Rimming and HIV risk

[gala1017]

Hello,

A little background: I am very adamant about safe sex and staying HIV negative... to the point where one may counter it as obsessive compulsive.  I met this guy on a dating site about 48 hours ago.  We met, we talked and I asked him when his last HIV test was. He said three months ago, negative.  We started kissing for a while, then went on to a little more.  I sucked him off for about a minute and he sucked me off after for about 5 minutes.  After that, I rimmed him (I licked/sucked/ kissed his anus) for a while, followed by fingering him. I stuck my index finger all the way into his anus a few times.  

After I fingered him, I immediately went to the bathroom and washed my finger with warm water and soap. There were no visible cuts on my finger. I put on sanitizer on my finger as well to "feel" the burn when you put sanitizer on unbroken skin, but felt no "burn".  

To no avail, I get paranoid and go to a clinic in Los Angeles to seek advice from a PEP nurse.  She told me no need to warrant PEP since I had no risk to HIV...

I asked the guy if he wanted to get tested together and he said: "I'm HIV negative... but I feel that's a personal thing and would rather do it alone..." I understand what he means, but why would he want to get it alone if he is "for sure" HIV negative?

But now I have a sore throat and am very concerned!

My questions are delineated below per the experience listed above:

1) Fingering the anus and risk for HIV acquisition?  How likely is this as a mode of transmission? Have there been reported cases?

2) Me performing a rim job on him and my likelihood of contracting the virus? I did have a cut on my lip, but I think it may have scabbed.  

3) Oral sex, I know to be low to no risk for HIV, so I'm actually not worried about that incident.

4) Would you recommend PEP despite what I heard from the PEP nurse?

and lastly

5) Is my current sore throat an HIV symptom? Even though symptoms should never be used for HIV diagnosis.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  I'll try to help.

I have an initial reaction to the title you chose for this question, before reading anything else.  While it is not possible to say rimming carries no risk for HIV transmission, it has never been known to happen; and based on what we know about the biology and mechanisms of HIV transmission, little or no risk would be expected.

Now I have read the details.  In the context of sex with other men, you certainly are pursuing a very safe sexual lifestyle.  If nothing changes in the care with which you select partners, discuss HIV status ahead of time, and do not participate in penile-anal sex (or consistently use condoms if and when that happens), you can expect to never be at significant risk of HIV.  Fingering, kissing, rimming, etc are not known to have ever transmitted the virus, and I agree with the advice you had about PEP; I also would not have recommended it.  And of course sore throat is among the most common of all symptoms in all people; the chance you caught some garden variety cold virus are infinitely higher than the likelihood of HIV as a cause.

As for your partner wanting to be HIV tested on his own, that doesn't suggest anything at all to me.  My bet is that most people would feel the same and I doubt in signifies he is more likely to have a positive result.

Those comments directly or directly answer your questions, but to be explicit:

1) Fingering carries no known risk of HIV.
2) Ditto.
3) We agree about oral sex.
4) I agree with the nurse.
5) Almost certainly you have a cold, nothing more.

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

[H. Hunter Handsfield, M.D.]

No, for sure no need to worry.

Thanks for the thanks.  Glad to have helped.

[gala1017]

Hello Doctor,

I really do appreciate the empowering information you have given me. It's kind of strange how scared I am about HIV... since HIV is innocuous to me, it's extremely hard to enjoy sex anymore without being overly paranoid... over paranoid with circumstances which aren't relative to my feelings. I over-exxaggerate and this is a problem I do recognize.  I need to probably seek a therapist's help in trying to better control how I express my anxiety.  

But all in all, I do thank you for your time in your thorough explanation. It's quite great that you and Dr Hunt do this for our community. It truly means a lot that you took time off your busy schedule to help answer our incessant questions! :)

So to be clear and reassured once more: No need to worry for HIV from my experiences listed above, correct?

Thanks! Oh, and Happy New Year!