[Question #11012] Rubbing

17 months ago

Greetings,

Yesterday, I met a sex worker who rubbed my penis against her anus and vagina. Is rubbing my penis against someone's anus and vagina a risk for HIV transmission?

H. Hunter Handsfield, MD

17 months ago

Welcome to the forum and thanks for your succinct question.

STIs rarely if ever are transmitted by non-penetrating sex. Direct genital apposition -- i.e. immediate genital-genital or genital-anal contact -- probably carries small risk of those STIs transmitted primarily by skin-to-skin contact, i.e. HPV, herpes and syphilis. There is no risk at all for those transmitted primarily in genital fluids, like gonorrhea, chlamydia, and HIV -- at least the risk is so low that there are few if any reports that such transmission ever occurred.

In addition to inherently low risk based on the kind of contact, remember that the vast majority of female sex workers do not have HIV. And even with penetrating vaginal sex, the chance of transmission -- if the female partner is infected -- is in the ballpark of one chance in 2,500 for each exposure.

For these reasons, there is no need for HIV testing after such an event. If you have a regular partner, you can continue your usual sexual practices without putting that person at risk of HIV.

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

HHH, MD

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17 months ago

Thank you for your reply.

I have a few more questions. I sometimes engage in both anal and vaginal fingering with sex workers. Does this pose a risk for HIV transmission? What if I have hangnails or recent cuts on my fingers, such as those on the hyponychium?

H. Hunter Handsfield, MD

17 months ago

Fingering is risk free, and is generally considered risk free even with hangnails or other injuries such as you describe. Don't worry about sexual acquisition of HIV until and unless you have actual sex, i.e. penile penetration into a partner's vagina or rectum.---
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16 months ago

I managed to find the password for this account. Sorry for any inconvenience caused previously.

If my calluses were bleeding during my exposure, would my HIV risk still be considered zero (or nearly zero) such that it can be ignored without HIV testing? I am sure the bleeding was not in large amounts, but since I can now see some of my blood on and around the calluses, let's assume they were bleeding during my exposure.

The only activities were performing anal and vaginal fingering on sex workers and receiving handjobs. I am very regretful and anxious now.

From a medical point of view, can I really move on without HIV testing?

H. Hunter Handsfield, MD

16 months ago

Glad you got into your original account!

You have almost answered this yourself. There are no known cases of HIV being acquired by vaginal or anal fingering, and of course many, many people have calluses or other lesions of their finger -- not just calluses, but hangnails, minor wounds, and so on. So there must have been millions of fingering events by people with these problems -- and still no known HIV infections. Hand genital contact -- like receiving handjobs -- also are free of HIV risk.

But you raise a valid point when you ask for a "medical point of view". For that, the answer is yes: you definitely "can move on without HIV testing". On the other hand, simple reassurance also can be a valid reason to be tested for HIV. If you continue to worry despite this reasoned, science based reassurance, you could consider testing if it would help ease your fears. Personally I would not do it, and I stress again there is no need from a medical or risk standpoint. But it's up to you!

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful.

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