[Question #10787] Curiosity

19 months ago

Hello Doctors. I’ve been a fan for a long time and I often read your responses to people question and I use it as part of my sexual education to measure my risk. The last two years I’ve been exploring my bisexuality a little more. Most of my activities involve giving and receiving oral which I know is low risk. Over 8 months ago I met an older male in his 50’s with a professional job. I had an encounter with him where there was a lot of body rubbing and mutual masturbation. I’m not ready to receive anal and might never be ready but we did use lubricants and I got on my belly and he rubbed his penis between my buttocks for 30 minutes. At one point he tried to go in and I stopped him. He later ejaculated on my face and it got in my eye. I was not happy and I asked him if he was STD free and he said yes but he acted really nervous when he responded. My anus was sore for a day after that night and it was most likely because of the friction. Now I know this is low risk. I know semen in my eye is low risk and even the friction of his penis against my anus is very low. This happened 8 months ago and I took a Oraquick exam last week and it was negative. I know most people do not lie when asked directly about their status but let’s say he did will my risk still virtually be low?

H. Hunter Handsfield, MD

19 months ago

Welcome to the forum. Thanks for your ongoing reference to it. As you probably know, most users don't get nearly real-time replies to their questions, but I happened to be logged in when your question showed up.

I reviewed your question of several years ago (no. 2972, if you want to review it yourself). Looking back at that discussion, much of what you ask now was indirectly covered there. The main thing to emphasize now, which you seem to know anyway, is that HIV is rarely if ever transmitted by any sexual contact other than penile penetration. That means vaginal or anal sex, since even oral sex to completion is extremely low risk. (There has never been a proved case of HIV transmitted oral to penis, for example.) Exposure of semen or other body fluids to eyes and face probably isn't zero risk but it's extremely low.

So the answer to your direct question is yes: your risk from the event described is extremely low, even if your partner was untruthful (or unaware) and had HIV. In any case, your recently negative oral fluids test is reassuring. As discussed last time, this test isn't the best, since it is only about 95% sensitive, i.e. it misses up to 5% of HIV infections. However, given your partner's assurance he doesn't have HIV, the minimal risk of the exposure, plus a negative test result that is 95% reliable collectively mean the chance you caught HIV during that event is on the order of one chance in many million -- zero for all practical purposes.

If you can get past your needle phobia, you could have a lab based HIV test, ideally an AgAb (4th generation) blood test. But I really don't think it's necessary. All is well.

I hope these comments are helpful. Let me know if anything isn't clear. Happy new year!

HHH, MD

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