[Question #7149] HIV from small cuts little bleeding on uncovered area on penis during protected

8 months ago
Hi,

I am a male and was in a sexual encounter with a girl.
We started with unprotected blowjob without condom, 
she sucked and slightly bitted my penis base and the skin on body above penis.
The unprotected blowjob has caused me a few small cuts on base of penis
and also caused 2 small cuts on skin on body above penis.
The small cuts on base of penis and skin on body above penis were little bleeding not significantly, but they did bled.

Afterwards we continued to protected sex, 
the condom was covering 70% of penis but the small cuts on penis base 
were outside condom and not covered by the condom,
and I am pretty sure these small cuts little bleeding on uncovered area/penis base got into girl's vagina during sex.

My questions are the following : 

1.   What is the HIV risk from unprotected blowjob if the girl had HIV infected blood in mouth which had a direct contact
      with the small cuts little bleeding on base of my penis and skin above penis?
      Do the small cuts little bleeidng on base of my penis and skin above penis cause an additional HIV risk
      when contact HIV infected blood during the unprotected blowjob?
2.   What is the HIV risk from protected sex if the small cuts little bleeding on base of my penis 
      on the uncovered area of condom had a direct contact with Infected HIV blood or vaginal fluid during the sex 
      when uncovered area of penis with small cuts entered into the girl's vagina?  
      Does the small cuts little bleeidng on uncovered base of my penis cause an additional HIV risk when 
      entering girl's vagina with HIV infected vaginal fluid or blood?  
3.   What is HIV risk from small cuts little bleeding on skin above penis contact HIV blood or vaginal fluid 
      when they touch the girl's vagina?
      Does this contact between these small cuts little bleeding on skin above penis 
      and vaginal fluid or blood on girl's vaigna increase HIV risk?

I have previously read an article saying that for cuts on skin to gain access to HIV they have to be profusely bleeidng  
and in need of stitches or medical care.

What is your professional opinion about the kind of cuts I have had(small and little bleeding) 
on penis base and skin above penis with each of the cases mentioned in the questions above?

Thank you for your time and help.

Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago
Welcome to our forum. Thanks for your question. I appreciate your confidence in our opinions. Questions about small abrasions or cuts on the genitals and their risk for acquisition of HIV are common.  The fact of the matter However is that while such lesions represent a theoretical risk for acquisition of infection, in fact no scientific study and no carefully conducted research has shown that they are important or modify risk for HIV. The likely reasons that they represent no risk for infection includes the fact that these lesions seal off quickly, even when they are in the process of actively bleeding. In addition please remember that unlike injections in which material is actually injected directly into tissue, the direction of flow fromCuts and abrasions of the sort you describe is outward. In general, and overall I would classify the encounter that you describe in great detail as a no risk of it.  Thus, in response to your specific questions:

1.  There are no proven instances in which a person has acquired HIV from receipt of oral sex. This includes many situations in which the person performing the sex acts have poor dentition, oral lesions themself, or the person receiving the sexual act have small cuts or abrasions on their genitals. You are not going to be the first person to acquire HIV in this way.  

2.  My statements above also are applicable to any small cuts or abrasions which may be present at the base of your penis, whether or not it was covered with a condom. Please remember that even when persons engage in mutual masturbation with a partner who has HIV, direct exposure to genital secretions has never led to an infection. The situation is lower risk than with mutual masturbation.

3.  This question is a bit repetitive and has a been addressed in my responses above. Still no risk.

You ask for my opinion,. In my opinion the situations you describe did not put you at any meaningful risk for acquisition of HIV. In your situation I would not bother to test for HIV. I understand however that if you are concerned, you may choose to test. I have no objection to that and I’m confident that should you choose to test, your test will be negative. 

I hope my comments and the information I have provided is helpful to you. If you have further questions or any of this is unclear please feel free to use your up to two follow-up questions for clarification. 

Take care. EWH
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8 months ago
Hi,

Thanks for the reply.

I understand your answers and explanations regarding the No HIV RISK for oral sex and skin contact 
of small cuts little bleeding on penis/skin above penis (Questions 1 + 3 ) with contact with blood or vaginal fluid. 

Thank you for that.

Regarding Question 2 which is  HIV risk during protected sex from the small cuts little bleeding on base of my penis 
on the uncovered area of condom which had a direct contact with possible HIV Infected blood or vaginal fluid,
when uncovered area of penis with small cuts little bleeding entered into the girl's vagina during sex.

