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Starting new relationship; being socially responsible; HIV and precum and fingering
Hello Dr.
First and foremost, I appreciate your time in helping all of us out. I commend you in being an effective orator and advocate for HIV prevention in both an individual level, as well as a community level.
As per my risks: Let me delineate the series in which I am worried about. I, myself, am an HIV counselor, but it's always a tad bit different when you want to assess yourself. Thus, I hope you can help me out.
I am starting a new relationship (MSM; I am a 21 y.o. male, partner is 27 y.o. male) and want to be responsible. So, before we had sex, we both decided to get tested for HIV. We met about 6 weeks ago and he got tested this weekend with a negative result. Thus, we decided to have sex. We are both versatile, so we take turns bottoming/topping, and ALWAYS use protection. Just this morning, I noticed he was fingering me and he used his precum to lubricate me (my butt-hole; trying to find a correct/just word for that haha). I was wondering, is his precum and him using his precum in me a risk? The only other risky thing we've done is unprotected oral sex, where neither party has swallowed the cum. Albeit his test was negative, he had protected sex (not with me, with someone else) 10 weeks ago, was his test conclusive? I know I can answer these questions with my background, but it would be more settling if you help me out.
So, in briefings, my questions are:
1) HIV transmission with precum as lubrication and fingering; I had eaten a very spicy dish before so when I defecated before he fingered me, I am pretty sure I had some (few) scratches in my hole.
2) HIV transmission with oral sex (low, I know)
3) HIV transmission present if cum is on skin (perhaps have a cut on skin?)
Sorry to bother you, but I would appreciate your empowerment!
Thanks, once again doctor!
Hopefully next year I will start medical school and be someone like you! You have been nothing less than an inspiration, and I thank you for that!
:)
-UC Berkeley Student
First and foremost, I appreciate your time in helping all of us out. I commend you in being an effective orator and advocate for HIV prevention in both an individual level, as well as a community level.
As per my risks: Let me delineate the series in which I am worried about. I, myself, am an HIV counselor, but it's always a tad bit different when you want to assess yourself. Thus, I hope you can help me out.
I am starting a new relationship (MSM; I am a 21 y.o. male, partner is 27 y.o. male) and want to be responsible. So, before we had sex, we both decided to get tested for HIV. We met about 6 weeks ago and he got tested this weekend with a negative result. Thus, we decided to have sex. We are both versatile, so we take turns bottoming/topping, and ALWAYS use protection. Just this morning, I noticed he was fingering me and he used his precum to lubricate me (my butt-hole; trying to find a correct/just word for that haha). I was wondering, is his precum and him using his precum in me a risk? The only other risky thing we've done is unprotected oral sex, where neither party has swallowed the cum. Albeit his test was negative, he had protected sex (not with me, with someone else) 10 weeks ago, was his test conclusive? I know I can answer these questions with my background, but it would be more settling if you help me out.
So, in briefings, my questions are:
1) HIV transmission with precum as lubrication and fingering; I had eaten a very spicy dish before so when I defecated before he fingered me, I am pretty sure I had some (few) scratches in my hole.
2) HIV transmission with oral sex (low, I know)
3) HIV transmission present if cum is on skin (perhaps have a cut on skin?)
Sorry to bother you, but I would appreciate your empowerment!
Thanks, once again doctor!
Hopefully next year I will start medical school and be someone like you! You have been nothing less than an inspiration, and I thank you for that!
:)
-UC Berkeley Student
MEDICAL PROFESSIONAL
Welcome to the HIV forum. Thanks for the advance thanks.
Congratulations on your sense of responsibility; I wish more persons at high risk for HIV would be tested before starting new relationships. That said, I stress "at high risk". There are 2 ways to look at this in your situation. First, as a men who have sex with other men, you and your partners are inherently at much higher risk, as a population group, then are heterosexual men and women -- and that includes men and women whose sexual behavior, partner choices, and so on are equivalent to yours. All those things being equal, MSM are at much higher risk for HIV than heterosexuals in industrialized countries.
Second, your specific sexual exposures and behaviors put you in a very low risk category. You know with great certainty that neither you nor your partner has HIV. With the standard tests in normal use today, almost all newly infected people have positive test results within 10 weeks; the window period rarely extends anymore to 3 months. Equally important, you have only had safe sex. Exposure to pre-ejaculate fluid on fingers carries little if any risk. There's probably a greater chance of transmission as the result of an unrecognized condom failure.
1) "Scratches" in your anus from feces passing through? I can't imagine that never happens, unless rarely from sharp bones -- or maybe if you chewed up and swallowed a beer bottle. Certainly spicy food can't do that. But even if there were such lesions, this still was a zero risk exposure.
2) You answer your own question; fellatio is very low risk for the oral partner and exceedingly low, perhaps zero, for the penile/insertive partner.
3) It takes lots of HIV exposure for infection to occur. Even when HIV infected semen is deposted directly into a partner's rectum, the transmission chance averages once for every 100-200 exposures. It is unlikely there is sufficient virus in pre-ejaculate fluid to transmit infection given the small volume exposure associated with the amount on a finger.
MSM should not over-think the HIV transmission details. What you need to do to avoid HIV is 1) always be aware of partners' HIV status, as best it can be known (and avoid risky activities with those who are positive, not tested recently, don't know, or seem evasive in answering); and 2) using condoms for anal sex with new or potentially infected partners. Do those things and you can expect to go a lifetime without catching HIV.
