from HIV and other viruses. However, the foreskin, if intact, is potentially more vulnerable in acquiring HIV and potentially other organisms. This difference is so striking in studies of heterosexual transmission from women to men that there is consideration for a trial to randomize uncircumcized men to continue "as is" or undergo circumcision. Whether this will happen, and whether men would leave this decision up to the toss of a coin, is unclear. But the data appear strong enough to lead to this being considered.

Now, since I don't know your status on this issue, it is hard to know if this added info is of comfort or adding to your concern. Nonetheless, in either circumstance, acquiring HIV through a few minutes of oral contact is very very unlikely. Why you then had the symptoms you describe is unclear and hopefully something you can address with your medical provider. Including HIV testing to simply address the concern with what is likely to be a negative test, so you could put this issue and event to rest.

As for this one episode leading to your foreswearing off sex in the future, perhaps it may be fair to point out that if your first ice cream was caramel licorice chip, you should just consider that oreo cookie or Cherry Garcia is just too good to not try... at least once.

Good luck.

About your HIV Cure post dated April 16, 2001
Adjust Abacavir dose with Kaletra?

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