Possible Tramsmission

[Steve458632]

Dear Doctor H:

I can't emphasize how honored I am for you to answer my question.

I am a married male.  Prior to marriage (four years ago), I engaged in a lot of mutual masturbation and oral sex (gave and received) with men.  The oral was a one time only occurrence and only lasted a minute with no ejaculation.  The rest of my activities with men were ONLY mutual masturbation sessions.

Being married for the past four years, my wife and I have had unprotected sex throughout our relationship.  We also just had our first child together. As part of pregnancy tests she had two HIV tests and both came back negative.  

My questions are the following:

1. Considering I engaged in mutual masturbation with men (don't know their status), was this a safe activity?  What if I was in contact with semen? I can't recall

[Steve458632]

Doctor --

Your comment "if you were to turn up positive someday, I would be 100% convinced there are other risks that you did not divulge (or perhaps did not know about)" really upset me.  

What do you mean by "perhaps did not know about?"

If I am not a drug user and use condoms for intercourse and anal (if I were to engage in that, but I am not), what other things should I know?  

[Steve458632]

Thanks Doc!  

I wish it was three to four times a week though.  More like once a month... at best!

Either way, I hear you.  

THANK YOU!

[strangeworld]

Relax ! Doctor did mean to scare you or anything. Its just that he is trying to tell you that you did not had any risk wit the exposure which you have mentioned. Simple.

Do not fear anything you have nothing to worry about.

[H. Hunter Handsfield, M.D.]

Semen under nails, cuts on hands, etc make some theoretical difference, I suppose, but no realistic increase in an exposure risk that is zero for all practical purposes.

Maybe "strong" was too strong a word; to split hairs about, how do you like "pretty good reassurance"? The risk of heterosexual transmission averages one per 1000 episodes of vaginal sex.  So an HIV-discordant couple in a 5 year relationship at the American average of sex 2-3 times per week (100-150 times per year) probably has something like a 50% chance of transmission, which would rise proportionately with a longer relationship.  So repeatedly negative tests in a spouse in a long-term relationship is at least "pretty good reassurance".

But you don't need to factor that in as an important consideration.  Your other risks are simply too low.  If you were to turn up positive someday, I would be 100% convinced there are other risks that you did not divulge (or perhaps did not know about).  Put things in perspective.  If you're going to worry about HIV at the risk level you describe, I have to assume you have decided never to drive, to cross a busy street, or to take commercial flights, all of which carry greater risks of killing you than the chance you have HIV.

HHH, MD

[Steve458632]

Thank you, doctor. It is interesting that you say my wifes HIV tests are a "strong reassurance" I am not infected.   I thought so too, but reading of other cases where the spouse is positive and the other is negative scared me.  Why doesn't that imply in my case?  

Also, even with mutal masterbation, if semen from another guy touched a hang nail or even the tip of my penis, would you still think I am fine?

Thanks again, Doc.

[H. Hunter Handsfield, M.D.]

You can relax. You describe a very safe sexual life, one that really has not risked HIV at all.  Certainly mutual masturbation is totally safe.  Giving oral sex carried a slight risk, but extremely low for any single event; and in any case, your wife's negative tests during pregnancy are strong reassurance you aren't infected.

Bottom line: You truly have not been at risk and have no reason to be worried.  But if it continues to play on your mind despite this reassurance, it's no big deal to get tested for additional confidence.  The result will be negative.

Good luck--  HHH, MD