MTF Transsexual - Fingering/Sex/HIV

Hi....

I was incredibly stupid and visited an
escort (Male to female transexual..post op).

Vaginal sex was safe (covered, no direct oral
contact with genitals).  Lots of lube.

However, I was concerned that my rubbing and
fingering her might lead to HIV transmission.  I
may have had tiny cuts near my fingernails (not fresh or
bleeding, but from earlier that day...very tiny).

I figured a MTF transsexual would present
a lower risk of transmission.  

I'm worried, feeling like I have the flu (~week after encounter), and
terrified I've been infected.  I intend to seek testing in ~3 weeks to
know for sure.

Am I worrying for nothing? Am I imagining the flu for something more?

Thanks!

[H. Hunter Handsfield, M.D.]

Welcome to the HIV forum.  I'll try to help.  Initial reaction, only to the title you chose for your question, before I read anything else:  HIV is not transmitted by fingering, ever. It doesn't matter who the partner is or his or her risk of having HIV, and small nicks, cuts, etc of the fingers make no apparent difference.  So unless there is a surprise as I read the question, you were not at risk and do not need testing for HIV.

Now I have read it.  Guess what?  I can't comment on whether MTF transsexuals as a group are at higher or lower risk of HIV, other things being equal.  To the extent that some such persons have had sex with gay men, the risk might be elevated.  But as I said above, for fingering (basically for any exposures except unprotected vaginal or anal sex) this makes no significant difference.

You don't say what you mean by "flu-like" symptoms.  But even among people at maximum risk for HIV -- e.g., men who have anonymous unprotected sex with other men -- the large majority of people with flu-like symptoms in fact have garden-variety viral infections, not a new HIV infection.

Feel free to get tested for HIV if this reassurance doesn't completely settle your fears and you would feel better knowing you have had a negative test.  But I suggest a single test at 6-8 weeks; a negative result at 3 weeks would be somewhat reassuring, but you'll still need a second test.  But be clear:  if you test positive, it will be necessary to address other risks for HIV that you don't describe -- because you didn't get it from the events described here.

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