[Question #10235] HIV risk, need for testing, mutual masturbation
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24 months ago
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I am a gay man married to a man who had encounters outside our relationship. I usually bottom with my husband and we receive and give oral to each other unprotected. I worry because I don't want to put my husband at risk. I've read in other answers that the activities I participated in below have low to no risk, and might not even justify testing for HIV, but it would be great to have your perspective.
Encounter 1: A man briefly gave me oral (my penis, his mouth) before I ejaculated. We mutually masturbated, he ejaculated on me, and let us assume that his semen came into contact with my urethra opening
Encounter 2: With two other men, we all mutually masturbated, and they ejaculated on me, and let us assume that the semen came into contact with my urethra opening
There was no anal-penile penetration.
In other answers the risk from the above is described as extremely low and theoretically possible to transmit HIV. What I would like to know is if that risk is so small that I shouldn't be worried about putting my husband at risk or modifying our sexual activity. In some answers it was suggested that testing, for these events specifically, may not be warranted.
Thank you for your time and expertise!
Encounter 1: A man briefly gave me oral (my penis, his mouth) before I ejaculated. We mutually masturbated, he ejaculated on me, and let us assume that his semen came into contact with my urethra opening
Encounter 2: With two other men, we all mutually masturbated, and they ejaculated on me, and let us assume that the semen came into contact with my urethra opening
There was no anal-penile penetration.
In other answers the risk from the above is described as extremely low and theoretically possible to transmit HIV. What I would like to know is if that risk is so small that I shouldn't be worried about putting my husband at risk or modifying our sexual activity. In some answers it was suggested that testing, for these events specifically, may not be warranted.
Thank you for your time and expertise!
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H. Hunter Handsfield, MD
24 months ago
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Welcome to the forum. Thanks for your question and your confidence in our services. FYI, your question arrived while I was on the forum myself: most users should not expect nearly real time replies!
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Congratulations for what I assume is your recent marriage. I wish you and your husband a lifetime of happiness together.
If the past sexual exposures you describe are the only sex you had in the weeks before beginning your relationship with your husband, there is very little risk. And if these were your only lifetime sexual experiences, it's even less likely. Hand-genital contact (i.e. mutual masturbation, also anal or vaginal fingering) are free of STI/HIV risk. Receipt of oral sex is very close to zero risk for HIV; in fact, after all the decades of the worldwide HIV/AIDS epidemic, there still have been few or no proved cases of HIV being transmitted oral to penis. The risk of STDs is higher, but still very low -- and given the minor contact you describe, e.g. with semen possibly landing near your urethra, there is no significant risk.
Unless I'm missing something, by far the greatest STI/HIV risk in your relationship with your (new?) husband is his sexual lifestyle, as you describe it. And being the receptive partner in anal sex ("bottom") is the highest STI/HIV risk of all sexual practices. In other words, from a statistical/probability standpoint, you're likely at far higher risk from your husband than he is from you. Most men entering a new, mutually committed relationship -- with or without marriage -- would have both been tested for the main STIs of concern. HIV of course is the most important, but I would also advise mutual testing for syphilis, gonorrhea and chlamydia. (The particular anatomic sites for gonorrhea/chlamydia testing depend on past and current sexual practices. For most men who have sex with other men, that means urine [or urethral swab], rectum and throat.) If not yet done, I would encourage the two of you to be tested. Even if both your current risks are very low, it can be a sign of commitment and caring, and the anticipated negative results likely would be mutually reassuring. Better safe than sorry, right?
I hope these comments are helpful. Let me know if anything isn't clear. Congratulations again and best wishes.
HHH, MD
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24 months ago
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Thank you for the prompt reply. And thank you for the good wishes!!! I have been happily married for years now!! It was I who messed up though in the last couple months. And, given the remorse that I have, I'm definitely not going down this road again.
It sounds like my risk is still very low and that there is no need to modify our sexual activity? I realize I am most at risk in the relationship, and our sexual practices are built on the assumption of monogamy. We do get HIV testing at our annual check up and have been HIV negative, but the next check up is months away at the moment. I messed up bad. But I am trying to separate the personal remorse from the scientific risks at the moment.
