Sperm on cut hand

Hi Dr. HHH,

Here's my situation:

I am male. I met another stranger online (male also). Basically, we started masturbating on our own. Then, I touched his pubes, nipples, body, etc. In the middle, I was so stupid and I started giving him a handjob. He also touched my testicles area slightly. In the end, while I was stroking his penis, he ejaculated. So, he spilled his semen all over my hands. (He covered his penis with a towel when he ejaculated, so I couldnt see how much semen he ejaculated. I only felt the warm fluid running down all over my hands.)

My concern is that I have a very very dry skin. Since, I washed my hands frequently, there are some openings/cracks (on my knuckle area). It didnt bleed or anything. But, I can still feel the inflamation (inflammation) feeling when I washed my hands or when I put some pressures on it. So I assumed it's like cuts on my knuckles/fingers.

I'm concern because I dont know his status. But, he said he had sex with women, men, shemales. I believe he had many wild random sex before. So, I'm really really concern that he might have HIV or STDs. And that his semen got into contact with my cuts on my knuckles/fingers and thus infected me.

1) Am I at risk? Do I need testing? We didnt have any oral/anal sex. Just pure handjob with ejaculation.

PS: I've been constantly checking on the openings/cracks/cuts on my knuckles. I could see some small blood dots on it. So, I'm really afraid that at the time when he ejaculated, the cracks are connected to my blood stream or something like that.

2) Let's say in general, if someone has cuts on his hands, and semen got in contact with the cuts. Is the person at risk?

3) If someone has precum/semen on his hands, and he touched someonelse's rectal area. Is the person at risk?

Thank you so much for your help

[H. Hunter Handsfield, M.D.]

As the first questioner, welcome to the new HIV Prevention and Safe Sex Forum.

HIV is not transmitted by skin contact, and has never been known to be transmitted in the way you describe, en with abraded or inflamed skin.  An exception would occur if there were an overt, bleeding wound, such as a brand new cut; or perhaps if the infected secretions were vigorously massaged into the inflamed skin.

1) No, there was no appreciable risk and you do not need HIV testing based on this non-exposure event.  However, sexually active people at risk for HIV (including all sexually active gay men) should be tested for HIV at least once a year.  If you have not been tested in the past year, now would be a good time.

2) See my opening comments.

3) No risk here either.  Maybe if there were an open anal lesion, such as an anal fissure or a herpes lesion; but even then the risk would be low.

I hope this helps.  Good luck--  HHH, MD

[HHH,MD]

I forgot to ask:  What were you thinking when you decided to have a sexual encounter--even a low risk one--with someone whose HIV status you didn't know?  Since your exposure wasn't high risk, it turned out all right.  But sex being what it is, it's pretty common that someone's intentions for safe sex go out the window in the heat of the moment.  A cornerstone of sexual safety for gay men is to know your own HIV status, share it, and ask your [potential] partner's HIV status before having sex.  Even when safe sex is planned, it's still a good idea.

HHH, MD

[Willl]

Enough of the virus cannot enter through small cracks from hand washing to cause infection. It is thought that any wound is closed from HIV as long as it is not bleeding (no fluid going out, none coming in). Even when bleeding it is not a good entrance for HIV. You are obviously germ conscious if you wash your hands that much. I would be careful about getting intoxicated around this individual you encountered to save yourself great distress in the future.

[Radak]

"I forgot to ask: What were you thinking when you decided to have a sexual encounter--even a low risk one--with someone whose HIV status you didn't know?"

This seems like an extreme departure from your usual non-judgmental style.

I have felt that you were a bit too liberal in disease transmission, but always applauded you for not passing judgment.

What happened?

[chdj]

Hi Doc,

Yeah I know it wasn't the best idea to hook up with a person without knowing about his status. I'm not OUT. I think that's the reason why I meet strangers for discreet one time encounter.

I only had sex once in my life (with another stranger). I totally regret it. I already got tested for that encounter like 6 months after and it turned out to be negative. Thank God !!!
So now, I never want to have oral/anal sex anymore. And, I think it's working out fine with me. I just need to work on "not meeting random people".

After reading your comment "the infected secretions were vigorously massaged into the inflamed skin", I remember when he "came" on my hands, (1) he asked me to squeeze/grip his penis tighter and I did and I also kept stroking for a while. And afterwards, (2) I didnt wash my hands directly, I only wiped it slightly on the sofa or something. Do you think these two things add any risk?

And also, do you agree on Will's comment? "any wound is closed from HIV as long as it is not bleeding (no fluid going out, none coming in). Even when bleeding it is not a good entrance for HIV."

Thank you so much for your reply.

I'll try no to hook up randomly anymore.

Peace

[Pretty Boy Floyd]

I think it's because he really wants to help, he's not coming down harder on gays out of malice or anything. But I agree with you, it seems like this website plays into a lot of the stereotypes of HIV being a gay disease.

[Pretty Boy Floyd]

Don't make yourself promises you can't keep. Go ahead and have oral and anal sex, just be safe about it.

[needitresolved]

I actually wondered if that second post of the doc's was someone else using his username...

[monkeyflower]

He's not passing judgment; he's just noting that you have to be prepared to be sexual. One of the many problems with swearing abstinence is that sex is a pretty powerful urge. If you're not accepting of your sexuality and thus not prepared for a sexual situation, you're probably going to end up in an extremely risky encounter with an extremely risky partner. Funny how all your common sense just disappears when you're horny ;-) I think all he's saying is, allow for the possibility that you might have partner sex, keep condoms with you, and ASK your partners their STD status first. That's all.

