Question regarding risk potential, anal insertive fingering

I asked this question in the non-expert forum but felt more comfortable receiving advice from an actual doctor.

I had a few minutes of condom protected anal sex with a white 25 year old male, me as the insertive partner, as well as mutual oral sex and mutual masturbation.... all of which I understand to be virtually no risk of HIV.

However, I fingered my partner anally for quite some time. I noticed there are a couple of small shallow cuts/breaks in the skin around my cuticles.  Does this pose any risk of HIV?

The partner is a friend not a stranger by any means, but I am unaware of his status. Should I be tested?

Thank you

[H. Hunter Handsfield, M.D.]

Welcome back to the forum.

This seems to be a different exposure than the one you described in another thread on this forum 4 weeks ago.  Even if not, Dr. Hook's reply pretty much covers this situation as well.  As all men who have sex with men should know, safe sex means that you avoid a bare penis (no condom) inside a rectum, vagina or mouth (although unprotected oral sex is quite safe).  Fingering never has been known to transmit HIV.  Nobody can say the risk is zero, since it is impossible to prove a negative -- but with no known cases, it is fari to say the chance of transmission is very close to zero.  And as you also learned in the earlier discussion, and on the community forum, nicks and cuts on the fingers probably make no measurable differnce.

However, I still have a fear that HIV is in your future.  You will always be at significant risk unless and until you modify another critical aspect of your sexual lifestyle.  No man should EVER have sex with another man, even when entirely safe sex is planned, without knowing his HIV status.  Sex should be avoided (or at least there should be no anal sex, even with condoms) with positives or with men who haven't recently tested negative or who seem evasive about it.  Condoms do fail from time to time, and intentions for safe sex sometimes fall by the wayside in the heat of the moment -- e.g. if alcohol is involved and condoms aren't handy.  Indeed, alcohol-induced lapse in judgment and memory was part of your story a month ago.

So please, please, please start discussing HIV status with your partners before sex.  I call it "Do ask, do tell".  In the long run, it's just as important as consistent condom use for anal sex.  Following it, plus condoms for anal sex (even with presumed negative partners) will keep you HIV free forever.  Fail to follow it, and there's a good chance you'll be infected someday.

But going back to this particular exposure, you should have no worries about HIV.  Still, you should plan on a routine HIV test from time to time, like every 6-12 months -- as should all sexually active men having sex with men.

Finally, since this is your second question in a month, please note that MedHelp permits a maximum of 2 questions every 6 months on the professionally moderated forums.  Don't risk losing your posting fee by asking another before next May or June.

Best wishes -- HHH, MD

[questioningWW]

Thank you for your response doctor.  Also, thank you for your advice.  I will be sure to follow it, as it sounds conducive to a far better life than worrying so much everytime I have a sexual encounter.

I am thankful that I need not worry about HIV for this encounter, but in any event I have a regular check-up in January and plan to get a full STD screening then anyway.

And no worries on the # of questions per 6 months.  I intend to never have to post a question on this forum again.

[questioningWW]

One  last related question......So you would definitely say there is no reason for a DNA/PCR test in the next two weeks?

[H. Hunter Handsfield, M.D.]

No, I would not recommend such testing.

[questioningWW]

Would a fever, bad cough, and diarrhea (now a week after the above described exposure) be any cause for concern?

[H. Hunter Handsfield, M.D.]

Acute HIV doesn't cause cough and usually not diarrhea.  Sounds like a garden variety viral infection.  If the symptoms are severe or don't clear up in a few days, see a doctor or clinic.

[questioningWW]

I know you said it wasn't recommended, but due to anxiety I went ahead and got the RNA PCR Test, now a little over 4 weeks after the exposure.  It was negative.  Is this conclusive? Thank you.

[H. Hunter Handsfield, M.D.]

Yes.

No further questions or comments on this thread.