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Vaginal fluid on hand touched inside of condom and head of penis

Scenario….. Female sex worker in Texas was fingering herself then she stopped in order to get a condom for oral sex. My question is can she have passed HIV if she had vaginal fluid on her hand and then touched the head of my penis? Can she have contaminated the inside of the condom? If the inside of the condom was contaminated then I ejaculated inside can the HIV virus crawl into the urethra? All this happened about a week ago and I’m worried that I could infect my wife and unborn child.

I just had an HIV test but it was only after 3days of exposure…Negative result but waiting three more months has been pure torture.

Can you PLEASE explain my risk and or chances of exposure?
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239123 tn?1267647614
MEDICAL PROFESSIONAL
The reason that some infections are transmitted only by sex, direct blood exposure, and other very intimate contacts (transplantation, childbirth, etc) is that they CANNOT be transmitted by other means.  Why not?  Because large amounts of the causative bacteria or viruses must have direct access to susceptible tissues, which typically are deep inside (gonorrhea, chlamydia, HIV, HBV, etc); or they must be massaged vigorously into susceptible tissues, often with microscopic trauma (syphilis, HSV, HPV).  This is how these bacteria and viruses, and the human interactions with them, evolved over thousands of human generations and millions of years, and it is an essential biological difference between STDs and, say, colds, influenza, common intestinal infections, measles, chickenpox, and a hundred other infectious diseases.

This is why STDs are not transmitted by kissing, hand-genital contact, contact with a contaminated environment, or from such fleeting contact like you describe here -- even fleeting contact with the genitals.  Nobody can say the risk is zero from what you describe.  But in 30+ years in the STD business, I have never seen or heard of such transmission occurring.  The people who show up in the clinic with HIV or other STDs always have had intercourse or direct blood exposure, as through shared injection equipment -- we simply see no exceptions.

So if there is risk in the sort of exposure described in your question, it is far too low to measure or worry about.  This also explains our universal reassurance to questions about mutual masturbation, contact with potentially infected secretions in the environment, and most sexual exposures other than insertive sex.

Thank you for another opportunity to explain these important concepts.  I'm going to bookmark this thread so I won't have to repeat it again!  But that will be all for this thread.  You need to accecpt the reassurance you have been given and move on with your life, without fear about this.  No more discussion, please.
Helpful - 10
239123 tn?1267647614
MEDICAL PROFESSIONAL
Good question, and a worthwhile addition to the general point about the biology of STD transmission.

In general, yes:  these comments apply to oral sex.  Most important, brief, fleeting oral sex probably carries little or no risk for any STD -- even less than brief or indirect genital contact.  The quick kiss of the penis, scrotum, labia, etc rarely results in STD transmission.

Even for more prolonged or vigorous oral sex, the STD risk is much lower for oral than for genital or anal sex.  As the STD bacteria and viruses evolved, they adapted to the genital environment, which is one reason that common STDs are less often transmitted by oral sex.  But it isn't absolute.  For example, gonorrhea is genetically related to bacteria that normally inhabit the mouth and throat, which may be why oral gonorrhea, and transmission of gonorrhea by oral sex, sometimes occurs -- although with less efficiency than by genital or anal sex.  On the other hand, chlamydia does not take hold in the throat, or only rarely.  Therefore, chlamydia is rarely if ever transmitted by oral sex.  HPV may be somewhere in the middle:  oral infection may be frequent, but usually without consequences, and oral sex apparently is not a common route of transmission, especaily from mouth to genitals.  (However, research on this aspect of HPV is in progress, and all the answers aren't in.)  For HSV, the two types have different predilections:  HSV-1 for the oral cavity, HSV-2 genital; but there is a fair amount of cross-over.  There are additonal reasons why HIV in particular is not often transmitted by oral sex, but that's too complex to get into in this thread.
Helpful - 7
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the HIV forum.

Sometimes there is enough information in the very first line, or in the title of a question, to respond accurately without reading further.  That is probalby the case here.  HIV is hard to transmit.  If it could be passed by the brief sort of superficial contact you describe in the title ("Vaginal fluid on hand touched inside of condom and head of penis") HIV would be easily acquired in public toilets, from shared towels, etc, and would be common in household contacts of HIV infected people.  None of these things ever happens.

Now I have read the question itself.  Guess what?  I nailed it.

Congratulations for having safe sex.  HIV is never transmitted by hand-genital contact and there is no chance you were exposed in this manner.  HIV is hard to transmit because lots of bacteria or virus has to have direct contact with susceptible tissues and it is not possible to carry enough bacteria on the hands.  

On top of that, HIV is rare in sex workers in the US.  It is very unlikely your commercial partner had HIV.

In summary there was no risk, you do not need HIV testing, and there is no risk to your wife or baby.  Don't worry about it.

Regards--  HHH, MD
Helpful - 3
Avatar universal
I'm very sorry ...one last thing!!!

What if the contamination from her hand was immediate?  I'm I at risk of any other STD's?

Thanks,
Helpful - 1
239123 tn?1267647614
MEDICAL PROFESSIONAL
Your family doctor is just being careful.  Or maybe he doesn't understand the transmission risks as well as the experts do.

Oral sex is generally considered no risk even without a condom.  Absolutely no risk with a condom.

All will be well. Really, don't worry about this.
Helpful - 1
Avatar universal
A related discussion, fear for hiv was started.
Helpful - 0
Avatar universal
A related discussion, chance of infection was started.
Helpful - 0
Avatar universal
A related discussion, pealing of the penis was started.
Helpful - 0
Avatar universal
A related discussion, Vaginal secretions thoroughly massaged? was started.
Helpful - 0
Avatar universal
Doctor, this is great explanation. Is it also apply to oral sex.
Helpful - 0
Avatar universal
I guess I was just scared becasue when I explained this to my Family Doctor he said that I need to go ahead and get tested. Can I safely go on with life?Do you think he is just being careful? I will never let this happen again ..talk about scared straight!!!

What about the oral sex with condom on?

I promise no "what if " questions will follow !!!

Thanks,
Helpful - 0

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