Possible exposure

[Benb00]

Dear doctors,

Recently I had an experience with a male to female transexual (so anatomically speaking a gay man). I inserted my penis into his anus (I was wearing a condom).

I thought that he was a girl at the time, when I realised that he was a man I removed my penis put my pants on and left. I left so quickly I didn't even remove the condom

I got a taxi home, it took about 5 mins. When I got home I took the condom off and filled it with water to see if it had broken (it hadn't).

Unfortunately after touching the used condom with my hands I then rubbed my eyes

I'm worried that I could have transferred the virus from the used condom to my eyes due to the above

This happened in London, UK where there is a relatively high rate of HIV amongst gay men

Do you think I should get PEP? or be tested due to the above

Many thanks

[Edward W Hook, MD]

No, none of this makes any difference.  None of these activites put you at risk for HIV. EWH

[Benb00]

Thanks again for the response it's very helpful.

Sorry to ask so many questions but I just wanted to mention, despite this happening in the UK, I think the transexual was from somewhere in South America, he also took drugs and didn't seem to care about contraception (the only reason I had a condom on at one point was because I refused to do anything without it)

So I think he was really high risk. Sorry to ask so many questions it's just because i'm worried,

i also remember him grabbing my penis and smacking it on his anus. this was after i had inserted my finger into his anus. So I was worried that i may have pulled up some of his anal mucus as i removed my finger from his anus and then got the mucus on my penis when he smacked my penis on his anus

he also gave me oral sex,

Sorry again for all the questions but does  this make any difference to your assessment?

[Edward W Hook, MD]

No, no change at all in my assessment or recommendation.  Your balanitis and smegma make no difference.  Same is true for contact with his anus.  EWH

[Benb00]

I should also mention that I have balanitis and had some smegma on my penis at the time,

Does this make it easier to catch STD's?

[Benb00]

Thanks for the response, there was one extra thing I forgot to mention.

I inserted my finger into his anus, (it seemed moist) right afterwards I masterbated my penis with the hand that had the finger I inserted into his anus

Does this put me at any risk?
Does the above mean I should seek PEP and/or be tested?

[Edward W Hook, MD]

Welcome to our Forum.  I would not recommend PEP in this situation.  Several reasons:

1.  About 10% of MSM in London have HIV, thus there is a 90% chance your partner did not have HIV.  In the future, I suggest you ask all partners about their HIV status and when they were last tested.  Most people tell the truth.
2.  Your ano-genital contact was condom protected and therefore safe sex.
3.  Hand to eye transfer of genital secretions will not lead to infection.  This is particularly true in your situation in which, as I understand it, the condom remained on your penis inside of your pants during the time that you were leaving your partner. HIV does not survive well outside of the body, dying almost immediately.

Bottom line, I don't think you were at any risk for HIV or for other STDs and therefore see no need for testing, much less PEP. I hope my comments are helpful.  EWH