Overly Worried?

[spd69]

Dear Dr.

Here is my story:

I am in a relationship with a male partner of 5 years.  Together we have unprotected anal sex.  We have a agreement that we can "mess around" with others as long as it is safe (mutual masturbation, touching).  

Incident #1: Aug 15, 2009, i messed around with a guy that involved body rubbing and mutual masturbation.  while rubbing he did get some pre-*** on my lower abdomen (possibly on my penis/urethra).  

Incident #2:  August 30, 2009  I messed around with a guy that involved touching.  He masturbated me to ejaculation, but i only touched his penis (no pre-*** noticeable, no ejaculation by him).  The issue with this incident was that about one hour before I had cut my right hand.  Not a deep cut, but it had not healed.  This hand was the one that touched his penis, but again there was no pre-***.

Incidnet #3: Sept 12 i had an interaction with a male that involved mutual masturbation to ejaculation.  It is possible that some of his pre-*** got on to the and i used to masterbate my self with.  No cuts or other issues.

I had a rapid HIV test today (Sept 16) (neg result). My parnter had an HIV test in May 09 (neg).

I felt that all these things were relatively safe untill the day after the last incident (mid Sept), I had three consecutive nights of sweating.  I woke each night to a damp body, pillow and sheets (not drenching).  I have had no fever before bed or at any other time.  


Questions:
1. Should any of the above incidents cause concern?
2. I get mixed info. about safe sex from the internet:  If my parnter and i keep an agreement where we do not have unprotected anal sex or perform oral sex on others but continue to have unprotected anal and oral with each other should we be in good shape?
3. is mutual masturbation safe, cuts and all?
4. any thoughts on how to best not obsess about HIV and "all that could happen"



Thanks again for your help.


stephen

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.

Congratulations for your understanding of safe sex and apparent successful adherance to it.  Within the context of your relationship and your agreement with your main partner, you are being very responsible.  Safe sex for men having sex with men isn't very complicated.  It means no unprotected anal sex (and preferably no anal sex at all outside committed relationships with partners known not to have HIV); and for super safety, no unprotected oral sex.  All the rest pretty much is irrelevant:  hand-genital contact, kissing, frottage (body rubbing), and getting sexual secretions on the skin are not known to transmit HIV.

The only aspect of safe sex that you don't mention is that you say nothing about your casual partners' HIV status.  Even when you plan only the safe practices described here, remember that even the best of intentions sometimes get out of hand and before you know it, one of you has penetrated the other.  So you should always ask about HIV status and either avoid contact entirely, or be especially certain about safety, with those who are positive, don't know, or seem evasive about it.

I think that answers most of the specific questions. but just in case not:

1) No concern from the events described.

2) If you and your partner both adhere to the agreement, and especially if you both add my advice about partner's HIV status ("do ask, do tell"), then there is no risk to any sort of sexual practice between the two of you.

3) Mutual masturbation is safe.  Obviously if there is an overt, fresh, deep, bleeding wound, lay off.  But don't worry about everyday minor nicks and cuts.

4) This is a psychological question and not one I can help with.  I hope a clear understanding of the facts about HIV transmission risk helps you, but that's as far as this forum goes.

However, like all men having sex with men, you need to have a realistic understanding of the world. Your chance of having HIV someday probably is a lot higher than that of the average sexually active straight man or woman. There are a lot of "ifs" in the situations you describe, and when it comes to sex and relationships, many peoples' best of intentions don't always hold up.  What if your relationship someday starts to sour?  Are you confident that in such a situation both you and your partner would still adhere to the "rules" about other partners?  While I don't doubt either your or your partner's intentions, do keep a realistic perspective about the way the world works and how people behave.

I hope this helps.  Best wishes--  HHH, MD

[spd69]

Thanks for the response.

I did talk to 2 of the 3 guys. Both stated that they were HIV neg (at least at their last testing).  I could do better job of asking up front.  I think  I worry that I am offending them by asking (my issue, not theirs).

My partner and I are goign to sit down this weekend and talk more about this (our agreement, my/his comfort).

I assume when you note the "if's" you are referring to our agreement.  If so, that is a good point. you can never controll what another does, only yourself.  

thanks again.

stephen

Thanks again