Male to Female Fingering, blood, HIV

[mcaskingaquestion]

Hello,
(Sorry, I accidentally posted same question in the free forum, please don't count this against me)
I have an HIV question but I need to provide you with a little background information first). Last year, in October of 2010, I had a LEEP done for cervical dysplasia. My two PAP smears since have both come back NORMAL (the last one was on August 18 of this year, 2011). Five months after the LEEP, I had bleeding after sex. When I went to see my doctor for the follow-up PAP she said that some of the blood vessels had not quite healed from the LEEP procedure and she had to re-apply some silver nitrate to my cervix. The bleeding stopped after that. Then, like I said, I went back just two months ago, this past August, had the repeat PAP, which again came back NORMAL, but I had bleeding after the pap smear. I had not had sex since then.

Last night, I was with a friend who has longer fingernails. He fingered me with several fingers for quite a long time and hard and vigorously. When I got home, I had bright red bleeding. Now, its the next morning and the bleeding is tapering off, but still there is a little bit of blood. I have a couple of questions--

1) Could he have given me HIV from fingering me and causing me to bleed? I also gave him oral sex and a hand job.

2) Do you know if long nails can cause a cervix to start bleeding? I am scared because of my history with dysplasia, but again, just had a normal pap in August.

3) I have had only two of the three Gardisil shots. Does having only two of the three still offer protection against HPV?

4) Since I just had a NORMAL PAP just two months ago, could this mean the abnormal cells returned in the last two months and are causing me to bleed?

I am so scared, and since this whole LEEP/dysplasia thing, I have developed a high level of anxiety. Now I am terrified I got HIV from him fingering me last night and causing me to bleed. Have you ever heard of someone with long nails causing bleeding?

[H. Hunter Handsfield, M.D.]

The additional information doesn't change my opinion or advice.  Don't over-think it:  you are not at risk for HIV from the exposure described, even if your partner has HIV -- and almost certainly he doesn't have it anyway.  (Have you asked him?)  You need do only one thing to avoid sexually acquired HIV:  choose your partners with common sense, and if there is any doubt about a partner's risk or past sexual history, use condoms for vaginal or anal sex.  That's all.  You're not going to catch HIV from any other sexual practices.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

There's nothing wrong with positng both her and on the community forum.  You had accurate replies in both your threads on the other forum.  HIV is harder to transmit sexually than you seem to think.  Here is a thread that explains the scientific basis for that.  (Read it all; some of the key information is in the follow-up comments.)

http://www.medhelp.org/posts/show/1119533

To start, it is statistically very unlikely any of your sex partners have had HIV, assuming they aren't gay, injection drug users, or immigrants from HIV-endemic areas like tropical Africa.  To your specific questions:

1) No HIV infections have ever been known to be transmitted by fingering or other hand-genital contact.  Cuts or minor injuries of the hands or genitals might theoretically increase the risk, but still no cases are known -- so you can safely assume no risk, even if one of your partners actually ahs HIV.

2) I suppose this is possible if there is deep penetration.

3) There probably is substantial protection starting about a month after the second dose of vaccine.  Of course you should still have the third dose as scheduled.

4) I can't speculate on the cause of bleeding.  You should see the doctor or clinic that managed your abnormal pap smear, LEEP, etc.

Having had cervical HPV, dysplasia, and LEEP have absolutely no bearing on your risk for HIV.  You really should not be at all worried.  Of course all sexually active persons outside mutually monogamous relationships should have HIV testing from time to time, like every 1-3 years.  On that basis, consider HIV testing if it hasn't been done recently.  But not because of your recent fingering episodes or your HPV/dysplasia history.  Based on your sexual lifestyle, you can expect a negative result for sure.

I hope this helps.  Best wishes--  HHH, MD

[H. Hunter Handsfield, M.D.]

You caught a cold; your symptoms have nothing at all to do with the sexual exposure you are concerned about.  And based on your doctor's diagnosis, you definitely were not at risk for HIV from the exposure described.

The antibody tests, both rapid and lab-based, are probably around 60-70% reliable at 3 weeks.

Do try to move on.  Even if your HIV test were to turn up positive (it will not!), I would conclude you acquired HIV at some time and place other than the sexual event that caused your vaginal bleeding.

[mcaskingaquestion]

Hello Dr.,

Sorry to bother you again, but I was totally relaxed after your answers from a couple weeks ago. However, this past weekend I developed a sore throat. It would be two weeks post exposure. The only symptom was a sore throat--I woke up to it on Saturday night, but it went away Sunday. Then again last night I had a sore throat, but feel fine today. I have no fever (well, actually I had 98.8) or muscle aches or anything like that. Just a sore throat and some sneezing.

Right after the incident a couple weeks ago, I went to the doctor to find out what the bleeding was from, and it was not from my cervix, but instead, an abrasion in my vagina--the doctor said his long fingernails caused the abrasion and also caused the bleeding.

I know you said earlier there is no risk here--but I just can't get past the fact that I had active bleeding while he was fingering me and now a sore throat two weeks later.

If I test at 3 weeks--just the standard rapid antibody test, how accurate will that be?

Thanks again and sorry to bother you again.

[mcaskingaquestion]

Ok, thank you very much for your help and responses. It is much appreciated. Have a nice weekend, doctor.

[mcaskingaquestion]

Thank you so much for your reply. I made an appointment with an OB/GYN for this coming Monday. However, my regular doctor is out of town all next week, so I made an appointment with a different doc because I am so scared.

I don't think he had any cuts on his hands when he was fingering me--it  was me that was bleeding, and I believe it was from my cervix. That is why I am scared about a potential HIV transmission. Since I had open blood vessels in my cervix and he was vigorously fingering me, wouldn't it be possible that he could give it to me that way?

I was just tested about a month ago for HIV and it was negative, along with all other STDs.

Thank you so much for taking your time out on your Saturday to help me.