transexual exposure

Hi. Thanks in advance for putting y mind at ease.

Last Friday, I met a transexual I had been chatting too online. I repetitively asked about her hiv status before and after our meeting. She was adamant that she is negative.  She is a pre-operative male to female transexual (still has a penis).

We put condoms on before we started and performed brief oral on each other (no ejaculation) and played with each other a bit - still with condoms on. We kissed for a bit (with tongues) and she put her finger up in my anus for a few minutes. I am not used to having things in there and it was a bit uncomfortable for an hour after but there was no blood and it felt fine again later. There were no obvious cuts on her fingers.

We chatted a bit after and she says she always plays with straight guys - she said that gay guys don't get on with her. She says she always uses condoms and that she never does penetration in either direction. I don't know how much weight to put on what she says but she came accross as genuine.

I know our activities would usually be described as low risk but I am aware that transexuals have a higher incidence of hiv (not sure about NZ transexuals).

I just want to know what you think my risks are for the following with the transexual:

- oral sex with condoms on

- tongue kissing

- her finger up my anus

Thanks again.

[H. Hunter Handsfield, M.D.]

You describe a partner who almost certainly does not have HIV.  People rarely lie when asked directly.  And as a male to female transsexual, it may be that she hasn't been at particularly high risk.  Many such persons' main sex partners are straight men, not typical gay men with lots of same-sex partners.  That said, no data exist on the frequency of HIV acquisition from transsexual partners, so all I can do is give the standard, common-sense replies:

Oral sex is little or no risk even without condoms.  Definitely zero risk with condom.  HIV is not transmitted by kissing.  (Saliva inactivates the virus, which is one reason that oral sex is low risk, not to mention kissing.)  Fingering has never been known to transmit HIV.

As a sexually active person outside a mutually monogamous relationship, you should have routine STD/HIV testing from time to time, like once a year or so.  On that basis, it would be reasonable for you to be tested for HIV if that hasn't been done recently.  But you were at zero risk for HIV or any other STD from this particular exposure.

Best wishes--  HHH, MD

[magnum22]

Thanks for your reply DOc. You have been very helpfull. I just want to clear up a couple of other exposures I have had since June last year (when i last had a negative hiv test.

1) June 09 unprotected oral, protected vaginal with white woman 40 years old

2) July 09 unprotected oral 4 times and protected vaginal 2 times with white female 35 year old

3) September 09 unprotected oral, protected vaginal with 36 year old white female.

4) January 11th unprotected oral with 34 year old white woman, protected vaginal
    January 12th protected vaginal, unprotected anal with same woman
   January 14th unprotected vaginal and oral
    January17th unprotected oral, vaginal
   January 25th unprotected vaginal.

I repetitively asked this women if she was clean and safe and she assures me she is. I have been tested for gonnorea, chlamidya and NSU a couple of weeks ago and they were all negative. Only thought of hiv on monday when i had a couple of glands up.

I have currently just finished a weeks course of itraconazole for pitiriasis versicolor which i got whilst on holiday in Turkey in August last year. This is unilkely to be a hiv symptom though because it was after a negative hiv test two months before hand.

I think that females in NZ are much less than 1 in 1000 to have hiv as i think that we have a lower prevalence than the US but we'll go with 1 in a 1000 to be conservativ as she probvably sleeps with a few guys.

What is your analysis of my risk from the above exposures and what do you make of my slightly swollen glands and my versicolor of the pale variety that i picked up whilst travelling in Turkey in August 09?

[H. Hunter Handsfield, M.D.]

Now you are describing unprotected anal and vaginal sex.  But I gather that this partner (or  partners plural?) are not transgenders.  On the other hand, you have had negative HIV/STD tests since then, so I don't understand why you are concerned.  Your symptoms etc don't suggest HIV or any STD.  So this information does not change my opinion or advice.

[magnum22]

The unprotected anal and vaginal exposures were with a genuine woman but were in mid January this year. My negative hiv test was june last year. Therefore my test doesn't rule out exposure. The transexual exposure was my initial concern but then i started thinking about the others as well.

What is my risk?

[magnum22]

By the way the unprotected exposures were all with the same woman - who says she is clean and i have tested for chlamidya, gonnorea and NSU since. All neg.

[H. Hunter Handsfield, M.D.]

Your risk for HIV is nil.  From a risk assessment perspective you don't need testing.  But it sounds like my reassurance isn't calming your fears.  If you will feel better having a negative HIV test, feel free to have it done.

Accept the reassurance and move on.  That's the end of this thread.  No more comments will be accepted.