could i be exposed to an HIV

[john221151]

Dear Doctors,

hope you can help and kindly advise me

Approx 2 weeks ago i met up with a man and we had mutual masterbation with each other without condoms (I did not see any pre -semen), no ejaculation  took place, we also master bated ourselves in both ways front, and anus (Fingers)

1. would there be a risk i have seen on your forum that there is no risk with masterbation, but because the other man master-bated himself front and back than master-bated himself anal, would i be exposed to an STD or HIV virus? (when he fingered me?, hence fingering himself first,-then me)

2. do you think i need to test for HIV.

3. im concerned because i think i have developed ARS symptoms of seroconversion maybe cause i have developed a cold within the last few days

Thank-you for your advice

John

[H. Hunter Handsfield, M.D.]

Welcome to the forum and thanks for your question.

My analysis is that you are over-thinking the risks here.  You have correctly seen our frequent statements about hand-genital contact, fingering, etc (i.e., no risk), but you wonder whether those comments apply to any and all fingering events.  They do.  The reason that HIV is sexually transmitted only by unprotected intercourse (a penis inside another person's vagina, rectum or, rarely, mouth) is that being exposed to just a little bit of HIV is not sufficient.  It takes LOTS of virus in contact with just the right kind of susceptible cells.  It is not plausible that enough virus could be carried in the small amount of secretions that could be exchanged by events like you describe.  That's why nobody has ever been know to be infected by fingering or hand-genital contact, under any circumstances at all.  Therefore:

1) There is no appreciable risk of HIV, even if your partner had HIV.

2) If this is your only potential exposure to HIV, there is no need for testing.

3) ARS does not cause typical cold symptoms, i.e. runny nose, sneezing, or cough.  And because the exposure risk was so low, even truly typical ARS symptoms would not raise my suspicion.

You don't mention your partner's HIV status.  Presumably that means you don't know and didn't ask.  Please get into the habit of ALWAYS asking potential partners about their HIV status before going ahead with any sort of contact if they are positive (and untreatred), don't know, or seem evasive.  This is a good strategy even when entirely safe sex is planned, as you had this time.  First, you wouldn't end up anxious about it; and second, sometimes intentions for safe sex are forgotten in the heat of the moment.  Don't risk it!

I hope this helps.  Best wishes--  HHH, MD  

[H. Hunter Handsfield, M.D.]

As I noted above, unprotected oral sex can be considered safe sex with regard to HIV.  The main reason for condoms for oral sex is to avoid STDs other than HIV.  

[john221151]

so if i was giving oral my penile to the other person its a 1 in 20,000 risk so thats really really low then

so at this its best to use condoms for oral sex then

thanks for all your responses

thankyou

[H. Hunter Handsfield, M.D.]

Sorry, I missed that part.

The risk of HIV transmission by fellatio is very low; some experts believe it is zero for oral to penile transmission.  One calculation, from CDC, estimates infection risk of 1 in 10,000 for the receptive (oral) partner, if the penile partner has HIV; and half that (1 in 20,000) in the opposite direction, i.e. if the oral partner is infected.  These odds are equivalent to giving or receiving B-Js with infected partners once daily for 27 years or 55 years before transmission might be likely.

The actual risks may vary upward or downward depending on such things as the duration of exposure, ejaculation in the mouth or not, whether the infected partner is on ART and his or her viral load, and so on.  But given the miniscule overall risk, it can be assumed that even in the maximum risk situation the actual likelihood of transmission is very low.  For these reasons, oral sex can generally be considered safe sex with respect to HIV.  Of course transmission risks for certain other STDs are much higher.

[john221151]

Hi

you did not reply to my above question hear it is again thank you
can i just ask is there a risk from giving oral to a male? or receiving oral from a male- just so that i know for future reference, as again I'm vague on this has some boards/forums say yes risk some say none when receiving but giving there can be a risk- hope you can clear this up

thanks again

[H. Hunter Handsfield, M.D.]

All these statements are true, but that doesn't mean asking doesn't help reduce risk.  It does, probably a lot.  (We don't require perfection in any safety strategy.  People die despite wearing seatbelts.)  Most HIV infected people know it.  For example, at least 90% of gay men in the US have been tested, many within the preceding year.  And most people do not lie about HIV status when asked directly.  It's also possible someone genuinely believes he isn't infected but acquired HIV since his last test, but the statisitcal odds of that are low, especially if he was tested recently.  Asking isn't foolproof, but it is a major safety factor.  I call it "Do ask, do tell" and it is a central safe sex strategy for gay men -- almost as important as condoms for anal sex.

As for advice from other online sites, you need to distinguish those run and moderated professionally, like this one, and others that are run by advocacy groups and/or not monitored for accuracy.  And among professional ones, be aware that many agencies -- especially government ones like CDC -- have a CYA attitude about legal liability.  They often don't distinguish between theoretical risks and real ones that have been scientifically documented.

There is no single thread on exposures like yours; there have been hundreds (maybe thousands) of them.  Go to this forum's home page, find the search function near the top, and try entering terms like "fingering" or "hand-genital".

[john221151]

our frequent statements about hand-genital contact, fingering, etc (i.e., no risk), but you wonder whether those comments apply to any and all fingering events.  They do.  DO YOU have  A LINK to this thank you

[john221151]

Dear Doc
thank-you

I'm not over thinking, just concerned if i had an exposure, i know that masterbation does not carry a risk, but i was concerned about the secretions from the other persons finger going into me i.e. anal, because he fingered himself and then fingered me (and i assumed i was at risk of this) but you have now said there is no exposure hear and i do NOT need to test.

1)you mentioned about me asking my contacts status- i do not no weather he has the virus or not, even if i asked this stranger surely he could lie to me so what difference would this make? ??

2)Also what if the person who i met didn't have an HIV test and they don't know there actual stays which i assume allot of people do not know?

3) why do other forums on the net say there could be a risk, i guess that they are not medically trained like yourself and don't know the full details.

so at-least I'm more educated on HIV now that it can only be transmitted, through sexual intercourse direct,

can i just ask is there a risk from giving oral to a male? or receiving oral from a male- just so that i know for future reference, as again I'm vague on this has some boards/forums say yes risk some say none when receiving but giving there can be a risk- hope you can clear this up

thanks again

John