[Question #4475] Dr Hunter/Hook - Still worried re fingering with cut
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82 months ago
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Dr H/H-Im a mess. #4429
Im 40 male nurse, I think my activity is negligible risk. Please reassess in light of recollected events.
Day 0- fingertip cut by thick metal foil, bled, stop by plaster. deep cut/flesh seen.
Day 1- travel Thailand. Allow for time zones;18hrs later I masturbate +/-finger Thai CSW with uncovered cut finger. She offer sex so I feel she hiv risk (I refuse). She gave handjob with wet hands. Not aware of bleeding but was dark room.
Days 5&10- handjob from masseuse/ladyboy respectively.
Day 9-11- on/off mild nausea/epigastric pain.
Day 12-18- worse on/off nausea/epigastric discomfort (settled day18), aches pains in muscles>joints, mild sore throat & painful ?small neck glands. Felt hot-no fever. Felt/looked unwell. Thought I needed admission.
Day 19-23- tingling & weak feeling both legs, felt hot-no fever, nausea returned. Still mild painful neck.
Now Day 24- transient feeling unwell/nausea/tingling distal limbs. Lost 2kg.
No cough/runny nose/rash. Dont think fever.
Convinced ARS from HIV vaginal secretions in cut finger. I cant explain symptoms/their timing. No other diagnosis fits & ABx not helped. I want believe no risk & i feel i didnt finger just rub outside genitalia but Keep thinking people got HIV from this exposure but as they also had other exposures ?oral/penetrative sex - how prove cause.
thebody.com keeps coming top of google and they say low risk not no risk?
Its not just anxiety,i know this.improving but felt horrible last week+
is poz.com reliable site?
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H. Hunter Handsfield, MD
82 months ago
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Welcome to the forum. Thanks for your confidence in our services.
You really needn't be worried. There is no way you caught HIV or that ARS is the cause of your symptoms. Nobody has ever been known to be infected with HIV by hand-genital contact, fingering, etc -- even if there was simultaneous exposure to blood, or if genital fludis are used for lubrication. Cuts on the fingers are very common, so billions of fingering events must have occured with cut fingers -- still no known HIV infections.
Second, your symptoms are not at all typical of ARS. Without sore throat, very obviously enlarged (not "slightly" or uncertain), fever (not just feeling hot), and/or typical skin rash, ARS is very unlikely. Your symptoms are much more like a gastrointestinal viral infection of some sort, which of course is very common in travelers to Thailand or developing countries in general. I have no doubt you have had some sort of infection, i.e. it's not anxiety -- and I'm glad to hear it's getting better. But you did not catch HIV and it isn't ARS.
I'm not very familiar with poz.com, but thebody.com is very reliable. The key to reliability from such sites is that they are run by professionals, e.g. public health agencies -- or, like this site and thebody.com, moderated by science based professionals.
You should have an HIV blood test, preferably an antigen-antibody (AgAb, duo, combo) test. Not because there is any chance you have HIV, but because anxious persons in your situation usually need the negative test result to convince themselves they aren't infected. If you do it now, it will prove your symptoms are not due to HIV (everybody with ARS symptoms has a positive test).
I hope this information is helpful and reassuring. Let me know if anything isn't clear.
HHH, MD
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82 months ago
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Thank you for your reply,
Despite being asked the same Q's over and over again, you continue to always patiently provide helpful answers.
I wondered if you could clarify some points for me.
In my original post i did say that had a sore throat only that it was not severe. Online material state not all symptoms need to be present in ARS, and despite no confirmed fever or rash, i did have sore throat, nausea, myalgia, arthralgia, & now pins & needles from knees down & wrists. I only stupidly went & put my symptoms into an online diagnostic tool which had to list HIV in the top 20 diagnosis!!! I am aware you will advise me to stay off the net so can you at least tell me
(1) Do ARS symptoms come & GO at the same time. The reason i ask is that most of my symptoms have gone but i have had pins & needles below knee to feet & wrists, & episodic nausea only. I have had a rush of blood & weak/aching feeling last 2 evenings for 30-60 minutes or so. But sore throat settled. My worry was i didn't have sneezing and runny nose for coryzal diagnosis, nor cough or fever for flu diagnosis, nor Diarrhoea/Vomit for Gastroenteritis diagnosis.
(Generally) how deep a finger cut would have to be to be considered real risk during masturbation or fingering?
(2) Would a cut on the fingertip by a knife than bled be considered as deep if it stopped with soon after applying a plaster?
Unfortunately I can not test until April when I get back to my home country.
(3) Will this be an issue for accurate testing?
Regarding thebody.com - recent answers regarding fingering with cuts state no risk, but older answers from Dr Bob used to state low risk. There archived posts have caused me a lot f stress. Poz.com state no risk & from fingering even with bleeding cuts (you should check their forum out).
(4) Would you agree with this?
Finally.
