I recently visited a strip club while on a business trip.  While extremely intoxicated, I agreed to a private dance from a stripper.  I got carried away and begin rubbing her vagina, intrigued that she had a pierced clit.  I then inserted a finger in her vagina for about 30-45 seconds.  We were using her vaginal secretions for lubrication while I was rubbing her vagina.  There was absolutely no other sexual activity beyond hands in this private dance encounter.

I've read all over that fingering is a little to no risk.  I bite my nails and they were pretty short that night.  And no cuts.  I've seen similar (maybe worse with cuts) scenarios where Dr Handsfield has recommended no testing, and go on with sex with your spouse.  I have done that.  Though it's been 3 weeks since the strip club and now I'm feeling achey and had what i think might be a night sweat.  Might just be anxiety.  

Would like to know if I overlooked any other risks here.  And if you recommend testing?  

You have correctly predicted my response. Fingering and hand-genital contact, or contamination of hands of skin with genital fluids, is one of those theoretical risks that nevertheless never (or virtually never) carry actual risk in the real world. Nobody has ever been reported to have acquired HIV through such contact, of because of contact of contaminated blood or fluids with pre-existing cuts or wounds, like finger nicks, hangnails, etc. In spite of what some people might assume, it is not true that "just one virus" is enough to transmit. Look at it this way:  if a man has HIV with high viral load in semen, injection of that semen deep inside the vagina -- that is, a single episode of unprotected vaginal sex -- carries a transmission risk for the woman somewhere around once for every 1,000 exposures. What then could the risk possibly be for the exceedingly small amoung of virus that could come into contact with susceptible cells from the sorts of events you describe?

In addition, HIV remains more rare than most people assume in sexually active women. Even if we consider the stripper to be a commercial sex worker, the odds she had HIV are well under one percent, and more likely no higher than one chance in a thousand. In the US, the large majority of women who acquire HIV sexually are the regular partners of HIV infected men, who typically caught it from injection drug use. Of course there are plenty of exceptions, but few women are infected by their sex work clients -- and even fewer of those clients catch HIV themselves.

So I think you're just fine continuing sex with your regular partner and don't recommend testing. A single evening of damp sheets isn't the same as real night sweats, which result from high fever breaking during the night. Of the many symptoms that can be associated with a new HIV infection, none occur alone -- that is, any single symptom by itself is generally meaningless. A little achiness doesn't concern me either.

Of course you remain free to be tested, if the negative result will improve your comfort level. If so, have a duo (4th generation) HIV blood test 4 weeks or more after the strip club event. This doesn't mean I really believe you are at risk. It just recognizes that some people are more reassured by negative testing than by scientific analysis, no matter how expert it may be.

I hope this has helped. Let me know if anything isn't clear.

HHH, MD

To help me avoid becoming worried about every ache and pain, can you point out a series of symptoms (occurring together) that would concern you?

Best wishes and stay safe--  HHH, MD