[Question #12880] Does this count as a risk for HIV?
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4 months ago
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I am a queer female from the US. I had an encounter with a couple (cis male and female) from developed western countries. They claim they have been monogamous for over a year a tested for STIs prior to getting together in a relationship. As far as I remember (it was quite late, and I was tired) we only used hands (I.e they fingered me, I fingered the woman). I did not touch the man’s penis. I do not believe he penetrated me with his penis — i asked immediately after we finished just to confirm (my back was facing him the majority of the time) and even again the next day and he said he only used his hands. If anything, he maybe touched the entrance of my Anus/vagina with his bare penis but I do not recall full penetration. It is important to note that the couple identified as queer but again claim to have been monogamous and previously tested before entering their relationship. I typically demand to see test results from partners before having any sort of sex but I made a mistake in the heat of the moment by just taking their word for it.
I became very anxious because the next day, I noticed some superficial tears at the opening of my vagina, presumably from rough fingering (it is not uncommon for me to tear from sex) However, upon seeing the blood my first thought was potential HIV exposure. I know that HIV does not transmit through intact skin (I.e intact skin on hands and fingers) but my fear comes from 1. Possibly precum on his hands or vaginal fluid from the female or 2. Brief unprotected insertion/external genital rubbing that I may not have noticed, again potentially with precum. I don’t think they would have reason to lie about there not being any insertion, but I suppose you never know.
In the scenario described above, would you recommend testing? I am admittedly very anxious and almost willing to spend a lot of money on a PCR test at the 9 day mark.
Thanks again.
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Edward W. Hook M.D.
4 months ago
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Welcome to our Forum. Thanks for your questions. I'll be glad t comment.
My recommendation is to trust your memory. Even if you were tired or had been drinking, you would know it if penetration had occurred. Simply touching a bare penis to your rectum of vagina would not put you at risk. If the encounter involved only masturbation, even if one of your partners transferred their genital secretion to you on their hand,, then the encounter you describe was virtually no risk. There is widespread agreement by all experts that mutual masturbation, even when participants transfer genital secretions to one another on their hands, is a no risk activity for HIV or virtually all other STIs. Exposure to the environment as well as the physical process of transfer eliminates infectivity and therefore risk for infection. As a general rule, no penetration, no risk, even if one of your partners did have HIV or other STI.
in terms of testing, this is always a personal choice. If you are anxious, the cost of testing may be worthwhile to address your anxiety. If HIV is your major concern, HIV RNA PCR testing will be entirely conclusive any time more than 11 days after the encounter and testing with a 4th generation, combination HIV antigen/antibody test will be 98% conclusive at 4 weeks and entirely conclusive at 6 weeks. Testing for more common STIs such as gonorrhea or chlamydia can be performed much sooner- any time more than 3-4 days after the encounter.
I hope this perspective and information is helpful. EWH
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4 months ago
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Hi Dr Hook, I genuinely appreciate your compassionate and thoughtful response. That does help to reassure me a bit.
I guess the part that concerns me the most is the tearing around my vaginal opening. The tears were pretty shallow but definitely bled. Even with those tears, would you consider potential penile rubbing against my vulva/anus as relatively low risk?
I am definitely reassured that my partners were very willing to discuss their sexual history and testing even though it was after the fact (which is obviously not ideal). I do acknowledge that I have health anxiety which is of course my responsibility to manage, I guess I just wanted to ask an expert opinion rather than drive myself crazy with Google.
Also forgot to add that the male did not fully ejaculate at any point.
Thanks again!
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Edward W. Hook M.D.
4 months ago
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I did consider that you noted tears, as well as your stated tendency to tear during sex in my response. In general, blood exposure would not change my assessment, whether it was a partner's blood or yours (that said, given the tearing, the blood would be most likely yours, not his and the flow of blood would be from inside your body outwards while t0 cause infection would require introduction of infected material into your blood stream).
I remain confident there was virtually no risk of HIV to you from the interaction you describe.
---p.s. I applaud your decision not to pursue your questions on Google as well :). EWH
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4 months ago
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Thank you so much for your quick responses, you (and the rest of the experts here!) are truly providing an amazing service :-)
I am definitely reassured by your expert opinion. I’ll plan to get a test in a few weeks just to be safe (I always get tested after new partners anyways!), but I certainly feel less anxious now. It was hard to find a specific scenario like mine on this forum so I felt it was worth to ask :-) I assume you wouldn’t recommend RNA testing in this scenario? And rather just routine 4th Gen testing when I go for a routine panel?
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Edward W. Hook M.D.
4 months ago
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Correct. I think your risk of infection is close to zero and if you’re comfortable with doing so, would suggest waiting until you can get a fourth generation test and have accurate results. (6 weeks to be entirely conclusive although results will be more than 98% conclusive at 4 weeks)
We provide up to three responses to each clients question. This is my third response. Thus this thread will be closed shortly without further responses. Take care. Please don’t worry. EWH.
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