[Question #3673] Hiv and std risk

35 months ago
I'm a gay male. Yesterday I traded handjobs with another gay male who I don't know well. Today, a friend told me the guy is HIV positive and he's not sure how frequently he takes his meds. I'm having an anxiety attack. Here's what we did: we traded handjobs over the course of about 10 minutes. We used lubricant. His precum definately was rubbed onto my penis, testicles, and peehole. His precum may have gotten inside my peehole, but I'm not sure. His actual semen did not get on me. I had a small four day old cut on my hand that was not bleeding. Am I at risk for HIV or any other STD from this event? Do I need to seek out prep? I guess I'm most worried about his precum possibly getting into my urethra from the handjob.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Welcome to the forum. Thanks for your confidence in our services.

You shouldn't be at all worried. Neither HIV nor other STDs are transmitted by hand-genital contact, even when genital fluids, such as pre-ejaculate fluid, are used for lubrication. This sort of contact simply doesn't allow for enough virus or bacteria to come into contact with susceptible cells. There has never been a known case of HIV transmission by hand-job. Having small cuts, abrasions, rashes etc of the hands or genitals makes no known difference. If you thin about it, there must have been billions of episodes of hand-genital contact, fingering, etc between HIV infected and uninfected persons during the 30+ years of the worldwide HIV/A(DS epidemic, and since such lesions and rashes of the hands or genital are common, there must have been millions of exposures in their presence. But no known infections. The same is true for other STDs. You really shouldn't be concerned and do not need testing for HIV or other STDs on account of these events.

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

HHH, MD
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34 months ago
Thanks Dr! This is really reassuring. I guess it surprises me that getting his precum on or possibly in my urethra is no risk in the context of mutual handjobs. But I trust you! In the future if I continue the activities I described I now understand it’s risk free. How about if I ever took it one step further and I the other guy and I rubbed our penises together during mutual masturbation with precum present? Is this still risk free? Would it be because it’s notvtaking place inside the body? Thank you for your help. 
34 months ago
I was just reading through other questions and saw #3366. I’m a little worried now. The other guy’s (who was hiv+) precum definitely got onto my urethra  (and possibly into my urethra during the hand job). I’m confused now if this was all still no risk as you first replied in light of the answer to 3366. I’m sorry to ask for clarification. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
That user asked about direct urethra-urethra contact. As I said there, even then, the risk would be trivial with no known cases of HIV ever byding so transmitted.

Like a lot of people, you seem to assume that any exposure at all to HIV -- "just one virus" -- might be enough to transmit. Not true. It takes lots of virus having contact with specialized cells, typically deep inside the body. Even in the highest risk of all sexual transmission scenarios, i.e. ejaculation by an HIV infected man into the rectum of an uninfected one, transmission occurs only once for evern 200-500 exposures. If a woman is infected, unprotected vaginal sex, lasting several minutes, has 1 chance in 2,500 for the male partner. Given these numbers, how high could it possibly be with the very small amounts of fluid involved in the events you have described.

So this doesn't change my assessment of your situation or my advice. But of course you are free to be tested for HIV if the reassurance of a negative result would be helpful beyond my words.
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