To the original poster:

You're definitely fine. No one EVER got HIV from a handjob, cuts or no.

For most people, partner sex is an important part of life; don't swear to give it up because you're afraid of whatever. First of all, sex being what it is, you're probably NOT going to be able to be abstinent, and you won't be prepared. Second, you don't need to work on not being with random people. Being able to be out, to whatever degree is possible in your situation, involves first being out to yourself. I think you might feel better if you came to terms with who you are sexually. Depending on where you live, there may be lots of in-person support groups, unless you're unfortunate enough to live in my town. In that case, you may have to travel a little, or choose an online support group instead. But either way, I think you'll feel a zillion times better once you really get okay with yourself, and you won't necessarily feel you have to resort to random, anonymous hookups to meet your needs. You might still WANT random hookups, lol, but it can then be a choice - and a reasonable, thought out choice at that. :-)

[Pretty Boy Floyd]

Being very out could go either way. I came out with flying colors and ended up becoming much more promiscuous, because the gay community's a hard place to find lovers in. Sometimes coming out and taking on the values of the gay world can desensitize you to these things and put you at greater risk. It depends on the person.

You shouldn't be too surprised if the doctor does reveal some judgmental bias toward one group or another at certain times. Aren't we all biased against something or someone? For me it's dogs -- don't try to convince me that they're man's best friend or actually very smart, I can't stand dogs, period. I guess for the doc it's gay men; he's convinced that gay men have to be more dissiplined than everyone else.

[H. Hunter Handsfield, M.D.]

Yes, the second post was me.  Anybody who has spent time on the STD forum has seen the identical advice many times.  It is not judgmental at all, at least not at a personal level or against any particular group of people; I pride myself on my neutrality in that regard.  (Not that I don't make mistakes; undoubtedly I do. And I certainly understand that not all gay men agree with me on this.)

My comments and advice on sexual safety in gay men is based on a simple fact, well proved in lots of research:  the risk of HIV acquistion and transmission among gay men is markedly lower in people who know and share their HIV status and use condoms for anal sex with non-regular partners.  And it's not as if it's all that tough (any more) to find partners or initiate relationships even when raising the HIV question.

These standards are the behavioral norm among gay men.  My colleagues and I recently published the only population-based survey of sexual behavior in men who have sex with men that has been done in the HAART era.  (Population-based means an attempt to survey a true random sample; not, for example, men seeking HIV testing or men attending STD clinics, where most such resarch is done.  We used random digit dialing.)  Among sexually active HIV negative gay men, in the past year only 10% had had unprotected anal sex with a man whose HIV status was positive or unknown.  That means that 90% routinely know and share their HIV status and/or use condoms for every episode of anal sex.  My advice is aimed at the other 10%, the ones most likely, by far, to get or transmit HIV.  Also want them to know that they are the minorty, as are those who promote barebacking or are otherwise resistant to routine safe sex.

My advice on this is absolutely consistent over the past decade:  no gay man should ever have sex with another man without knowing and mutual sharing of HIV status, even when condoms or other safe sex practices are planned.

HHH, MD

[Radak]

Over in the STD forum, someone asked what was a married man doing visiting a massage parlor and your reply was that the forum was for sharing information; not passing judgment.

How is that different from your reply #2 to chdj?

Your advice is primarily consistent across the board, but NO ONE should ever have unprotected sex with anyone without being absolutely sure of their STD status in a monogamous relationship. (Unless they have weighed the facts and decided it is worth the risk.)

But that brings us back to the married people messing around: They SHOULD be told, in this forum and elsewhere, Do NOT put your unsuspecting spouse in danger (however remote) by doing this! If the spouse knows and has given informed consent, OK, but otherwise, NO!

Your advice to heterosexuals seems to say, "Oh, don't worry about it. You have placed your spouse at practically zero risk" and I that scares me.

[monkeyflower]

First of all, they really HAVE put their spouses at almost zero risk. Have you READ those questions? Almost all the massage parlor questions involve unbelievably low risk encounters, gay or straight. Don't get me started... they're the reason for this new forum and the new rules. And as for the supposed gay bias, well, it's true that gays are statistically at much higher risk overall, so gay encounters simply warrant more caution. Most of my male partners are MSM, and I agree with Dr. Handsfield's perspective.

As for the rest, I agree that you owe it to your primary partner to protect him/her at much as possible. I think it's probably unreasonable to expect 100% monogamy, but you CAN be careful.

[H. Hunter Handsfield, M.D.]

It is well and good to give the same advice to all sexually active persons, regardless or gender or orientation, and theoretically you are right.  But in North America and most industrialized countries, the odds and stakes are very different for gay/bi men than for most straight men and women.  When appropriate, I have indeed given that advice to heterosexual questioners on the STD Forum.  But the fact remains that most sexually unsafe straight people will go a lifetime without seriously risking HIV (although they certainly will be at risk of other STDs), whereas many (most?) gay men who ignore such advice can expect to acquire HIV someday.  Exceptions are common in both cases, but the generalization holds.

HHH, MD

[HHH,MD]

I should add my thanks to Radak and the rest of you for pressing this issue.  I can't think of a better theme and commentary for the very first thread in this new forum.  Thanks!

HHH, MD