I was planning on going to go to a Planned Parenthood and request testing for HIV and other STIs, just to be very safe for me and know I'm not passing anything to my husband.
I guess my follow up questions/confirmations are:
1) Just to confirm, from the events that I described, there is no need to modify our current sexual practices?
2) If I am to be tested, given the risk level and window period, when and how far out do you recommend I get tested given my circumstances? I realize longer out is more certain, but also it would be good to have a test as quickly as possible, to alleviate my anxiety and from the perspective that I would want to know as soon as possible if I don't modify sexual activity with my husband. 4 weeks, 6 weeks, 3 months post these events? If it's truly a non-significant risk, then maybe 3 months is warranted, because it would mostly be for reassurance? Our annual check up where we are tested by our doctor would be in about a year.
Thank you again, not only for this answer, but your other posts, which are very helpful!!!
It sounds like my risk is still very low and that there is no need to modify our sexual activity? I realize I am most at risk in the relationship, and our sexual practices are built on the assumption of monogamy. We do get HIV testing at our annual check up and have been HIV negative, but the next check up is months away at the moment. I messed up bad. But I am trying to separate the personal remorse from the scientific risks at the moment.
I was planning on going to go to a Planned Parenthood and request testing for HIV and other STIs, just to be very safe for me and know I'm not passing anything to my husband.
I guess my follow up questions/confirmations are:
1) Just to confirm, from the events that I described, there is no need to modify our current sexual practices?
2) If I am to be tested, given the risk level and window period, when and how far out do you recommend I get tested given my circumstances? I realize longer out is more certain, but also it would be good to have a test as quickly as possible, to alleviate my anxiety and from the perspective that I would want to know as soon as possible if I don't modify sexual activity with my husband. 4 weeks, 6 weeks, 3 months post these events? If it's truly a non-significant risk, then maybe 3 months is warranted, because it would mostly be for reassurance? Our annual check up where we are tested by our doctor would be in about a year.
Thank you again, not only for this answer, but your other posts, which are very helpful!!!
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H. Hunter Handsfield, MD
24 months ago
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I misunderstood the context. Thanks for clarifying.
Indeed your risk from the exposures described is very low. I did not intend to cast aspersions on your husband's sexual lifestyle, other partnerships, etc. My comments were under the belief the marriage was recent and his sexual lifestyle until now the one of greater risk. As you undoubtedly know, many marriages -- independent of the two partners' genders -- are relatively open. If either of you is likely to have other sex partners from time to time, I certainly endorse annual HIV testing for both of you, and perhaps testing for other STIs as well. That said, I certainly would not consider the exposures you described as having "messed up bad"! You're the only one who has a right to that determination: we moderators never pass judgment on sexual choices, as long as there is no evidence of harm or coercion.
Feel free to be tested at Planned Parenthood, but honestly I see no need at all. But (in reply to question 1) it's a good idea if you would find the negative results add to your reassurance about it. If you do it, your only anatomic site at risk is your urethra, and for both the BJ and possible exposure to your partner's semen, the only possibilities are gonorrhea and chlamydia, and those tests are valid any time more than 3-4 days after exposure. If you feel you want reassurance about syphilis and HIV, those blood tests should be delayed to 6 weeks after the event. Neither needs testing later than that; 3 months is old news and definitely not necessary.
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H. Hunter Handsfield, MD
24 months ago
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On further reflection, the chance of either syphilis or HIV from the events you described is microscopic. Even with your next routine testing a year away, if somehow I were in your situation I would wait until then. But of course it's still up to you.---
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24 months ago
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Thank you very much!! I appreciate your time and consideration, your advice has helped relieve my anxiety considerably. Thank you!
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H. Hunter Handsfield, MD
24 months ago
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Thanks for the thanks. I'm glad to have helped. Given your satisfaction, perhaps you would like to consider making a tax deductible donation to the sponsor of the forum, the American Sexual Health Association (www.ashasexualhealth.org). ASHA is the nation's leading private nonprofit agency in support of sexual health with emphasis on STIs. There's a Donate link on the website if you're interested.
Best wishes and stay safe.
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