Context: A woman, whose health status is unknown but is known to have had multiple partners, gave me a handjob. Before she started, she applied hand sanitizer. She then used a condom, which she put on me. While doing so, she steadied my penis with her other hand. However, her nails, which were quite long and from a nail salon, accidentally made contact and possibly scratched either my scrotum or shaft. I didn't notice any bleeding or visible scratch marks, but it's possible there were tiny scratches that weren't visible to the naked eye.

For argument's sake, let's say she was HIV positive. My question is: Could HIV be transmitted through a nail scratch on my scrotum or shaft if it did scratch, even though it wasn't visible to the naked eye? Although she used hand sanitizer, I'm concerned about the hypothetical scenario in which there was blood or bodily fluid on her nail. Could this pose a risk of HIV infection?

I'm a bit nervous because, even while trying to be careful, the nail made contact with my shaft or scrotum, the scratch did occur, despite it not being visible. Could I get your assessment on whether I should be okay or if I should seek medical help?

Thank you, Doctor, for your assistance.

Not only is receiving oral sex little or no risk for HIV, so is hand-genital contact. There has never been a known case of such transmission. And if you think logically about it, there must have been millions (perhaps billions) of such events involving HIV infected persons and some of those must have had minor scratches of the penis; or occurred in the presence of pre-existing cuts, wounds, etc. And yet still no known transmissions of the virus. This is true regardless of using genital fluids or saliva for lubrications. And of course condoms in this situation provide an additional layer of 100% protection. As for a fingernail scratch that doesn't even leave a visible wound, of course that makes no difference. You cannot expect hand-genital contact that doesn't have possible contact with the partner's fingernails.

If for "argument's sake" we assume your partner the chance of HIV from this event remains zero. You definitely do not need to "seek medical help" of any kind and should not be tested for HIV on account of this event.

Please understand this:  Nobody ever gets HIV sexually without unprotected penile penetration into a partner's vagina or anus. As you learned in your two previous discussions with Dr. Hook, even unprotected oral sex is risk free (or such low risk that it can be considered zero risk, since here too there has never been a proved case of HIV being passed in this manner.

I hope these comments are helpful. Let's make this your last question until such time as you have an unprotected episode of penile penetration with a potentially infected partner -- OK?

HHH, MD