[Question #6355] HIV Risk and Fingering

17 months ago
Hello Doctors,

I am male and visited a male massage studio.  I ended up fingering the masseuse.  I didn't have any cuts on my fingers or anything, but I do have dry skin from it being cold.  I noticed after my massage, I did have one dry spot where the skin was peeling on my index finger from being dry.  Honestly, no more than a millimeter or two.  (Kind of looked like a hangnail where the dead skin is still attached)  At any rate, the new skin underneath was pinkish but completely formed. I had no blood or anything. You read so much online these days, it has me terrified to be honest.  Also, this is my only sexual episode of any kind for months. So I am not even remotely concerned about anything else.

1. What, if any, is my HIV risk for this episode?
2. Do I need to test for this?  I don't want to hurt my significant other.

Thanks!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
17 months ago
Welcome back to the forum. Thanks for your continued confidence in our services.

I glanced at your discussion with Dr. Hook almost 3 years ago. As discussed then, oral sex is extremely low risk for HIV transmission. Hand-genital contact, including fingering the anus (or any body opening) is even lower risk, indeed risk free or very close to it. There has never been a reported case of scientifically docukented HIV transmission by fingering. And obviously, since various cuts, nicks, skin problems, etc are very common on the fingers and hands, there must have been millions if not billions of fingering episodes with HIV infected partners in presence of such skin problems-- yet no known transmissions.

Those comments direclty answer question 1. Do you need to test? From a medical/risk perspective, definitely not. On the other hand, many anxious persons find negative tests more reassuring than professional advice, no matter how expert the source. (I don't take it personally!) Also, all people at potential risk -- which includes most men who have sex with men should be tested for HIV from time to time, e.g. every year or two (even if entirely or mostly monogamous). So if a negative test will help you sleep, or if you haven't had an HIV test recently, this probably would be a good time, while it's on your mind.

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

HHH, MD
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17 months ago
Hi Dr. Handsfield,

Thank you for your response.   As a bisexual male in the Midwest without access to a lot of resources nearby, I've turned to you and Dr. Hook's advice at the various places  that you have educated for about 6 years. It is a privilege to get to converse with you.

I appreciate your advice below.  I actually am what you would call an "overtester" more than anything.   Due to upbringing and other things I'm sure, I believe I confuse guilt with science in this area . Which is odd because in other areas of my life I tend to be very logical.   (I'm guessing I am not the only one you have seen with this problem over the years?)

Anyway, I decided ahead of time with this event that I described to you in my initial question,  I'm going to break the habit of testing out of some personal guilt issues I have and follow your advice, whatever it would be, and quit trying to equate emotion with the science.  When I look at this objectively, if I needed to test from this episode, you wouldn't have hesitated to tell me to get tested.   So, I will continue to test regularly every 6 months, and in the meantime, I'm going to release this episode from my mind and live life for a change.

Thanks again for all you do.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
17 months ago
I'm glad to have been of help. Don't give this particular event another thought -- certainly it does not justify altering your ongoing strategy of testing twice yearly.---
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17 months ago
Hi Doctors,

I am now clear on the fingering episode but since I have one additional response, I will use it to address one final concern. On November 3 (33 days ago) I had another massage and in that one I provided oral sex with no ejaculation. 

I did an RNA test on November 14 (11 days) which came back negative, and then a 4th gen on both November 26 (23 days) and December 2 (29 days) as I thought that was conclusive based on previous guidelines. All were negative. I didn’t think to mention this is my earlier post because I learned after of the new 6 week conclusive guideline. This would be on December 16 which is actually 43 days because labs are closed on Sundays. Do you think based on your experience I will see a change from my earlier tests?  And just to confirm, I don’t need to do any other tests for the fingering episode on December 1 from my original post  at all, correct?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
17 months ago
The opportunity for follow-up comments is for clarification of the main/original question, not to raise entirely new issues. The quick response is that you can consider your current test conclusive. The extremely low risk of HIV from oral sex was discussed in your previous thread a few years ago. With this exposure and testing done so far, the chance you have HIV is under 1 in several million, zero for all practical purposes. I've never seen or heard of a patient whose test became positive between 4 and 6 weeks. Of course you're free to be tested again if it will make you feel better, but I certainly wouldn't do it if somehow I were in your shoes. (I wouldn't have had an HIV test at all.)

That concludes this thread. Please take home the bottom line:  men who have sex with men are infected almost exclusively through unprotected anal sex. It shouldn't be necessary to ask about any other sorts of sexual exposures. But I do hope this discussion has been helpful. Thanks again for your conifidence in our services.
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