[Question #6616] Std risk assesment

67 months ago

Hi,

First of all, I must admit I get very anxious when dealing with HIV risk, so my question might be kind of unnecesary, but your answers are always a good source of reassurance.

2 days ago I had a low risk experience. I am a bi man, but have really sporadic encounters with men (and almost always get anxious after the fact). This time it involved:

Mutual masturbation with genital to genital contact, he finished on my hand and chest. Hand had no open wounds, if anything some healing skin as I sometimes bite my nails, but probably healing for a couple days at that time. Skin on chest intact, some on chin with beard coming out, but again, nothing opened.

I licked his genitals once, but no precum or fluids , just shaft, as 2 weeks ago I had wisdown teeth removal, no open wounds, but holes are there, so I did not want to take any fluid in my mouth.

Tried bottoming, just half a minute as it was painful, condom all the time and properly used, I also made sure no breakage after the fact. This is when we just kept on masturbating and he finished on hand and chest.

Now, partner claims to be negative, and no sores of any time were observable.

What are my risks for stds, should I worry about HIV at all, is pep needed?

Also, I am overthinking risk factors like beard coming out or bitting nails as potential openings? What kind of would should I worry in hands, body or mouth so that I am not stuck thinking on little things later on?

Thanks so much in advance.

Edward W. Hook M.D.

67 months ago

Welcome back to the Forum and thanks for your continuing confidence in our service. I'll be glad to comment. The short answer is that the activities that you describe did not put you at risk for acquisition of HIV or other STI. There is no need to think about PEP and, as an FYI in case you should need it in the future, it is borderline late to start PEP if your exposure was two days earlier- PEP is most effective the sooner after an exposure it is taken and there is no known benefit by 3 days following exposure. Two days is sort of borderline in terms of benefit.

Mutual masturbation is a no risk event despite the fact that it is usual for partners to get each others' genital secretions on one another. The presence of the sorts of superficial cuts, scrapes and closely bitten finger nails do not change this. Recent dental work has no effect as well. Still entirely no risk.

Similarly, licking the shaft of your partner's penis does not put you at risk for HIV or other STIs either. This is again, the case despite your recent wisdom tooth removal.

The bottoming you describe did not put you at risk either as long as your condom remained intact. Condoms remain the most effective means of preventing STIs including HIV when exposed to an infected partner. I should mention to you for future reference however that when used for rectal intercourse condoms do fail a bit more often than with other sorts of exposures. Lubricants help reduce the risk for infection.

Thus, in summary, congratulations on your practice of safe sex. Nothing about the activities that you describe suggest a need for concern or even a need for rapid testing. No need for PEP as well. I hope that this information is helpful. EWH

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67 months ago

Thanks so much for your reply. I also want to add you make a great job with the response time, not sure if there is any reply time agreement, but un any case both of you are amazing at it.

So, since I am anxious about this and always think about worst case scenario, I want to ask some questions for further referece (I am clear this one event is safe).

*You normally claim oral or mutual masturbation (like this case) is HIV extremely low (oral) to no risk. Will this change based on viral load? In other words, should I overthink risk when unprotected oral, or can I just go on with my life? What I am looking here is for a small guideline on when to not worry, as I am sick of getting through this often so.

*About this event, I now recalled: partner was putting condom on, but revesed (ie, it did not roll back) so I just place it the right way. Is there any danger a little bit of preseminal got it the tip that ended up facing out? Would that be an issue? If this happened I cannot see it being more than a drip, and of course when rolling back the right way it might just get on ones hand. Also a couple minutes before trying insertion.

Thanks so much again, I will just leave the last follow up in case something weird goes on in the next couple weeks.

Edward W. Hook M.D.

67 months ago

Thank you. We try to respond to clients in les than 24 hours. Typically our response time is less.

I do think you are overthinking this. Your partner said he did not have HIV. Most people tell the truth. Certainly the viral load of persons with HIV can vary substantially. Nonetheless, with respect to mutual masturbation and oral sex, there are no data to indicate that a high viral load has a significant effect on risk for acquisition of infection.

Inside out or not, the condom most likely did its job.

Please relax. your 'what if" questions suggest you are overthinking this. Please do your best to contain your concerns. EWH

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