Hi Dr. F ~

I appreciate this website and I've read the postings on oral sex extensively over the last couple of months! My donation confirmation number is EPCE3EC1DF26.

I know you say that in general, oral sex is very low risk. A lot of people have asked about their specific circumstances, and I'd like to ask about mine. I have had a chronic, low-grade tonsillitis for about a month; it's minor, it doesn't hurt, and I've forgotten it's there a few times, but there *are* small sores and white spots on my tonsils. During this time period, over the last month, I've given oral sex to about four guys, to completion, with swallowing. The last time was about two weeks ago. I know about when to test, etc. What I'd like to know is if you think the tonsillitis I describe increases exposure risk significantly, in the same way that having an oral STD would. Without the tonsillitis, I would *know* that receptive oral sex is considered very low risk. But what about with the tonsillitis? Please, please, please take pity on my and send me your answer specifically talking about tonsillitis and oral hiv risk. Thank you.

Hi,

There are many different types of tonsillitis with varying degrees of severity and associated amounts of inflammation, from a severe bout of strep throat where it is painful to swallow (let alone think about deep-throating a throbbing tallywhacker) to low-grade cryptic tonsillitis (low-grade chronic inflammation). Consequently I'll only be able to address theoretical risk. Certainly if your tonsils are inflamed or actively infected, there would be a theoretical increased risk for the inflamed area to come into contact with HIV-infected fluids, such as spunk. This can be analogous to having an active STD in the mouth (gonorrhea, syphilis, herpes, etc.). However, it's the degree of inflammation and the presence or absence of open sores or lesions that determines the level of HIV risk.

I'd suggest:

1. Get a single HIV-antibody test at the three-month mark to put your worries permanently to rest.

2. Get your chronic tonsillitis treated so you won't have this

concern the next time "something cums up" (so to speak).

Thanks again for your donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org).

Be well.

Dr. Bob