Concerns

[rocket515]

Dear Doctors:

I have three questions, two of which are more specific and one is more general.  I am 22 year old gay male.  I am also not circumcised.

I engage in mutual masturbation with other men and get their fluids all on my penis and stomach.  I then proceed to take a shower.  I use a body sponge always.  My first question is 1) - if I just engaged in mutual masturbation and took a shower, could HIV survive on the body sponge and potentially cause exposure in later showers?

I rarely give oral sex. However,  I'm concerned about toothbrushes after oral sex.  My second question is 2) Could HIV survive in the mouth and then get on the toothbrush after brushing after oral sex and then potentially reinfect in later teeth brushing?  

Finally, I read here on and many sites that HIV cannot infect from environmental sources.  The CDC says this has never happened.  However, I read of a case of a girl  getting HIV from sharing a toothbrush with her HIV+ mother and this was on the CDC website.  I also read of one brother getting infected with HIV by using his brothers razor. My third question is 3) How then with cases such as these can it be said that HIV cannot be transmitted by an environmental source?  I'm confused.

Thank you and looking forward to your reply to my three questions.

[H. Hunter Handsfield, M.D.]

I cannot say there is no potential.  As I said above, "I cannot imagine it is a realistic risk and certainly tranmission by this route has never been reported."

[rocket515]

Thank you for your reply doctor.

I gathered this from your statement - please make sure that I am correct

If I were to shower/brush my teeth after coming in contact with bodily fluids in mutual masturbation and oral sex, there is no potential for infection in later showers/teeth brushing from my body sponge or toothbrush.

Please confirm.  This is my last post, I promise!

[H. Hunter Handsfield, M.D.]

Welcome to the forum. I'll try to help.

In general terms, you are worrying about trivialities.  Congratulations for pursuing a very safe sexual lifestyle.  If it does not materially change, you can expect to go a lifetime without catching HIV, regardless of showering, toothbrushes, and similar considerations.

As you apparently know, for men who have sex with men, the basic elements of safe sex are avoidance of unprotected anal sex with infected or potentially infected partners; and perhaps, to be super safe, avoiding oral sex (as the oral partner) -- but as you seem to know, that's a low risk practice.  You also should be routinely asking all potential partners about their HIV status, and sharing your own, and avoiding contact with those who are positive, don't know, or seem evasive.  "Do ask, do tell" is a basic element of sexual safety for MSM.  (You might be doing this, but don't say so.)  

There is no risk associated with skin contact with HIV infected secretions or showering those secretions off.  I cannot imagine that anyone in the world ever became infected through such a route, regardless of potential contamination of sponges or washcloths with HIV.  There has been speculation, but no data, that vigorous tooth brushing after oral sex could increase transmission risk by abrading the gums in the presence of infected secretions.  I cannot imagine it is a realistic risk and certainly tranmission by this route has never been reported.

I agree with CDC about lack of transmission from environmental sources.  "Environmental" means picking up the virus from things like doorknobs, towels, bedsheets, etc; it does not include such things as shared razors, toothbrushes, etc.

Bottom line:  Continue to follow the safe sex practices you describe and you'll be fine.  If not now doing so, please add "do ask, to tell" to your approach to safe sex.  Don't worry about showering, brushing your teeth, and that sort of thing.

Best wishes--  HHH, MD

[rocket515]

And of course my first comment with regards to the shower is showering off my partners body fluids.

Thanks!