Possible Exposures

[James99]

Dear Doctor,

I'm a gay male who has obsessive compulsive disorder and I might be over analyzing some of my possible exposures. I was wondering if you could tell me the odds of me contracting something in the following scenarios that I went through.

1) I had masturbated using soap as lubricant and it kind of eroded my skin away and it became kind of stingy. I was engaging in mutual masturbation with my friend and I accidentally used his towel to clean myself off. Would having his semen touch that stingy layer of skin be a high risk exposure?

2.) I had these blisters on my hand that i popped earlier in the day and after masturbating with another partner, I touched his semen covered towel because I thought the keys to my room might have been under them. It touched the exposed skin that was still somewhat oozing with that brownish yellow fluid.

3.) The same partner on another occasion had touched my penis while he was masturbating, and I ejaculated inside of my boxer shorts by rubbing on the fabric and caused a rug burn (it scabbed over later in a manner where it looked like there must have been some bleeding or something). If there had been pre-ejaculate on my penis while that happened, would that have been a high risk?

4.) Another time after mutually masturbating, I accidentally whiped my penis off with my partner's cloth about 20-30 seconds after he had cleaned himself off. I kind of felt myself ejaculate while I was cleaning myself off for one reason or another and I think that some of his semen might have moved into my uretheral openening while this happened.

5.) 3 minutes or so after performing oral sex on my partner, I flossed my teeth and caused some bleeding. If he pre-ejaculated in my mouth, and I caused those cuts to happen, would that have been a risk?

6.) I also was hit with some semen in the eye.

Thanks for your help.
- James

[H. Hunter Handsfield, M.D.]

I'll go directly to your questions.

1) No semen contact with skin is likely to result in HIV transmission, regardless of irritation from soap, masturbation, or anything else.

2) Hand contact with sexual secretions also carries no measurable risk, regardless of the skin condition you describe.

3 and 4) No risk here either.

5) Can I guarantee 100% no risk?  No.  Has anybody ever been known to catch HIV by such exposure?  Also no.

6) Low risk but not zero.

You are over-analyzing things, undoubtedly a symptom of your OCD.  Get this straight:  ask about your partners' HIV status and share your own with any and all partners; avoid sex with those who are positive or whose answers are evasive (even when safe sex is planned); and use condoms for anal sex.  That's it for safe sex.  Do those things and you probably will never catch HIV.

If you are nervous about the sorts of exposures you describe, it seems to me you have 2 choices:  a) Don't have them and/or b) have an HIV test once in a while so that the negative results will help calm your fears.

Good luck--  HHH, MD

[James99]

SO semen getting into the urethera is no risk? How come blood getting in there during anal sex causes it?

[James99]

Oh yes, I had one more question about #4. Does HIV die quickly when it's in the mouth? Is that considered to be an exposure to an open air environment in which it would die in 30-60 seconds?

Thanks.

[James99]

Oh my last follow up question is in regards to #1, so even if the skin is eroded away down to the layer where it is stingy, there's no risk of blood exposure?

Thanks again and sorry if I'm over analyzing this. It can be kind of hard with my anxiety disorder.

Take care.

[H. Hunter Handsfield, M.D.]

From your description, I see no realistic chance that your partner's semen actually contacted your urethra.  If it did, it was in such miniscule amount it would not have a measurable risk of HIV transmission.  It doesn't matter whether or not HIV "dies quickly...in the mouth.  Oral exposure carries little risk; the detailed reasons don't matter.

You seem to assume that exposure to "just one virus" is enough for HIV transmission.  It takes large doses of virus that have to directly access susceptible cells.  If the highest sexual risk, anal sex with intra-rectal ejaculation, carries a transmission risk no more than 1 in 100 episodes, what can it possibly be from the sorts of exposures you describe?

Re-read my initial reply, including the comment about over-analysis.  No more comments, please; I won't have anything mroe to say on this thread.  Time to move on.  And continue to work with your mental health provider about that OCD.

[James99]

Okay, thanks for your responses doctor.