[Question #7105] HIV risk evaluation

9 months ago
Hi,

I was with a girl, we were both fully naked during the foreplay.
During the foreplay I was not wearing a condom, 
as part of BDSM game the girl slapped and spanked me on the penis when I was not wearing a condom, 
my skin on penis was red from slapping, 
but still the skin on penis was not broken and was not bleeding from the spanking.

Afterwards I have put a condom on my red spanked penis and than I had protected sex with condom with the girl.

The problem is that the condom was covering like 75 percent of my penis shaft, 
the buttom part of the red spanked penis shaft was not covered by the condom and it came in direct contact  
with the vaginal fluid or possible blood from the girl's vagina during the sex.

My questions are:

What is the HIV risk from this sexual contact?

The fact that the slapped skin on penis was red from spanking, 
does red slapped penis skin on exposed buttom pines  increases HIV risk when coming direct contact 
with vaginal fluid / blood from girl's vagina during sex?

Again as I have mentioned, the slapped skin on penis was red from spanking and slapping, 
but the skin on penis was not bleeding and was not broken and the condom was covering like 75 percent of my red slapped penis shaft.

What concerns me is that slapped expsoed penis's skin was red from spanking,
and it might provide easier access for HIV to bloodstram when coming direct contact  
with vaginal fluid / blood during the sex with the buttom part of exposed penis which had a direct contact with the girl's vaginal fluid or blood?

Thank you for the help.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
Welcome. Thanks for your question and your confidence in our services.

The bottom line (pun intended) is that these were entirely risk free events. There is no reason to suppose that slapping or spanking could transmit HIV. There is simply no risk of HIV transmission other than by infected blood or fluids being introduced directly into the bloodstream or under the skin; or sexually unless there is penile penetration into someone's vagina or rectum. (Even oral sex carries little or no risk.) I'll also add that heterosexually transmitted HIV is a lot less common than many people realize. The chance your BDSM partner has HIV is very low, probably under 1 chance in a thousand.

Almost all condom use entails coverage of about 75% of the penile shaft. Skin contact above the condom carries no HIV risk. However, this is exactly the reason that condoms provide in complete protection against STDs transmitted skin-to-skin (e.g. herpes, syphilis, HPV). 

Those comments pretty well cover your specific questions, but to be explicit and assure no misunderstanding:

HIV risk from this sexual contact? Zero.

What concerns me is that slapped expsoed penis's skin was red from spanking and it might provide easier access for HIV to bloodstram when coming direct contact with vaginal fluid / blood.  Almost certainly not. I don't see this as a concern at all.

Bottom line: To there extent there was any STD/HIV risk at all, it came from the vaginal sex, even though condom protected. HIV, gonorrhea, chlamydia and other infections transmitted by fluids were virtually zero risk (but even here, occasional unrecognized condom failures to happen from time to time). But you should be on the lookout for symptoms of the skin to skin infections (herpes, HPV/warts, syphilis). These are statistically unlikely, but still something to be aware of.

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

HHH, MD


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9 months ago
Hi,

Thank you very much for the quick reply.

About your comment :

"Almost all condom use entails coverage of about 75% of the penile shaft. Skin contact above the condom carries no HIV risk. However, this is exactly the reason that condoms provide in complete protection against STDs transmitted skin-to-skin (e.g. herpes, syphilis, HPV). "
 
It is obvious that skin contact above the condom is protected since the covered part of penis is protected by condom from direct contact with possible HIV infcected vaginal fluid or blood from girl's vagina.

As I wrote what concerns me is the direct contact of the buttom part of red slapped penis which was not covered 
by condom but did came in direct contact with the inside of girl's vagina during the sex.

Does this contact of  uncovered by condom red slapped penis skin with the inside of girl's vagina increases my HIV risk?

Regards

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
I don't think I understand your question about my comment. Is there confusion between "top" of the penis (nearest the body, i.e uncovered) and "bottom" part (the covered 75%)?

The uncovered penile skin above the condom often (usually? always?) is contacted by a partner's vaginal fluids. As I said above, slapping or redness of that area -- or the skin anywhere on the body -- would not increase HIV risk if exposed to the virus. But exposure of that uncovered penile skin is why condoms are not as effective against the skin-to-skin STDs as they are against those infections transmitted by genital fluids.
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9 months ago
Hi,

Thank you for 2nd reply.

You are right i got confused between "top" of the penis (nearest the body, i.e uncovered) and "bottom" part (the covered 75%), but after your explanation I think  is clear.  
When you said "Skin contact above the condom carries no HIV risk", 
you meant skin contact of the uncovered area of penis has no HIV risk when 
coming in contact with HIV infected vaginal fluid or blood from girl's vagina during protected sex. 

We can also conclude and say that only if uncovered part of red slapped penis 
was also broken skin and  had active bleeding there was an increase in HIV risk when coming 
direct contact with vaginal fluid or blood from girl's vagina druing  protected sex.

Red slapped uncovered penis area(without broken skin and without bleeding like my case) 
which comes with contact with vaginal 
fluid or blood from girl's vagina during protected sex  has no HIV risk.

Is it also true that red color is just a sign of increased blood flow under the skin of penis because of slapping, 
but is not a concern  as long as skin of uncovered  penis is not bronken and doesn't bleed 
when coming in cotact with the girl's vagina during sex.

I would appreciate your last reference for what I wrote.

Thanks again for the help.



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
"We can also conclude and say that only if uncovered part of red slapped penis was also broken skin and  had active bleeding there was an increase in HIV risk when coming direct contact with vaginal fluid or blood from girl's vagina druing  protected sex."  Correct. And even this would be very low risk. Superficial nicks and cuts probably aren't very risky.

Your next two statements also are correct, but I don't understand what you're asking with "I would appreciate your last reference....". Threads are closed after two follow-up exchanges, but I'll leave this open in case this needs one final clarification.
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9 months ago
Hi,

Thank you for the additional reply.

Just last question for general understanding of HIV Transmission and this specific case.

The reason that the buttom/covered part of penis is vulerable to HIV transmission when coming direct 
contact with HIV  vaginal fluid / blood during sex
is becuase it has the urethra 
and inner foreskin which has a very thin skin on it , and these 2 can easily allow access for HIV to body/blood stream.
For this reason it is important that the condom covers the urethra and inner foreskin to prevent HIV infection.

On the other hand, the top/uncovered part of penis has a thick skin, and for this reason even if this area is uncovered by  the condom and directly contacts infected HIV vaginal fluid/ blood from girl's vagina during sex the HIV risk is almost zero from this area uncovered by condom.
This is because the thick skin on top/uncovered area of penis prevents from HIV vaginal fluid / blood to enter blood stream.

Thank you very much for all help and time.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
Your statement from "The reason that..." through "to prent HIV infection" is exactly right.

The second ("On the other hand") is also right, except that the skin of the penile shaft is thin, not thick (as I recall, the thinnest skin anywhere on the body). But HIV cannot be transmitted across intact skin of any thickness. In other words, no HIV risk.

Thanks for the thanks. I'm glad to have helped. Best wishes and stay safe.
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