(5) In the absence of an obvious diagnosis for my symptoms, their timing (9-25 days after intimate contact), & the nature of my intimate contact (?fingering/rubbing wet genitals with cut finger), do you think it may be due HIV or are you confident it is not?
I have now started to worry if any of the CSW may have secretly injected me with HIV blood. I know this can't be true. So after reading your answer I will strive to stay of the internet.
Thank you for your time & patience in advance
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H. Hunter Handsfield, MD
82 months ago
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1) You're a nurse, so a professional slant on this question: some of your symptoms can occur in ARS, but all in all, they do not fit the pattern and are not typical. Anxious persons read lists of symptoms people can experience, see that they have 5 of them (maybe among a list of 25), and say "Damn, I've got it." Very faulty reasoning. Even with an entirely typical pattern, the symptoms are nonspecific, i.e. common in many medical conditions and therefore do not reliably point ot any single condition. Surely you have cared for patients who present with fever or any other complex of symptoms and signs that leave the doctors puzzled, because many explanations were possible, until the acutal diagnosis finaly emerges (or sometimes never does, as the patient recovers). For the same reasons, even in persons with entirely typical symptoms (and pattern) for ARS, the large majority do not have it, even if they have been at risk for HIV. And your symptoms and pattern aren't all that typical anyway.
2) No data exist, but the general consensus is that if a wound isn't fresh and bleeding, any risk of exposure to HIV infected blood or fluids is low. At least there are no reported cases of anybody ever catching HIV through an existing cut. Virtually all injury-related infections occur when the injury is with an HIV contaminated sharp instrument. (That's why you've been trained so assertively about sharps safety.)
3) As I said above, you don't need testing at all, except for reassurance. If you do it, a test any time more than 4-6 weeks after the exposure -- and for the rest of your life after that -- will be accurate. But probably you can be tested wherever you are. Even in countiries that eject HIV infected persons, e.g. in the Middle East, it isn't being tested that's the problem; and those rare persons who test positive have to leave anyway in order to get life saving health care. I am aware of an STD clinic in Dubai that tests many ex-pats on a regular basis (and almost never has a positive result among them).
4) I have read thebody.com quite frequently. Nobody can say exposure via a cut is truly zero risk. But with no proved cases ever reported, it's at least rare enough to be disregarded. I would advise you and anyone else to avoid fingering a sex partner if you had cut your hand immediately before the event. It's just common sense. But even then the risk probably would be low.
As for the CSW intetionally trying to infect you, either sexually or by injecting blood -- that's just plain nonsense and you know it. And how would she inject you without your knowledge? This question indicates a potentially serious mental health issue contributing to your fears. Maybe you should consider professional counseling -- mentally normal people don't have such thoughts. I suggest it from compassion, not criticism.
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82 months ago
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Thank you for your answer
As per the guidelines this will be my final post. May as well make use of the opportunity.
Both yourself & Dr Hook have told me that i need not worry regarding HIV given my intimate contacts - in particular fingering with a cut. Another forum has said the same and many other sites I have read state the same. There are a few sites that mention HIV transmission through cuts is possible which causes me to panic but they do state no known cases which again reassures me that it is a theoretical risk. If I wasn't symptomatic I would probably not test.
Given I have been unwell I will test when I get the chance in April.
Currently I am on Day 28 post contact and feel better today than recent days, the nausea is 95% better, sore throat 99% better, and neck ache 90% better. I am no longer feeling hot. I still have aches in my legs at times but my main worry is the tingling, from the soles of my feet to the my ankles and much less so in my hands. I am not looking for this but notice it is happening. There is no pain or obvious burning.
Up until now i am a healthy individual with no medical or surgical history and no medication daily use. This is why I guess I am getting worried.
1 - Can one ARS symptom appear later than others and remain whilst others settle? Clearly I am worried about ARS Peripheral Neuropathy.
2 - Finally to confirm - a bleeding cut from the thick foil of a medication blister pack that stops bleeding some minutes after pressure and plaster are applied is still classified as a paper cut - in relation to the answers given on the forum as regards paper cuts and HIV transmission.
Thank you for your advice, and I hope you keep well and continue this helpful resource.
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H. Hunter Handsfield, MD
82 months ago
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1) No. All symptoms appear at pretty much the same time and resolve on a similar schedule. Re-read my reply to no. 1 in your original question above.
2) The cause of the cut makes no difference. A fresh cut could risk HIV if exposed to the virus. But of course there are no data on the details you ask about. All I can do is repeat again that nobody in the world has ever been known (or to my knowledge, even suspected) to have caught HIV because a skin cut was exposed, for example by fingering or other hand-genital contact.
There is no realistic chance you have HIV. Of course you are free to be tested, as I recommended in my original reply. It's obvious that my knowledge and advice aren't convincing you. Maybe a negative test result will. I hope so.
I hope the discussion has been helpful. Best wishes and stay safe.
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