[Question #12493] Fingering with cuts and Unprotected Oral

7 months ago

Hi,

Exposure was 33 days ago. Received unprotected oral from a female friend and fingered her. The female had just started her period and there may have been some blood. Morning after I noticed two small dried cuts below my fingernail of the sort that happen when skin peels due to dehydration. Female has been in monogamous relationship for a number of years as have I and this was a one off for me and potentially for her outside of these relationships.

1. If my cuts were fresh at the time of the fingering what are my risks for HIV and Hepatitis? This took place in India and the female is Indian. I developed a blister on the cut on day 4 and on day 6 I was prescribed Flucloxacillin for 5 days and the symptoms improved within a couple of days.

2. I have had no penile symptoms and I did a Urine test for Gonorrhoea and Chlamydia on Day 11 which came back negative. This was a day after my antibiotics course ended. Could the antibiotics have cleared up an asymptomatic infection I had and resulted in a negative test? Would Flucloxacillin in that dose also prevent/cure syphilis?

3. Day 31 onwards I have noticed ongoing loose stool and very mild pain/discomfort in my right lower abdomen. Could this be related and a cause for concern?

Edward W. Hook M.D.

7 months ago

This was a no risk event. Your friend sounds to be low risk but more importantly, masturbation (fingering) is a no risk exposure in terms of HIV risk with no need for even testing. The presence of small cuts does not change this. FYI, in infected persons, the amount of HIV present in menstrual blood is about the same as is present in genital secretions.

1. No change in my response. Zero risk

2. Your penis was not exposed. Therefore there is no risk of penile gonorrhea or chlamydia. These infections are transmitted only through direct contact. The flucloxacillin is likely to have prevented syphilis.

3. No

Please don't worry. There is no need for testing. I encourage you to move forward without concern. EWH

---

7 months ago

Thank you for your prompt reply, Dr Hook. Having read your site for the past month I understand that rationally my worries are most likely based on anxiety and guilt. However, I just want to take this opportunity to gain additional knowlege.

1. My female friend has been promiscous in the past and I can't be 100% sure she has been completely monogomous recently. Does this change your opinion at all? What are the chance that because she is in India she has Hepatitis B and could have passed it on through the activities described? I'm not worried about HIV but Hepatitis is said to be more contagious than HIV. I'm not sure if either of us are vaccinated.

2. Just to clarify my penis was exposed as I did receive unprotected deep oral. I did not develop any symptoms but did have intercourse with my regular partner which was briefly unprotected but then with a condom to finish. This was on day 2 and then again on day 8 and 9 after exposure. By day 8 and 9 I was already on the antibiotics. My partner complained of having a particularly painful period last week hence my worry that I passed something to her while being asymptomatic before I started the Flucloxacillin and subsequently tested negative. Does this change your advice at all? Could she develop painful periods within a month of me passing an infection to her?

Edward W. Hook M.D.

7 months ago

You did not mention the you had received oral sex, not that that changes my assessment. The information you receive will only be as good as the information you provide. When you leave things out it does not help.

1. That your partner, whom you just said was monogamous for a number of years does not change my assessment. Your risk of hepatitis B remains very low.

2. In the absence of symptoms, it is unlikely that you were infected. Your urine test for gonorrhea and chlamydia make it very unlikely that you infected your regular partner.

You have one follow-up remaining. EWH

---

7 months ago

Sorry Dr Hook but I did mention the Oral in my first line - "Exposure was 33 days ago. Received unprotected oral from a female friend and fingered her"
It was maybe just overshadowed with all the other information I included subsequently focussing on the fingering.

So to recap -

1. My risk of Hepatitis B is very low even with the menstrual bleeding and cuts on my fingers?

Can this be quantified at all?

Is the risk of infection still low even if she had Hepatitis B?

2. For the unprotected oral - it's highly unlikely that I was infected in the absence of symptoms and a negative test though as stated my worry is about the painful menstrual period my regular partner complained about.

Could she develop painful periods within a month of me passing an infection to her?

Can a sexual infection spread to Pelvic Inflammatory Disease so quickly or is this just a coincidence?

I assume if I had come to you in a clinic you wouldn't recommend any testing?

All in all you have put my mind at ease and once I get your advice on the queries above I am ready to put this behind me.

Thank you!

Edward W. Hook M.D.

7 months ago

Thanks for the clarification. Sorry I missed the mention or oral

1. Hepatitis B is present in infected persons in similar amounts in genital secretions and blood in persons with active hepatitis B. You have no evidence that your partner has hepatitis B- I would not worry.

2. Yes, IF you had infected your partner, she could develop pelvic inflammatory disease. Painful periods however are not a sigh of PID. I suspect her uncomfortable periods are coincidental.

Testing is a personal choice. I see little reason to test (either for gonorrhea again or for hepatitis B) from a medical perspective. If you do so to relieve your anxiety, that is up to you.

This completes this thread which will now be closed. EWH

---