I am very careful when I have sex. I always use condoms for anal intercourses and only get sucked. 

Yesterday, I licked or rimmed my partner's anus for like 20 seconds. I am not sure I pushed tongue in his ass. I didnot see his anus' conditions as we turned off the light. 

What are the hiv risks associated with this practice ? I am aware of hep A and microbes but confused about hiv risk. I read thzt there has never been a recorded case involving rimming but also that rimmed has never been studied as such.

I dont know if his anus had sore or if it was bleeding? I cant remember.

Should I get PEP? 

Thank you for your answer.

As Dr. Hook pointed out, many online resources, especially government agencies, make little distinction between common risks for HIV transmission and theoretical ones that in fact are rare or even nonexistant. The fact is that the vast majority of HIV transmission episodes involve the standard, well known risks:  blood exposure by shared drug injection equipment, unprotected anal or vaginal sex, transmission to babies during delivery by infected mothers, etc. While one can understand the possibility of transmission by such things as oral sex, kissing, blood or sexual fluid contact with cuts or nicks (e.g. during hand-genital contact or fingering), biting, exposure to blood or other infected secretions in the environment, stepping on a used needle, etc, etc, the fact is that there are few or no known cases of such transmission. So while it is not possible to say the risk from such exposures is zero, it is exceedingly low and may in fact be truly zero in many of these circumstances.

Analingus (rimming) falls in the latter category. Your statements are correct about no known cases and also no research on it. But the reasons for no research is that there is no apparent need for it. Who would spend valuable research dollars to study something that appears to have never happened? In general, mouth exposure or swallowing are low risk. For example, CDC has estimated that performing fellatio on infected men, with ejaculation in the mouth, carries an average risk of 1 in 10,000. That's equivalent to giving BJs to infected men once daily for 27 years before transmission might be likely. Obviously the amount of oral exposure through rimming is far less than taking an ejaculation in the mouth, so the risk must be correspondingly lower.

Some experts might recommend PEP in this circumstance if the anal partner were known to have HIV and to not be on antiretroviral treatment (ART). But even in this case, I suspect most would not and neither would I, and for sure I would not recommend it in the circumstance you describe, even if your partner's anus were known to be sore, bleeding, etc; and even if you had sores of some sort in the mouth.

You are already on a very safe path in regard to sexual risks for HIV, and you really needn't be worried about things like kissing, analingus (in either direction), mutual masturbation, fingering, etc. However, I would suggest you also start routinely discussing your mutual HIV status with potential partners before getting intimate, and either avoiding sex entirely or being especially careful with partners who are infected (or claim not to know their HIV status), and not taking ART. Because condoms sometimes fail, you are taking far more risk of HIV due to condom protected anal sex than you are by rimming or these other sorts of non-penetrative sex. Also, intentions for sexual safety sometimes are blown off in the heat of the moment.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Thank you Dr Handsfield for your very detailed answer.

I keep in mind Dr Hook's answer and fingering is no longer a risk to me. I am getting better at understanding and accepting risks. My  apologies for this question which falls in the same category than the one I asked to Dr Hook.

I did not have any sore or cut in my mouth. My tongue looked healthy.  Even if there was some blood, it could not get into my bloodstream. Therefore based on your answer, my risk is virtually zero - such as kissing - and I wont be the first to be contaminated by rimming. I can safely move on with my life. 

Please correct me if I am wrong.

Thank you. 

Thanks for the thanks -- I'm glad to have helped.