[Question #2192] encounter with transexual hiv risk

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92 months ago
hi
i just visited in moscow russia. i been there with csw transexul. she gave me massage and rubed her pennis against my anus but she didnt penetrate me. 
she put finger in my anus - she sucked my penis without condom for  1 second and then i stoped her and ask for condom. i sucked her with condom but it sliped and i stoped when i noticed that she also insert a toy (vibrator) with condom to me (penetrate). so all the encouter include - oral without condom recive and insere for few seconds, oral with condom, finger in my anus, rubing her penis without condom against my anus and she pentrate me with toy (with condom).
 now im in panic that those acts could put me in risk for hiv. im married and dont know if it safe to make love with my wife. pls help!
i hope its clear cause my english is not 100%.
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Edward W. Hook M.D.
92 months ago
Welcome to our Forum.  I'll try to help.  The prevalence of HIV is relatively high in Russia and over 10% of transsexuals there will have HIV.  Receiving oral sex, even without a condom is a very low risk activity with official estimates being that less than 1 in 20,000 exposures to infected persons will lead to infection.  I have never seen a person who became infected in this way.

It is not clear to me whether when the condom slipped as you performed oral sex on her whether the condom slipped off entirely or not. If the head of her penis was covered, even if the condom slipped there was virtually no risk.  If the condom came off completely, then the risk for infection, if your partner had HIV (which you do not know) is estimated to be less than one infection for every 10,000 acts of oral sex. 

The other activities you describe- mutual masturbation (penis rubbing) or penetration with a condom covered sex toy should not put you at risk.

Thus, overall, I would estimate that your risk for HIV is very, very low- less than a 1 in 100,000 (0.001%) chance and is probably not something to worry about.   I do not feel strongly that testing is needed in this case but you will need to decide.  If you do choose to test, you can test with a combination HIV antigen/antibody test at 4 weeks after your last exposure and be completely confident of your test results.  I hope that these comments are helpful to you.  Take care.  EWH
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92 months ago
ok. thank you!
those rates are real high so im little more stressed.
the condom slipped completely. I noticed that because the all condom insert to my moth. guess I was sucked her without condom for a few seconds.
she sucked me without condom for second or two, I stopped her right when she started.
you don't have to answer this question but if you where in my condition - would you just forget that story? I don't know if it's safe to make love with my wife.
damn I'm so angry about myself.
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Edward W. Hook M.D.
92 months ago
I'm not sure I agree with you- while the rates of HIV infection among Russian transsexuals is rather high, the rates of HIV acquisition from the sex acts you describe are very low.  For instance, with a 1 in 10,000 chance of getting HIV you would need to be performing oral sex on an infected partner once a day for over 27 years to be sure of becoming infected.

If I were in your situation, I would not be worried.  You will need to decide if you need to be tested before you feel comfortable having unprotected sex with your wife but I would not be too worried.  I hope this helps.  EWH

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92 months ago
thank you doctor.
last question - you didn't relate to the part when she rubbed her penis against the out side off my anus - is it no risk? 
I'm little confused, she didn't ejaculate at all so I didn't came in contact with her body fluids and you saying I'm not should be worried, but can't saying that it's safe to make love with my wife. I will ask it from other perspective - did you see medical reason for test due those acts, or you think I should do it just to feel better.
promise - that was my last post. 
best regards!
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Edward W. Hook M.D.
92 months ago
Frottage or rubbing of her penis against you anywhere (including the rectum) without penetration is safe, sex which does not put you at risk for HIV.  It is a form of masturbation.  We have learned that sometimes out clients are more nervous about heir encounters than we are.  For that reason, I indicated that I saw no reason for concern and would not be worried about unprotected intercourse with your wife.  Similarly, I see no medical reason for testing but if it will make you feel better, obviously you can test. 

This will conclude this thread which will be closed later today.  Take care.  EWH
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