HIV - Prevention Expert Forum
Menstrual Blood Hiv Risk
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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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Menstrual Blood Hiv Risk

Dear Sir,
I had engaged in vaginal intercourse with a CSW with a condom here in the Philippines. After around 4 minutes of thrusting I was surprised to see that there was blood on my pubic area and on the shaft. Needless to say, I assume this was menstrual blood. I had also earlier performed some cunnilingus on her earlier but did not see blood at that time. Surprised and freaking out, I tested the condom by filling it with water. As far as i could tell there were no leaks. I then finished off via handjob. Please enlighten me by answering the following questions:

1. Is HIV testing warranted?
2. Are there any other STDS to look out for? Which symptoms should I look out for? How soon do these onset?

Thank you for your response.
239123_tn?1267651214
Welcome back to the forum.

This was a no-risk situation.  As discussed with Dr. Hook 3 in your other question in January, most CSWs in most Asian countries -- including the Philippines -- do not have HIV.  But even if your partner was infected, blood (or sexual secretions) on intact skin carry no significant risk of transmission.  Despite blood on your pubic area skin, the important thing is that the condom did not break, and therefore protection from HIV was complete.  To your specific questions:

1) I do not recommend HIV testing on account of this exposure.  But of course you are free to do that if my words don't settle your fears and you need the additional reassurance of a negative test result.

2) Sex with condoms always carries at least a small risk of infection with STDs transmitted skin-to-skin, like herpes, HPV, and syphilis.  The actual risk of any of these is extremely low, and I don't recommend testing for them.  If you were to develop herpes, the symptoms (blisters/sores at the sites exposed, e.g. the base of your penis) would appear 3-5 days, rarely as long as 2 weeks; for syphilis, the initial lesion (an open sore called a chancre) appears at 2-4 weeks; for HPV, most infections cause no visible abnormality, but HPV caused genital warts, typically they would show up 3-12 months later.

3) In HIV infected women, genital fluids and blood usually contain roughly the same amount of HIV.

I hope this helps.  Best wishes--  HHH, MD
8 Comments
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Avatar_m_tn
Also, does menstrual blood contain more HIV?
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239123_tn?1267651214
See above.
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Avatar_m_tn
thanks doctor, also any risk from cunnilingus with blood? possible menstrual
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239123_tn?1267651214
Oral exposure to blood is generally pretty low risk, and cunnilingus has never been reported to result in HIV transmission.  And if you think about it, over the years there must have been been millions if not billions of cunnilingus episodes involving mentruating HIV positive women.  No risk.

That will wind up this thread.  Really, you shouldn't be at all worred about this event.
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Avatar_m_tn
last question doctor,
what if the menstrual blood ended up in my eye by inadvertently rubbing?

thanks
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239123_tn?1267651214
If you want me to tell you that this exposure was 100% safe, with absolutely zero risk of HIV, I cannot do that.  Theoretically it could happen, whether via the eye or other mechanisms.  I also cannot guarantee you won't be struck by a meteorite someday -- but I would not advise you to take any precautions against it.

That's definitely the end of this thread.  I won't have any further comments or advice.  It's time for you to move on.
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239123_tn?1267651214
"That's definitely the end of this thread.  I won't have any further comments or advice.  It's time for you to move on."
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University of Washington
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