[Question #3411] Question about recent exposure

38 months ago
Hello Doctors. 

On a recent trip in the US, I engaged the service of a body rub only CSW.  

One thing led to another and me performing analingus on her.  This was fairly deep and lasted 5-10 minutes.   Aside from a hand job that she provided this analingus (me performing on her) was the sole sexual act. 

Via this singular exposure, could I have contracted HIV?

I have a regular sexual partner at home and am very nervous about this.  

Thank you. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
38 months ago
Welcome back to the forum, but sorry you found it necessary.

As it happens, another recent thread (#3403) asked about analingus. My reply there is also perfect for this question:

"There have been no studies of analingus risk, but recent research suggests that saliva exposure (e.g. using saliva as lubricant) raises the risk of gonorrhea and maybe ohter STDs when the anus and rectum are exposed. So there may be risk to your partner, if you have oral gonorrhea. However, there are few if any STD risks for the oral partner. We know that cunnilingus (oral-vaginal contact) carries very low risk for oral STDs, and almost certainly it is the same for the oral partner in analingus. The main risk is for gastrointestinal infections. The most common such infection is garden-variety viral diarrhea (e.g. norovirus), so that's the main risk. There are possible but very much lower risks for hepatitis A, bacterial intestinal infections like salmonella, and parasitic infections, but these are rare in most female CSWs. In theory there could be risks of herpes and syphilis. Probably no measurable risk of HIV.

"All in all, the risks are low enough that I would not recommend STD testing of any kind. Be alert to the possibility of nausea, vomiting and diarrhea in the next few days due to gastrointestinal viruses."

And as I think you know, hand-genital contact is risk free, so no concerns there.

I hope this infrmation is helpfu. Let me know if anything isn't clear.

HHH, MD


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38 months ago
Thank
you, doctor. 

Shall I rephrase: based on the exposures described, this is a no risk event for HIV and no testing is necessary (unless for mental
reassurance)?

Would that be a fair summary?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
38 months ago
Exactly right.

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38 months ago
This will be my last question here. 

I have read the following on another forum:

HIV is instantly inactivated in air and also in saliva which means it is effectively dead so it can't infect from touching or oral activities. It doesn't matter if you and they were actively bleeding or had cuts at the time either because the HIV is effectively dead.   
Only adult risks are the following: 
1. unprotected penetrating vaginal 
2. unprotected penetrating anal sex 
3. sharing needles that you inject with. This sentence is all you need to know to protect yourself against HIV. Your situation is a long way from any of these 3. 
Even with blood, lactation, cuts, rashes, burns, etc the air or the saliva does not allow inactivated virus to infect from touching or oral activities. The above HIV science is 40 years old and very well established. 
No one got HIV from touching or oral activities in 40 years of HIV history, so likely no one will in the next 40 years of your life either

Would you agree with this assessment?   Does saliva inactivate the virus?


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
38 months ago
Yes I agree with the assessment, and indeed saliva inactivates HIV. That's probably while all oral sex and kissing carry little or no risk for HIV.

Looking back at your several other threads, most if not all the questions you have asked this time were addressed previously, and all concerned obviously low risk exposures. Here is a warning you were given in at least one of your previous threads:  "Please note the forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions about this exposure, testing, and your fears about HSV, syphilis or other STDs will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand."

That policy definitely will apply going forward. I do hope the various discussions have helped you, but this will have to be the last one along hese lines.
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