[Question #11783] Hiv risk mutual masturbation
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12 months ago
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Hello Doctors, I am male and had a sexual exposure around 3 days ago. I was mutually masturbating and deep kissing another man, who said he was tested 3 weeks ago and got off PreP recently. We both ejaculated, and I made the mistake of using my hand, which was covered with the other person's semen, to rub my own penis, specifically the head of my penis. I am sure his semen made contact with my glans and maybe my urethra. I have heard mutual masturbation is risk free, is this true even for my case? He came a lot, so the semen was thick and moist even after exiting his penis. I have heard from other forums that this is safe sex and of no concern, even if I happened to "dip my penis in a pool of semen", do you agree with this statement?
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H. Hunter Handsfield, MD
12 months ago
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Welcome back to the forum, after a few years. Thanks for your continued confidence in our services.
It is correct that mutual masturbation -- or any hand-genital contact -- is risk free for all practical purposes, even if semen or other genital fluid (e.g. vaginal) is used for lubrication. Does that mean truly zero risk? Probably not: all we can really say is that our personal experience, and that of virtually all STD experts, is that they've never seen a patient with HIV or other STD whose only potential exposure was hand-genital contact, fingering, etc. So any risk is low enough to be considered zero for all practical purposes. But I wouldn't go as far as saying dipping in a pool of infected semen would be safe!
Since you mention kissing, I'll say the situation there is similar. There is a school of thought, largely from highly respected investigators in Australia, that kissing sometimes transmits gonorrhea among men having sex with other men. It's controversial and the risk from any single kissing event undoubtedly is low.
All in all, I see no need for testing for any STD after any single encounter of the sort you have described. OTOH, once you have had such contacts several times, it might make sense to be tested for common STDs anyway: better safe than sorry!
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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12 months ago
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Thanks for the quick reply Doctor, appreciate the response. So am I correct in assuming that even rubbing semen is not something to test over?
Would the other person's semen have to enter my urethra for infection to occur? Since the semen was on my hand for at least 30 seconds, would the infectiousness of HIV become null?
I plan on getting a rapid antibody test, specifically INSTI 7 weeks in the future. For such a low risk event, would a negative result be conclusive at that time?
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H. Hunter Handsfield, MD
12 months ago
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As I said, I've never seen (or heard of) any patient with any STD whose only possible exposure was hand-genital contacts. Obviously such events are common, and some of course involve more vigorous rubbing/massage than others. But having never seen such a case, it's fair to conclude that even with heavy rubbing, the HIV/STI transmission risk is extremely low. But I can't say it's zero.
If you're going to test at all, why wait until 7 weeks? You could have 95% assurance with a negative result at about 3 weeks. But it does take 6 weeks to be 100% confident in a negative test result.
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12 months ago
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Appreciate the confirmation. Just wanted one last question to ask.
You have said in your final sentences that testing 3 weeks would be 95% accurate.
Was that for 4th gen testing only? (Ag ab)?
I only have access to INSTI, which are 3rd gen (ab only).
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H. Hunter Handsfield, MD
12 months ago
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You're right --my mistake -- INSTI detects ~75% of infections at 3 weeks. Apologies. Conclusive ~8 weeks. But as discussed, you really don't need testing anyway. Don't lose sleep over this as the next few weeks pass.
That concludes this thread. I hope it has been helpful.
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