HIV - Prevention Expert Forum
HIV- "Low risk" behaviours.
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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HIV- "Low risk" behaviours.

I am a 21 year old gay man, and I regularly get STI and HIV testing.. I got tested at 4 months (NEG) in February, and since that time I have had a few "exposures" that are now causing me a lot of anxiety.
1) I received/gave oral sex with another male my age, and ejaculation took place both ways, and was swallowed both ways. I had no cuts or sores in my mouth, so I was not too worried.
2) I received oral sex from a guy I was seeing, and I rubbed the outside of his anus with my finger. I was not worried until he admitted to being an escort, and then to alleviate my stress he got an HIV test and showed me the results (NEG), 2 months after a previous oral encounter.
3) Most recently, I have been seeing an 18 year old male. We talked about sex and HIV, and a month ago he was the top in unprotected anal sex with another man.. We decided  not to engage in any oral/anal until he is 'officially' out of the window period and even then, we will use protection.We have only engaged in heavy kissing, both performing and receiving hand jobs (and ejaculating on hands, body etc), and I fingered his anus. I tend to pick alot at my nails, and because of work, have little cuts and nicks on my hands that I KNOW have come into contact with his semen.
I keep reading about cuts and abrasions being exposed to semen being a HIV risk.
To clarify: Do these 'cuts' have to be DEEP in order for transmission to even have a chance to occur? (As in requiring stitches?) And not a ‘surface’ cut? I don't remember any bleeding on my hands but there could have been some.
I apologize if my fears seem illogical, I just can't seem to find any solid information on this. In your opinion (both medically, and from a 'real-world' point of view) have I had ANY risks for HIV in particular?



239123_tn?1267651214
Welcome to the forum.  You've been asking variations on the same questions for a few weeks in threads on the HIV community forum.  From scanning those discussions, it appears you have had accurate replies.

First, in regard to oral sex, please read the following thread from a few weeks ago.  As you will see, you can safely consider any and all oral sex exposures to be no risk at all for HIV:  http://www.medhelp.org/posts/show/1922236

That thread covers the first exposure.  The second also is no risk; HIV is not transmitted by fingering or other hand-genital (or hand-anal) contact.  Finally, kissing is also zero risk -- which covers the last event you are concerned about.

The business about cuts and other skin lesions increasing risk is pretty much theoretical.  It is probable that nobody has ever been sexually infectd with HIV simply by exposure of a cut or wound to infected semen or blood.  Of course, nobody can say it is zero risk -- just as oral sex may not be truly zero risk -- but it's sufficiently low that it really shouldn't be a significant worry.  Common sense would say to avoid exposure of any known cuts or wounds, especially if they were deep and freshly bleeding -- but that's easy by just avoiding sex entirely at such times.

The facts about HIV transmission are really very simple:  if a bare penis (no condom) does not enter another person's vagina, rectum, or (maybe very rarely) mouth, there is no risk of HIV.  I encourage you to continue to ask your partners about their HIV status before having any contact, even safe contact like mutual masturbation or oral sex; and not to go forward with those who are positive (and not on effective treatment), don't know, or seem evasive about it.  Also keep condoms handy, in case in the heat of the moment you have anal sex.

If you follow these guidelines, you can expect to go a lifetime without being at significant risk of HIV.   You really needn't be worried about exposures other than unprotected anal sex.

Best regards--  HHH, MD
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