[Question #4482] Mutual Masturbation and Anal Fingering

31 months ago
I am experiencing regret and worry about a recent encounter. I met a man on the internet - 10 days ago. We masturbated each other and he put his finger in my anus for a while, not hard or very long. (An inch deep for a minute or two).  Although our hands did go back and forth, For the most part, I had one hand on him and he one on me. I did rub my hands together after touching when applying lube to both of us. He did not have an orgasm. There was no oral or anal sex. I have been married for 20 years and have not had any other sexual partners. My curiosity has finally gotten me in a bad situation. I read your site and understand that this is probably safer sex, but can you address the following exposure risks. 1.  HEpatits B. - The internet says fluids from this could  cause Hep B.  I’ve read there is a shot you can get within 14 days of exposure. Should this be considered?  2.  HSV - I have been sensitive to feelings in my penis and the head seems sore/red/pink. 3.  HPV. 4.  Syphilis. 5. HIV.  I feel itchy and super aware of my body, examining it frequently.  Wondering if it is OK to have sex with wife. I will never do this again. Thanks. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
31 months ago
Welcome to the forum. Thanks for your question.

First, congratulations for having safe sex. Between men, any sexual practice other than anal sex (penile-anal penetration) is safe sex. Even oral sex is very safe, with very rare HIV transmission -- indeed, very few or no proved cases from mouth to penis. Fingering, body rubbing, etc are risk free, or sufficiently low risk to be considered zero. All this applies to HIV; the risks are probably a bit higher for other STDs, but stilll low.

1) Yes, hepatitis B virus is possible, but still very low risk. Most HBV transmission is via semen in the rectum or by blood  contact. If your partner were known to have untreated HBV, the anti-HBV immune globulin shot might be wise, but not otherwise. Or just talk with your partner and see if he has been vaccinated against HBV, in which case no risk. For that matter, what about you? If you're under age 30 or so, you likely were HBV vaccinated yourself when young.

2) Herpes is very unlikely without either anal or oral penetration. Herpes doesn't cause increased penile sensitivity or redness. Without obvious blisters/sores, you can be confident you were not infected.

3) HPV probably is the highest risk here. Still probably low risk, without penetration, but good data on this are not available, especially for mala-male contact. However, all sexually active persons get infected with HPV, often several times. Assuming you have not been lifelong monogamous with your wife, this particular event does not further elevate the chance you have HPV. Even if your wife someday has an abnormal pap smear, there would be no basis to link it with this event. Don't worry about it.

4) Syphilis also is possible, but also rarely transmitted without anal or oral penetration.

5) HIV:  See my opening comments above.

Should you be tested? From a risk analysis standpoint, there is no need, and it is safe to continue your normal sexual practices with your wife. That said, anxious persons often are more reassured by negative test results than by expert opinion based on probability and statisitics. If so, have syphilis and HIV blood tests (an AgAb, i.e. duo, combo, etc HIV test) 6 weeks after the event. For all the others, the risks are too low and/or the tests too unreliable to be tested.