This event concerns me at most.

Your answer : 

"My statements above also are applicable to any small cuts or abrasions which may be present at the base of your penis, whether or not it was covered with a condom. Please remember that even when persons engage in mutual masturbation with a partner who has HIV, direct exposure to genital secretions has never led to an infection. The situation is lower risk than with mutual masturbation."

You wrote that this situation is lower HIV risk than mutual masterbation.

In mutual masterbations the genital secretions are exposed to air before 
the other side contacts to them on his genital
(I have previosly read that exposure to air significantlly weaken HIV material and prevent infection).
But in my situation the small cuts little bleeding on base of penis on uncovered area
entered into girl's vagina and had conatct with her genitial secretions or blood in  an enviorment 
without air(inside her vagina). Her genital secretions were not exposed to air 
before touching the small cuts little bleeding on base of my penis.

So beacuse of no exposure to air in my event,
I thnk my event is more HIV risk than mutual masterbation.

Anyway, are you still sure this situation is no HIV risk ? 
This situation is no HIV risk even though during  sex the small cuts little bleeding 
on base of penis on the uncovered area directly entered girl's vagina and had a direct contact
with possible HIV infected Blood or vaginal fluid in an enviorment without air?

Thanks in advance for clarification

Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago
Thanks for your follow up.  I do understand how a perceived misstep Of the sort you describe can be concerning. In our experience this leads to theoretical, “what if” questions.  Our forum deals with science-based data and our more than 70 years of focused research and study on STIs and, since the first days of the epidemic, HIV.  We deal with questions such as your follow up questions by acknowledging your right to your own opinion but respectfully disagreeing.  Your perceived lack of exposure to the environment (which I disagree with) in no way changes my opinion.   I see no meaningful risk for HIV from the exposure you describe.  No change in my assessment or suggestions.  EWH ---
8 months ago
Hi,

Thanks for the clarification.

About your answer : 

"Your perceived lack of exposure to the environment (which I disagree with) in no way changes my opinion"

Why do you disagree that there was lack of exposure to enviorment/air between the small cuts little bleedining 
on base of penis  and vaginal fluid / blood in girl's vagina?
The uncoverd area/ small cuts on penis  came inside the girl's vagina during sex, 
so the enviorment of the small cuts on penis should be without air if the exposed cuts on penis 
were inside girl's vagina?

I would apprecitae your explantion for this.

Anyway summerize your answer you say, that during the sex even if the enviorment was without air when 
small cuts little bleeding on uncovered are on base of penis
came in direct contact with vaginal fluid/blood inside girl's vagina, 

even with this lack of eposure to air druing eposure to vaginal fluid there is still no HIV risk.

This is becuase what you initially explained about small cuts which bleed a little and because the urethra
(Main entry point for HIV during unprotected sex) was fully covered by condom.

I would appreciate your reference for this as well.

Thanks for  all the help.
Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago
Sigh.  You asked for my opinion, received a science-based opinion based on years of study and research, and apparently don’t believe the answer.  That’s up to you.  My opinion is not going to change in this final response.  ( Forum guidelines indicate that we provide up to three responses to each clients question. This is your third response. Therefore, this will be closed later without further responses following this reply).

Let me remind you that sex is all about friction between body surfaces.  That’s where the sensation comes from.  Small abrasions are typical of virtually all sexual encounters, whether or not they are visible and whether or not you are aware of them.  The “ small cuts” or abrasions you experienced were exposed to the air before you began your frottage.  Further any blood which may have been there was coming OUTWARD from you.  Any contact with genital secretions would not have entered your body below the surface of the abrasions.  For HIV to cause infection in not infected lesions it must be introduced deep into tissue, not just cause surface contamination.  Even if exposed while inside the vagina the abrasions would not be an entry way for infection.  This statement is based on common sense and the observations of thousands of scientists over the past almost 40 years since the epidemic began.  You are not going to be the first person infected in this way, even in the unlikely circumstance that she had untreated HIV.

In my opinion, this was a no risk event.  There is no scientific reason for concern or testing.

EWH 
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8 months ago
Ok thank you very much for all help and time.

I have reread all your answers and now I have got the idea of no HIV risk from the whole scenario.

All the best