[Question #11583] Frottage with Anal Fissure and HIV Risk

13 months ago

I'm gay and practice safe sex, so I only engage in frottage (body-to-body rubbing) with mutual masturbation, which I believe to be a safe sex with no risk of HIV.

However, a day ago, during frottage with another guy, he licked my anus a lot, and I think his tongue might have touched my anal fissure (caused by constipation due to a lack of fiber in my diet). The anal fissure isn't bleeding, but it appears as a red scratch and is irritated, causing a little pain when I have a poo in toilet. I have no any penetration.

Could this exposure lead to HIV risk since I have a wound on my anus that was exposed to his secretion (Saliva).

Maybe it might have a blood in his saliva suppose he has a gum disease.

Should I get test, Do this exposure is risk for HIV ? Low Risk or No Risk ?

H. Hunter Handsfield, MD

13 months ago

Welcome back to the forum. I reviewed your discussion with Dr. Hook a few months ago, which described a sexual lifestyle and sexual practices very similar to those here. I agree with Dr. Hook's advice about the absence of HIV risk.

The main difference and your main concern now is your anal fissure. But it does not significantly raise the risk of HIV. Open wounds are often stated as HIV risks, but they really are not a serious consideration. Superficial and non-bleeding wounds rarely if ever are a source of new HIV. And oral contact with your anus, including the fissures, is very low risk: saliva and oral fluids rarely if ever transmit HIV. In fact, saliva kills HIV -- and there has never been a proved case of HIV being transmitted oral to genital, or by oral to anal contact. There must have been billions of oral-anal contacts with HIV infected partners, and obviously many of those must have included blood contact as well -- and yet no known HIV transmission. That doesn't mean it can't occur -- but it does prove that such transmission is extremely low risk.

Therefore, from a medical/risk standpoint, there is no need for HIV testing. However, anxious persons often are more reassured by negative test results than by professional opinion, no matter now expert. (We don't take it personally!) If a negative HIV test would allow you to be less worried, of course you should do it. This does NOT mean that I believe there is actually any risk -- I suggest it only for reassurance.

You also might consider asking your partners about their HIV status before having sex, even if only safe sex is planned. Wouldn't you be reassured to know they have tested recently with negative results?

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

HHH, MD

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13 months ago

"Saliva kill HIVs"

So suppose there have some blood or HIVs in his mouth, It should be killed by Saliva. then it make my exposure is almost NO risk? my wound is very small and not bleeding just a little bit pain when I go to toilet.

Actually It's NO risk right ? in your expert opinion but test is just for reassurance?

I think I will take your opinion and NOT go to test, I will try to clam down and move on without worry.

H. Hunter Handsfield, MD

13 months ago

Whether or not saliva kills HIV, with or without blood, isn't the important point. What matters is that few if any HIV cases ever have been transmitted by exposure to saliva. The biological reasons don't matter. I also said "that doesn't mean it can't occur", but it does mean it is very rare. Of course nobody can guarantee it is no risk at all. But the risk is low enough that I advise testing only for reassurance. If personally somehow I were in your situation, I would not get tested. But you'll need to make your own decision.---

13 months ago

"If personally somehow I were in your situation, I would not get tested."

You don't get test and would you feel free to continue unprotected sex with your wife ?

should I have unprotected sex with my partner after this exposure with this guy?

"very rare" how frequent or how much case like this have been reported ?

thanks you

H. Hunter Handsfield, MD

13 months ago

You don't get test and would you feel free to continue unprotected sex with your wife ? Yes.

should I have unprotected sex with my partner after this exposure with this guy? Given that reply, isn't it obvious? Yes.

"very rare" how frequent or how much case like this have been reported ? I'm unaware of any such reported cases. Probably under one chance in millions.

That concludes this thread. Do your best to accept, understand, and believe this reasoned, science based advice. Best wishes.

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