Dear doctor, I went to see a CSW yesterday. We gave mutual masturbation on each other. There was no vaginal or oral sex. There was seldom genital contact. However I inserted my fingers into her vagina for quite some time and after that I found she is in menstrual cycle and my fingers were covered in blood and secretion.
My question is:
1. Was our act safe for both of us?
2. If she is HIV positive and I happen to have a hangnail on my finger, what is the risk I catch HIV? Will presence of blood in addition to secretion increase infection risk?
3. If she is in HIV window period that will increase risk a lot, right?
4. I'm also worried about her health. The place we met doesn't seem to be too clean. I used a hygienic towelette to wipe my fingers carefully before insertion, but I'm not sure if it will be safe for her, since women in menstrual cycle are more susceptible to infection. The hygienic towelette is just a wet tissue with some weak detergent on it and I suspect if it can kill germs effectively. Do you think this act may hurt her health? Should I warn her to take any preventive actions?
Although that discussion emphasizes kissing, the comments also apply to hand-genital contact. Such exposure virtually never carries any risk for any STD. Menstruation or the presence of menstrual blood make no difference; the risk is no higher because of it. To your specific questions:
1) Yes, this was entirely safe.
2,3) The chance any particular female sex worker has HIV is very low, under 1 chance in 1,000. But even if she were infected, there was no risk from this sort of event. In theory, it would elevate the risk if she were recently infected with HIV and in the testing window. But the odds of that are less than one in many million and its not a rational consideration. And even then, this sort of contact would be risk free.
4) The hygiene where you met, or the overall health of the sex worker, make no difference in the STD/HIV risk.
You can assume the sex worker understands the risks. Unless you believe you have an STD, you need not warn her about anything. And for the reasons above, you do not need STD/HIV testing; if you have a regular sex partner, you can safely continue unprotected sex without fear of transmitting anything.
Thank you very much for your prompt and detailed answer, doctor! It is very helpful and reassuring. May I ask one more question please? Will such act (insertion of finger into vagina) during menstruation bring her other 'normal' infection (not from STD, but from common bacteria, fungus, etc.)? Should I avoid contact involving any form of penaltration during menstruation, for the sake of my partner's health? Thank you!
The genitals are generally quite clean in relation to common infections -- i.e. such contact carries no appreciable risk of staph, strep, respiratory or gastrointestinal viruses, etc. Don't worry about it, either for your health or your partner's.
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