Semen On The Face

I did a search of the archives and could not find an answer for this question.  If you have answered it and I missed it, I'm sorry for wasting your valuable time.  I did searches at the CDC and The Body and couldn't find a question that matched my situation.  (I did ask some members of a local TG support group I belong to and they all said I had nothing to worry about.)

I'm a man beginning my transition into a woman.  Until yesterday I had not had sexual contact of any kind with a man but the more I progress in my transformation the more attraction I feel toward men.  (I guess that's inevitable.)

I met a bisexual man who said he spends most of his time with other men.  We talked about each other's status regarding STDs and he claimed to be HIV negative.  (I am as well.)  

He did not have any condoms so I wouldn't allow him to penetrate me at all.  I gave him a hand job and when he came it shot all over my face.  I admit that I didn't pull away from him although I didn't enjoy it that much.  I now know why so many women over my life wouldn't let me do that to them!

None of the semen went into my nose and although I did have some on my lips I didn't lick it off.  I may have had some of the semen go into my mouth but I only vaguely recall a salty taste for a moment.  (I assume that means some hit my tongue.)

I had shaved only an hour before I met with the gentleman with an electric razor.  It's possible my skin was irritated.  I have a small irritated section near the corner of my mouth this morning that's consistent with when I shave too rapidly.

I was wondering what my risk was for HIV from this encounter.  I'm guessing it's rather low but I'm no expert.  This is the only encounter I've had with a man so it would be the only "risk factor."  

Again, if you've already answered this, I am sorry.

[H. Hunter Handsfield, M.D.]

The intellectual part of your analysis (low risk) is exactly right, even though part of you (the emotional side) is worried.  There are no data on HIV/STD transmission risks through exposure of the face, nostrils, eyes, etc to semen.  However, the risk must be extremely low--for practical purposes, zero.  Even ejaculation in the mouth and swallowing semen has an extremely low risk; the exposure you describe has to be still lower.  This applies regardless of recent shaving, the irritation at the corner of your mouth, etc.

Bottom line:  Relax and don't worry about it.  You don't need HIV/STD testing.

Good luck--  HHH, MD

[Willl]

It sounds like you would maintain the "don't need HIV testing" part for this person even if the exposure were from a known HIV infected source. Is that accurate?

[H. Hunter Handsfield, M.D.]

Willl is sort of right.  The threshold for testing would obviously be lower if the partner were known positive.  But this isn't a black/white, one-size-fits-all situation.

As I have said many times, in general I don't recommend testing for HIV after particular sexual exposures, except in obvious high-risk settings (e.g., unprotected vagainal or anal sex with a known-positive partner).  The better approach is periodic routine testing, e.g. every 3-12 months (depending on risk level).  Most people at risk do this--unlike most who post questions on this forum, who on average have inflated perceptions of their risks.

Here is a good rule of thumb (I just thought of it; don't assume it is a standard recommendation by CDC or any body):  If the risk is high enough to consider PEP, testing should be done.  Otherwise periodic routine testing makes more sense.

HHH, MD