[Question #7530] HIV Risk Assessment

3 months ago
Hello Doctor - I am 25M from Calgary, CA. I would really appreciate if you hear my situation and do a risk assessment for HIV. On the 25th of December 2020 - I met a trans women (CSW) - my first time, I was experimenting. We were in the car - it started with me feeling her penis and just stroking it with my hand only. I saw her leak some precum while doing so - which I normally spread around her penis head with my hand. I also used my saliva for stroking. While doing so we briefly kissed for like maximum 15 seconds or even less. It was an open-mouthed kiss but no tongue - the type of kiss where people taste each others lips. After this - she started stroking herself and I was just watching. She asked to see my penis while she was stroking herself. I took my penis out of my pants and she started stroking mine with the same hand that she stroked hers with. Her hand was not noticeably wet. She stroked me for like a minute or maybe two - I did not ejaculate and I put my penis inside my pants.  There was no oral and no penetration in the whole event. The closest anything got to my penis was her hand. My biggest concern - Before the touched my penis - she was stroking herself. I am worried about pre -cum getting through my urethra and causing HIV infection. Again - her hand was not noticeably wet but what if there were some. Second concern: I had a teeth extraction more than 2 months ago. The site healed long ago meaning it never bleeds nor does it hurt ever but there is a small hole as there is no teeth. Is there a possibility that IF she had a cut in her mouth - her blood may have travelled through that hole to my bloodstream? She did not taste like blood nor did I see any blood in her mouth. I know this all sounds low risk - however my worries have skyrocketed ever since I started noticing symptoms of gonorrhea and chlamydia Burning and discharge. If I can get gonorrhea or chlamydia from this encounter - there is a chance that I may get HIV?
Edward W. Hook M.D.
Edward W. Hook M.D.
3 months ago
Welcome to our forum. Thanks for your question. I’ll be glad to comment.  The encounter you describe was a totally safe encounter.  Despite the fact that persons engaged in mutual masturbation typically and routinely get each other’s genital secretions, including both ejaculate and pre-ejaculate in each other through transfer of secretions either directly or indirectly on each other’s hands, there is no risk for HIV acquisition.  This is the case even when the secretions get onto the tip of the urethra.  Similarly. Open mouth kissing has never been proven to be a mechanism for HIV transmission.

Finally. You do not know that your partner had HIV and while rates of infection are somewhat higher among trans women, most are still not infected.

There is no scientific reason for concern related to the encounter you have described and no need for testing.  I hope this information is helpful.  Please don’t worry. EWH 
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3 months ago
Hello Dr. Hook - thank you very much for your reply. I was trying to make sure for this to be a safe encounter as I usually am very concerned about contracting something. However - recently since 10 days past exposure I have clear symptoms of either gonorrhea or chlamydia or a STD of that kind. My urethra burns after peeing and I leaked a thick cloudy dischagre after peeing on a few occasions. I will be doing a urine test soon. In the case that I did get gonorrhea or chlamydia from this encounter (this was my only encounter of 2020) how is it still possible? there was no sex and no oral. Is there an explanaition? I would really appreciate your response. 
Edward W. Hook M.D.
Edward W. Hook M.D.
3 months ago
For you to have gotten an STI from the events you describe with any penetration of any sort would be extraordinary.  Ten days is an unusually long time to pass between exposure and the apparent onset of your symptoms. Given the events and your current symptoms I strongly encourage you to see formal testing and treatment.  Again I strongly encourage you to seek testing before you receive any treatment.  Please let me know what your clinician says.  EWH---