Possible Exposure?

Dear Doctors:

I am worried about a possible exposure to HIV.  While I know that individually these risks may be ow, I'm worried about them in summation as they all happened quickly and at the same time.  I am a male and engaged in activities with another male.  First off and what worries me the most, I have some pain behind a few of my teeth and a very small cut on the tip of my tongue that is continuing to heal.  Additionally, I am uncircumsised.   First, we engaged in deep kissing.  Then we engaged in mutual masturbation and I likely had his fluids on my penis - including the interior of the foreskin (as I am not circumsised), the penis head, and the urethra.  At the time, we also gave each other hickies, and I'm not sure why but we both drew blood from giving each other hickies - another worry.  Also, his penis touched my paraneium.  Finally, and this is what worries me the most, he had his fluids on his fingers and inserted them in my mouth and nose, my ear, and what worries me the upmost - also my anu!.  I'm very worried doctor, so please address the following.  This is my only possible exposure to HIV.  
1.  Has anyone gotten HIV over an exposure of this sort?
2.  What is my HIV risk?
3.  Do I need testing?

Thank you!

[Edward W Hook, MD]

Before I address your concerns, let me congratulate you on what appears to be your efforts to practice safe sex.  Safe sexual practices will keep you from getting infected with HIV or other STDs.  What you practices was, indeed, safe sex and thus you are not at risk.  To expand on this –

While you are right that with each sexual activity the risk is additive, your risk remains so very low that we can say that it is close to zero.   You do not say whether your partner was HIV infected or not so let's start with the fact that odds are that he was not infected.  You cannot get HIV from someone who is not infected.  Is it possible for you to ask him about his status if you do not know it (most people do tell the truth when asked.)?

So, then what if he was infected?  Your risk nontheless is close to zero.  Here are some facts that underlie my assessment:

1.  Deep kissing - NO risk
2.  Mutual masturbation - No risk, even if genital secretions are spread from partner to partner (in fact this is the norm yet no one has gotten HIV from mutual masturbation) and even though you are not circumcised.
3.  Cut on your tongue.  No increase in risk from oral exposure
4. His penis on your perineum.  Still no risk - see comment above regarding mutual masturbation, this is included.
5.  His placing his fingers, potentially contaminated with his genital secretions into your rectum.  No risk.  HIV does not live well outside of the body, genital secretions dry and are wiped of of fingers very quickly, and no one has ever been infected by HIV through transfer of genital secretions to another person on someone's fingers.

Bottom line, you are not at risk.  There is really no medical reason for getting tested but some of our clients choose to get tested for their own peace of mind. If you are amongst these folks, please wait until 6-8 weeks after your exposure to get tested.  At that time, given the nature of your activities, you can take the results as final and a definitive indication that you do not have HIV.

Hope this helps.  Take care.  EWH

[howdy21]

sorry, typo from the original:

I meant to say he also inserted his finger (which had fluid on it) in my anus as well.

Apologies.  

[howdy21]

Doctors:

When you post your reply, please note that you did take into account the fact that there was likely a finger or two of my partner with fluid on them inserted my anus.  It was really this that was the basis of my question and I'm worried that my typo may be confused and I'd like to avoid any follow-up questions after you post.  

Thank you

[howdy21]

And of course the fluid that was on his finger that was inserted in my mouth, anus, ear was his fluids of course.  

[howdy21]

Thank you Doctor.

I have a question.  My eye is a little irritated the day after, so I'm worried that in the course of mutual masturbation there could have been semen contacted with my eye.

Am I still at no risk with no need for testing?

[howdy21]

It seems someone has tried to post a different question on my forum wall.

Dr-I hope you ignore his quesiton as he didnt pay to post and I did.  This is my last comment.  

My final post/follow up question is the fact that there is a possibility that I may have my partners semen come in contact with my eye during the course of mutual masturbation and I want to see if this additional information changes your opinion that there is no risk with no need for testing.  

[Edward W Hook, MD]

I did notice someone tried to "jump" our exchange.  His question was deleted.

As for the possibility that you might have gotten some of his genital secretions in your eye, either directly or through rubbing your eye when you have some of his secretions on your hand (that is the way this question is typically asked), this does not change my assessment.  Still nothing to worry aobut.  EWH

[howdy21]

Absolute final post Doctor, this just crossed my mind:

Does your assessment remain the same if semen potentially came in cotact with both eyes?  Now both of my eyes are slightly irritated.

Thank you!

[Edward W Hook, MD]

No change in opinion. EWH