Hello,

My question is considering all the details i have provided, What would be my risk of acquiring HIV from this episode? Specifically focusing on the potential exposure to contaminated fingers with semen being used to finger me.

I did an HIV RNA yesterday but i m having a lot of anxiety over this , other than that no other symptoms at this time.

These were very low risk exposures both for HIV and other STDs. HIV seems to be your main concern.

HIV has never been known to be transmitted by fingering or by semen contact with skin, or by rimming. The oral sex component may have been the riskiest element of these exposures, but even here the risk is very low. I'm not sure how to interpret "receiver" -- but probably you mean your penis in the mouth of one or both partners. There have been few if any proved case of HIV transmission by such exposure. Based on how HIV infected people thought they were infected (which often is inaccurate), one calculation by CDC is one chance in 20,000 for the penile partner if the oral partner has HIV. That's equivalent to getting BJs by infected partners once daily for 55 years before transmission of the virus might be likely. (If I have it wrong -- i.e. if you were the oral partner, the estimate was one chance in 10,000 -- i.e. giving BJs to infected partner once daily for 27 years.)

For those reasons, the chance you acquired HIV is extremely low, even if one of your partners has HIV. And most likely they did not. (Did you ask?) Had you asked before being tested, I would have said that testing for HIV is optional in this situation. However, having started down that path, for reassurance you should continue. You definitely can expect a negative result for yesterday's RNA test; that would be about 95% reliable. Assuming the result indeed is negative, I would advise you also have an antigen-antibody tests (AgAb, i.e. 4th generation) blood test 4 weeks after the event. That combination -- negative RNA at 12 days and negative AgAb at 4 weeks -- will be conclusive proof you weren't infected.

I hope these comments are helpful. Feel free to let me know the RNA test result, or if you have any other questions. Stay relaxed in the meantime:  it is extremely unlikely you acquired HIV.

HHH, MD

I would definitely proceed with the   4th generation test at the 4 weeks mark as you suggested.

In the future, I would advise always discussing mutual HIV status before such events. People rarely lie about HIV status when asked directly, and it would have been very reassuring to know they were tested recently and not infected -- or if infected, on effective HIV treatment, which prevents virus transmission. In addition to condoms, discussing HIV status is one of the basic elements of sexual safety.