Semen to cut/oral sex risk

I gave my ex oral sex 2 days ago. He told me he was safe but I know he has dated several people since we broke up and he doesn't always use condoms. When he started to ejaculate in my mouth, I did spit the semen and I didn't continue with my mouth. Instead, I finished with my right hand. After that I went to the sink to spit the remaining *** that was in my mouth and I rinsed several times with abundant water. I did not swallow it. Later that night I noticed 3 small cuts in my right hand, on the thumb. The cuts, although very small, showed a bit of blood and now they are almost heald, although that night they were still open. I don't know if they are paper cuts, or nail cuts, but I do know that there was semen on them, since it was all over my right hand when my ex ejaculated. I did wash my hands when I rinsed my mouth. He got very irritated when I asked him if he has been exposed in anyway. My question is: should I get tested, do you think semen-to-cut contact  or some semen in my mouth is a significant risk? Thank you. I'm very concerned.

[H. Hunter Handsfield, M.D.]

I see no signficant HIV risk here.  First, it is unlikely your ex-partner has HIV.  Heterosexually acquired HIV is less common (in the US and other industrialized countries) than you may realize.  If he is an injection drug user or has sex with men, that's a different issue, of course.  But just having multiple female sex partners, even without condoms, doesn't make someone high risk for having HIV.  His certainty he doesn't have HIV also is reassuring.  He would tell you if he had it or believed he was at signficant risk.

Second, oral sex is safe sex, even with ejaculation in the mouth.  Not completely free of risk, of course, but much less risky than vaginal or anal sex.  The estimate is one transmission for every 10,000 exposures -- if the penile partner has HIV.

Third, hand contact with semen, even with cuts on the hand, has never been known to transmit HIV.

All in all, there is no reason for you to be "very concerned".  From a risk assessment perspective, you don't need HIV teating.  Of course all non-monogamous sexually active people should be tested from time to time, like once a year -- so assuming you haven't been tested for HIV recently, this would be a good time.  But not because of this particular event.

So wait until 6-8 weeks after the exposure and have a test; you'll sleep better knowing it is negative.  But in the meantime, try not to worry about it.  There is no significant risk  here.

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

[Mari99]

Thank you doctor. That did make me feel much better. I'll do a PCR test in a week just to rule out any remaining concern and anxiety. I guess my only other question would be: Is a negative PCR after a weeek a strong indicator?
Thanks

[H. Hunter Handsfield, M.D.]

Yes, a negative PCR at a week would be a good indicator you didn't catch HIV. Nevertheless, I recommend you don't do it.  The HIV PCR tests carries a slight chance of false positive results; if your result is positive it is more likely to be false and not true, i.e. even if positive it won't mean you have HIV -- and think what you'll go through for the next few days while additional testing is done to confirm that you aren't actually infected.

That you ask the question suggests you aren't seeing a provider about it, but making your own choices about lab-based or online testing.  I also strongly recommend against that approach.  Please see a health care provider who understands HIV and its diagnosis, then follow that provider's advice about testing.