Question about HIV Tansmission

[answerplz]

Hello Doctors

Back in late December around Christmas, I have a friend of mine (male), he met a girl off the internet, then he went to her house, they had sex and he found out she is transgender (Shemale) from (Middle East I think he said). He asked her if she is clean (HIV free) and she assured that to him, and she told him that she used to have sex only with one (boyfriend partner) before they separated. Anyway, he told me that she gave him a Hand-job and she rubbed her penis on his Butt while giving him a back massage (he is not sure if the shemale was wearing a condom because he was laying on his face), but according to what she told him she was wearing a condom and she put some hand cream or Vaseline on it, and then later she took off the condom and ejaculated on his back little bit and on his butt and she wiped them, He told me that he is 100% sure that he wouldn't and didn't let her to penetrate her penis in his anus it was only rubbing otherwise it would be obvious to him he would feel it (so no Penetration). He went to the restroom and cleaned off the sticky oily feeling off his butt cheeks that he felt. Then he went home and he washed.

But he keeps thinking what if the she wasn't wearing a condom, and still there no penetration, just rubbing and ejaculated around his anus so if we go with what he is thinking:
1) is he still at risk for HIV?
2) The mucous membrane which is the topic that scares him. if there were semen could he has pushed some in when he cleaned it off with the toilet paper? I have read that HIV virus doesn't live outside longer than few seconds is that right (in case if he pushed some in after)? and the mucous membranes are located within the inside walls of the anal canal with the skin working as an active barrier. is that right? so with no penetration (as the penis didn't get inside the anal canal didn't even get close to the anus hole), any explanation please.?
3) Does he still have to test for HIV?

Thank you.

[H. Hunter Handsfield, M.D.]

Thanks for coming online yourself, and for clarifying things.

The most important information you provide is "... that no penetration happened".  All by itself, that assures there was no risk of HIV transmission.  As for your symptoms, they are not typical for any STD -- and since an STD clinic agrees, you can be certain it's not an STD problem.  I'm sure this has nothing to do with the sexual exposure you described -- unless part of the symptoms are due to anxiety about it.

So still no worries, no need for testing, and if you currently have a regular sex partner, it is safe to continue your usual sexual practices without putting that person at risk.

Best wishes--  HHH, MD

[answerplz]

Thank u doctor im sorry if i let my friend talk on my behalf because i was really nervous... Now i got the username and password from my friend and now im the guy who had this exposure with same girl actually twice... The first time i had that body rubbing i was concerned about if there was no condom ( there was but took off the condom and ejaculate on outside my body) the second time there were condom cuz i seen it and ejaculate inside the condom which is not factor risk of HIV. Actually im not sexually active outside mutually monogamous relationships this was my first time and last time for sure. ( i can assure u that no penetration happened in both time)....

Only one more question that i only experience some muscle aches around my neck, shoulder and arms) pain comes and goes including twitching, pinching) also aches in my inner thigh and knee and also some redness like inside my skin (comes and goes too) don't look like rash as they barely itches. Could those be related to STDs cuz i went to a clinic and they told me those are not related to STD.??????

Thanks.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  However, we encourage people with questions to ask themselves.  My replies are brief -- if your friend wants more information, provide him with your username and password and let him do it.  (Or maybe it's really you that you're concerned about....)

HIV is rarely if ever transmitted sexually unless a bare penis (no condom) enters another person's vagina or rectum.  Even oral sex carries little or no risk.  Kissing, hand-genital contact, body rubbing, and exposure to sexual fluids all are risk free.  Even if fluids come into superficial contact with mucus membranes, HIV transmission is rare, because it takes lots of virus to result in transmission.  Therefore, if this is your friend's only potential exposure, he doesn't need testing for HIV.  OTOH, all people who are sexually active outside mutually monogamous relationships should be routinely tested for HIV and other common STDs (gonorrhea, chlamydia, syphilis) from time to time, like once a year. If he has been tested recently, perhaps this would be a good time, when it's on his mind. But not because of this particular exposure.

Best wishes--  HHH, MD