In summary, as an MSM, you should have a routine HIV test from time to time, like once a year. But there is no need for retesting now. Of course you (and your partner) are always free to be tested extra times if this reassurance doesn't seem sufficient.
Best wishes for success in your future career in medicine!
HHH, MD
Congratulations on your sense of responsibility; I wish more persons at high risk for HIV would be tested before starting new relationships. That said, I stress "at high risk". There are 2 ways to look at this in your situation. First, as a men who have sex with other men, you and your partners are inherently at much higher risk, as a population group, then are heterosexual men and women -- and that includes men and women whose sexual behavior, partner choices, and so on are equivalent to yours. All those things being equal, MSM are at much higher risk for HIV than heterosexuals in industrialized countries.
Second, your specific sexual exposures and behaviors put you in a very low risk category. You know with great certainty that neither you nor your partner has HIV. With the standard tests in normal use today, almost all newly infected people have positive test results within 10 weeks; the window period rarely extends anymore to 3 months. Equally important, you have only had safe sex. Exposure to pre-ejaculate fluid on fingers carries little if any risk. There's probably a greater chance of transmission as the result of an unrecognized condom failure.
1) "Scratches" in your anus from feces passing through? I can't imagine that never happens, unless rarely from sharp bones -- or maybe if you chewed up and swallowed a beer bottle. Certainly spicy food can't do that. But even if there were such lesions, this still was a zero risk exposure.
2) You answer your own question; fellatio is very low risk for the oral partner and exceedingly low, perhaps zero, for the penile/insertive partner.
3) It takes lots of HIV exposure for infection to occur. Even when HIV infected semen is deposted directly into a partner's rectum, the transmission chance averages once for every 100-200 exposures. It is unlikely there is sufficient virus in pre-ejaculate fluid to transmit infection given the small volume exposure associated with the amount on a finger.
MSM should not over-think the HIV transmission details. What you need to do to avoid HIV is 1) always be aware of partners' HIV status, as best it can be known (and avoid risky activities with those who are positive, not tested recently, don't know, or seem evasive in answering); and 2) using condoms for anal sex with new or potentially infected partners. Do those things and you can expect to go a lifetime without catching HIV.
In summary, as an MSM, you should have a routine HIV test from time to time, like once a year. But there is no need for retesting now. Of course you (and your partner) are always free to be tested extra times if this reassurance doesn't seem sufficient.
Best wishes for success in your future career in medicine!
HHH, MD
MEDICAL PROFESSIONAL
You can consider his window closed -- especially since there was no measurable transmission risk even if he had HIV.
Spicy food does not cause anal open lesions. The two most common causes are anal fissure, which is a very common condition in anybody but probably more common in people who are the receptive partners in anal sex; and herpes -- and about half of all MSM in the US have HSV-2. Syphilis is a less common cause (although not of recurrent lesions), and of course is epidemic in MSM, as you may know.
If your anal lesion persists or is recurrent, get it checked out professionally.
Spicy food does not cause anal open lesions. The two most common causes are anal fissure, which is a very common condition in anybody but probably more common in people who are the receptive partners in anal sex; and herpes -- and about half of all MSM in the US have HSV-2. Syphilis is a less common cause (although not of recurrent lesions), and of course is epidemic in MSM, as you may know.
If your anal lesion persists or is recurrent, get it checked out professionally.
Thanks for the reply, nonetheless. I wasn't sure of the rules, but thanks for letting me know :)
And I never asked the question in a new thread, it was just the one above, but I apologize for the inconvenience and appreciate the help.
And I never asked the question in a new thread, it was just the one above, but I apologize for the inconvenience and appreciate the help.
MEDICAL PROFESSIONAL
You may not keep returning with every additional anxiety driven question that comes to mind. The answer is obvious from my replies above. You also may not ask the same question in a new thread; it would be deleted without reply and without refund of the posting fee.
This thread is over as well.
This thread is over as well.
Thank you again for all your help. I myself got tested again and am negative, which is pretty conclusive. However, today I woke up with a flu... it may just be in my head, but is this an onset of "infection?". To recap, partner was negative as of a week ago, with his last sexual encounter 1.5-2 months ago. Just yesterday, with our results, I decided to swallow his semen in oral sex, my first time ever. Today I woke up with a sore throat and body aches (no fever, as of yet).
Is this cause to worry? Should I get PEP?
So sorry to bother you with these annoying questions, I can understand your frustration with this as well, and thank you in advance.
Thanks,
UCB Student
Is this cause to worry? Should I get PEP?
So sorry to bother you with these annoying questions, I can understand your frustration with this as well, and thank you in advance.
Thanks,
UCB Student
Thank you for your response, I truly appreciate the time you took in answering my question succinctly.
By scratches I meant that there seemed to be an open lesion (from spicy food directly burning my skin there). Is that still a low risk as per precum and transmission?
Apologies in advance for extending this so far. His test was negative as was mine, mine is 100 percent conclusive since he's been my only partner in the passed three months, and his, the last partner he had was 10 weeks ago. Just to reiterate for clarity, does that 10 week thing "close" his window? or should we both get tested once again?
Best,
UC Berkeley Student
By scratches I meant that there seemed to be an open lesion (from spicy food directly burning my skin there). Is that still a low risk as per precum and transmission?
Apologies in advance for extending this so far. His test was negative as was mine, mine is 100 percent conclusive since he's been my only partner in the passed three months, and his, the last partner he had was 10 weeks ago. Just to reiterate for clarity, does that 10 week thing "close" his window? or should we both get tested once again?
Best,
UC Berkeley Student
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