Another approach is to contact your partner and discuss his current risks and infection status;  and perhaps get tested together. For all you know, he might be as worried about his risk from you as much as you are from him. If you're both tested and negative at this time, you'd both be reassured and no need for testing in a few weeks.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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31 months ago
Thank You Dr for you quick reply. To follow up, I have tried to find the partner on the social media site that I met him on. He is either not there any more or has blocked me which makes me nervous. I did ask him about his status at the time and he said that he was tested a couple of months ago and was clean of STDs. That being said, he seemed rather experienced and promiscuous after I met him. I wonder if he was telling the truth. 
Which brings me back to a couple of questions.   The whole time we were together he did not touch himself with the hand that was touching me. I took the hand that I was touching him with and rubbed lube between it and my free hand  and applied the lube to my penis with that free hand.  He continued to rub me with that same hand that had not touched himself  and that is the hand that fingered me. I do not think that hand would have gotten any seminal fluid on it  except possibly if I had a trace on my hand when I rubbed the lube together.   I am wondering about the risk of Hep B from this description. If the only Semen was a trace and it had dried on my hand before rubbing the lube together and applying with my other hand and then later the light fingering. Could that cause much risk of HepB and should the shot be considered?  He said that he was 29 years. I suppose he could have been vaccinated as a child?  I am older and have not been vac. 
I examined my Anus for blisters and thought I saw some but realized they were skin tags and/or hair follicles. The head of my penis seems rougher than normal and I notice stretch cracks more that I normally do, but usually I am not examining it so much. There seems to be some minor redness/pinkness in those cracks. I see a few bumps on the side of the head that are the size of the tip of pen. They do not seemed raised much and are not fluid filled.  They may have been there before. I seem to be looking really close. No defined blisters that I can see. I have suffered from penile yeast infections before and redness from  leaking urine which causes redness on the shaft and/or head. I suppose/hope I could be suffering something like that.   Could what I describe be the beginning of an HSV outbreak?  If it was the beginning how long until I would notice the blisters for sure?  How long until they broke open? I have an awareness, fullness feeling in my anus and penis when I am walking around. I get the feeling that something isn’t right. I have applied an anti-fungal cream in the past. Would it be OK try that for the redness in the cracks on the head and the back of the shaft?  Thank you for your advise on testing. You do not advise the HSV test because they are not accurate?
I know I probably sound irrational and extra fearful. In a moment of weakness I decided to explore a side of myself that I always wondered about. That being said, you are correct I have become anxious over this. If I make it through this without destroying my marriage, I will NEVER do it again. Thank You so much for your help DR. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
31 months ago
You're over-analyzing all this. The amount of risk to you, for HBV or anything else, has little if anything to do whether he "touched himself" before contacting you. Anyway, I find it difficult to believe you can be certain whether or not he touched himself during these events.

You also should not be examining yourself. If you don't feel anything abnormal with your anus or anywhere else, there's no need to examine yourself vistually. An initial anal infection with HSV, for which you weren't at risk anyway, would be quite painful.
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31 months ago
Hello DR,  I wanted to run my most resent symptoms by you. I have noticed itching in my butt crack (between the cheeks, not all the way down to the anus).  Starts to 3 inches above anus and to top of butt crack. On inspection tonight, I notice a red rash  the whole length of the crack that is somewhat itchy. I do not see any blisters on it. Again, it does not go all the way to my anus. If I would have been infected with HSV, as decscribed in my original post, could I expect an initial outbreak in the vicinity of this rash.  It
Has been 15 days sense exposure. .  If this is not the beginning of an HSV outbreak, what else could it be?  I am worried. Thanks DR
31 months ago
Hello Dr’s.   My mind has been getting the best of me. Could you please advise on these questions. I went to the DR. Last Thursday. 2 -weeks post exposure. She examined my PEnis and didn’t see anything remarkable. She suggested testing. She did the Herpies IGG test - negative for HSV 1and2. Syphilis IGM and IGG - negative. Chlamydia and ghonerea. Both negative. I know from your forum that the HSV doesn’t tell me much at that point. Correct?  Will the IGG ever show a new infection at 2 weeks.   How about the Syphilis at this point?  I did not show the DR my butt. The thing is, the day after the DR office - Friday night - I noticed a rash on my bottom, not right around the anus but back further. It is red, but I have not notice any fluid filled blisters on that area. .   I have been aware of the rash for three days now. If infected, should I see blisters on this rash by now. Could this rash be something else.  I know I am super sensitive and do not look down there much.  Any advice would be appreciated!!  Thanks. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
31 months ago
Sorry for a couple days delay in getting to this.

Your symptoms are not at all typical for herpes or any other STD, as I'm sure your doctor told you. The blood tests you mention were too early to detect any of those infections; they're slightly reassuring, but are more important as a baseline for later testing, i.e. to know you didn't have them before the exposure. I'm confident your rash has absolutely nothing to do with the sexual exposure you are concerneda about, and part of the problem is that you're now more sensitive and aware of trivial meaningless symptoms, or even normal body sensations that you otherwise would ignore.

Continue to follow up with your doctor if you remain concerned. But I'm confident you have no STD from that exposure.

That completes the two follow-up comments and replies included with each question, and so ends this thread. I hope the disucssion has been helpful.

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