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Risk for toy sharing and finger cut
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Risk for toy sharing and finger cut

Dear doc, could you give me a risk assessment please? 

A 30 yo male, visited a CSW in Hong Kong. During the time, The CSW first tied some toy to his penis without a condom, so the penis was in direct contact with the toy. The toy was not cleaned before using, and maybe was used by a previous customer or herself. He also inserted his finger into the her vigina (vagina) for several minutes. Then they had protected oral and vaginal sex, which was pretty rough. When he inserted his finger, there was a small cut on the finger tip (a small cut, about 0.5 mm in length and not deep). However after the act he felt the cut hurt a little. The cut looks red in color, and hurts when applying alcohol, so there must be tissues in direct contact with the viginal tissue and fluids in the act. The health status of the CSW is unknown. 

I know protected sex has very small risk. But I'm not sure about the toy and the cut on the finger. If someone has used the toy before, there may be some virus or bacteria left on it. Also if he fingered her for a long time, wouldn't it be like penis-vagina sex with all the frictions? With a wound on the finger, will there be a risk?

My specific questions are:
1. What is the risk from this exposure to HIV? Does he need PEP?
2. What about the risk for HSV and HPV?
3. Does sharing a toy with someone spreads STD?
4. Is there a risk of HIV transmission in masturbation when there is a wound on finger or hand?

Thank you very much for your time doctor!
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Welcome to the Forum.  I'll be happy to comment on your risk which is very, very low.  First, it is unlikely that your partner has an STD- most commercial sex workers do not.  In addition, there is no meaningful risk of acquiring an STD of any sort, including HIV through transfer on a sex toy or due to contact of genital secretions with a small cut on your fingers.

To answer your specific comments:
1. What is the risk from this exposure to HIV? Does he need PEP?
No, not of the contacts you describe carry any risk at all for HIV. There is no reason to even consider PEP.

2. What about the risk for HSV and HPV?
Again, virtually zero risk.

3. Does sharing a toy with someone spreads STD?
No, not unless tha sharing occurs absolutely immediately and even then the risk if very, very low and not something to worry about.

4. Is there a risk of HIV transmission in masturbation when there is a wound on finger or hand?
No, even with masturbation when partners get each others' genital secretions on one another and if there is a wound on the hand or finger,  there is no risk for HIV.

Bottom line, there is nothing to worry about related to the exposure you describe and no need for testing,

I hope my comment is helpful. EWH
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