I am a male and was engaging in protected sex with an woman.

During sex I have had an active bleeding cut on top part of penis shaft(close to body) which was not covered by the condom.

The cut was caused from the rough unprotected blowjob with teeth grinding which happened before protected sex.

The cut on uncovered area of penis shaft had a significant amount of blood coming out of it.

Me and the woman were both under influence of alcohol so we noticed that cut

only in the end of sex.

Also I saw that the condom was covering only 70% of penis shaft which led me to believe that the bleeding cut was fully inside woman's vagina during sex.

I think that this bleeding cut on penis shaft could enable access for

HIV to blood stream because it had a lot of blood coming out of it during the sex.

1.       Assuming that this active bleeding cut on uncovered penis shaft could

          enable access for HIV to bloodstream,

          what is the HIV risk when this bleeding cut which

          was not covered by the condom,

          had a direct contact with possible woman's HIV menstural blood or HIV

          vaginal fluid, when the cut was fully inside woman's vagina

          during the multiple times I was thrusting in the woman's vagina during sex?

2.       Does this active bleeding cut on uncovered area on penis shaft

          when contact menstural blood/vaginal fluild in vagina during sex,

          increase my HIV risk?

          Or because this cut was on top of penis, thus it was exposed to air,

          each time I was thrusting out during sex,

          there  is no increase in HIV risk from this cut?

3.       Are there any similar documented cases of HIV infection like my case

          with active bleeding cut on uncovered area of penis shaft

          which fully enters into vagina during sex?

I would appreciate your professional explanations for the mechanics of HIV infections

through such active bleeding cuts on uncovered area

of penis shaft in such case, taking in account the partial exposure to air

of the bleeding cut during sex when thrusting out.

Thank you for the help and patience.

I can understand your concern; a fresh, bleeding wound exposed to HIV infected blood or genital fluids could result in HIV transmission. However, any risk from this is exceedingly low. First, it probably is unlikely your partner has HIV -- although of course this depends a lot on information you don't provide (commercial sex worker, other risks like injection drug use, whether you're in an area with high or low rates of heterosexually transmitted HIV, and so on. Still, in most locations world wide, even among the highest risk sexually active women, the large majority are not infected. Second, there has never been a reported case of anyone acquiring HIV in this manner -- i.e. no reports of sexual acquisition of HIV because of exposure of a penile wound. (And undoubtedly there have been millions of such exposures.) Even though you are focused on the penile wound, the important aspect of this event is using a condom.

Those comments largely address your specific questions, but to answer explicitly:

1. Of course no data exist on which to calculate a numerical risk of HIV transmission. But I would guess that even if your partner has HIV, teh chance you were infected is under 1 in many thousand, perhaps under 1 in a million. 

2. Air exposure such a brief period would have no effect on HIV survival or transmission risk.

3. As I said above, I am unaware of any reported HIV transmissions from this sort of event.

The quickest way to ease your fears would be to contact your partner and encourage her to be tested for HIV, if you are in touch or able to contact her. You may find she is just as worried about HIV from you ans you are from her. If the two of you are both tested, there would be no need to wait; and if both results are negative, you'll both know you could not have infected one another.

If testing your partner isn't feasible, I suggest you have an HIV RNA PCR test 2 weeks after the event; it almost certainly will be negative. Then for confirmation and a conclusive result, have an antigen-antibody (AgAb, "combo", "4th generation") blood test at 4 weeks. (Or skip the RNA test -- but in that case, you'lll also need another AgAb test at 6 weeks.) in the meantime, try not to worry. The chance you caught HIV is extremely low.

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

HHH, MD

I have read your reply, 

thank you for your answers.

Just have 2 additional questions about your answers for my first 2 questions: 

Your answers :

"1. Of course no data exist on which to calculate a numerical risk of HIV transmission. But I would guess that even if your partner has HIV, teh chance you were infected is under 1 in many thousand, perhaps under 1 in a million. 

2. Air exposure such a brief period would have no effect on HIV survival or transmission risk."

My questions : 

1.  In your answer to question number 1 you wrote that in my case even if my partner has HIV,

       the HIV risk is very very low in my case.

       We know that sex without a condom is a High HIV risk activity. 

        In my case if a fresh wound had contacted vaginal fluid or woman's blood 

       inside woman's vagina during sex, why do you think that the HIV risk in such case is that low? 

       My scenario  seems like the case of sex without condom just instead of the urethra which enables access to blood stream

        in unprotected sex,

       in my case the access for HIV to blood stream is achived by the fresh wound 

       contact vaginal fluid or blood inside woman's vagina during sex.

      What makes my case low HIV risk in comparison to sex without condom?

2.   When you say air exposure of brief period has no effect on HIV survival or transmission risk.

       You mean that each brief second when thrusting out is not enough 

        to reduce HIV survival  of vaginal fluid or woman's blood  

Thanks. But these comments do not change my opinions or advice. You are at low risk for HIV, but not zero risk; and you should be tested, ideally with your partner being tested as well.

2. HIV is indeed fragile and dies rapidly when it dries. Air exposure itself probably makes no difference, only drying. The risk you were infected was very low, especially if you took care to try to avoid direct contact of the cut with your partner's genitl fluids. But air exposure and drying probably made no difference.

Thank you for  your reply.

I read your reply,  it made facts and risk much more clear and more calm to me.

I will just wait for 4 weeks to be over from incident and than get HIV tested hopefully negative.

Last question: 

I Just remembered in the end of the encounter I was lying on bed on my back, 

and woman was on top of me,and we were engaging in sex in this position.

But during this final act, 

there were 2  times,  about 10 seconds each time,

in which the woman did not move and the exposed bleeding cut and penis 

were fully inside her vagina with no  exposure to air at all for 10 seconds.

Are these 2 times of 10 seconds each, significantlly increase HIV risk from this encounter?

Or the HIV risk is still low with these 2  times

(When the uncovered bleeding cut on penis is fully inside her vagina 

with no exposure to air and no movment  for 10 seconds each time)?

Thank you for all help and advices.

You haven't commented on my suggestion that both you andf your partner be tested. If both negative at this time, you would know you were not exposed and would not need to be tested again in a few weeks. It would end  your worries right now.