[Question #7955] Risk assessment

50 months ago

Hello Doctor,

I’m really happy with that there’s such this source I can take reliable information on the internet personally.

I’m a gay guy living in South Korea who is really cautious about any types of sexual events.

Since I lastly checked my STI status (All negative), I haven’t had any sexual events for almost 2 years.

2 days ago, I met a guy and gave him a handjob with lube, latex gloves on. And rubbing, humping my raw penis (without condoms) on his butt and a crack of buttocks (I’m pretty sure my penis didn’t touch the anus though). He touched my penis and the tip of urethra with raw hands a few times briefly.

The issue was at that time I had quite a large damaged parts (2 spots on both sides, around 3x4cm) on my testicles from scratching hard myself while sleeping because eczema was insanely itchy. Those were freshly bleeding when squeezing them and there also was a sore oozes from the wounds. When I was rubbing my penis on his butt my testicle must have been also rubbed on it.

I didn’t check if there were any cuts or blood on his hands and butt area.

I politely asked him and we ended up getting tested together. It was the finger prick antibody test and both turned out to be negative. (I know the test result is only meaningful "before" the 12 weeks mark from now because of window period)

He mentioned he has multiple sexual events during the last 12 weeks.

If he got infected recently (I’ve heard it’s 20-30 times more infectious when acute infection phase), Am I at risk? and how risky it is?

50 months ago

Sorry Doctor, I forgot to mention the place was really dark and the event was happening when he and I were both standing.

That's why I couldn't check if there were cuts or blood on his hands and butt (To me, possible blood on his butt includes pimples etc. Small cuts on hands or fingers count too)

Edward W. Hook M.D.

50 months ago

Welcome to our Forum and thanks for your questions. Congratulations as well for your practice of safe sex, it will keep you healthy and free of STIs. You handled your request for mutual testing well and I'm delighted to hear that both of your tests were negative. FYI, the antibody tests you describe are accurate after 8 rather than 12 weeks. The encounter you describe was virtually no risk for HIV or other STIs and the fact that you had several open eczematous sores on your scrotum does not change this. HIV is not spread through transfer of genital secretion or blood on the hands of one person to another, not are most typical STIs. I would not worry and would not seek testing as long as there was no penetration.

You are correct that persons with recent (within the past month or two), untreated HIV are more infectious than persons with more long term infection. That said, this does not change my assessment. I would not worry. EWH

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50 months ago

Thanks for the assessment Doctor.

I'm glad that now I know the window period of the test I have got is actually 8 weeks!

I have some other questions based on my knowledge. I apologize if they are ignorant.

You said that the event is no risk even considering my "what if" suppositions (like, Presence of blood on his body parts / He got recently infected).

To my knowledge, HIV is transmittable through open cuts (which were the open eczematous sores on my scrotum in my case) with body fluids such as blood, semen, rectal fluid etc.

Also I'm aware of that HIV virus isn't deactivated immediately after exposed to environment which makes me think logically it is possible to acquire HIV if there were something like bleeding pimples on his butt area.

Before I asked questions here I did some research and some information (All said by doctors) on the internet said it is possible I can acquire HIV in this way, but also some said it is only possible when they happen "inside of the body" (=penetrated intercourse) or if that happens outside of body, open cuts should be deep and wide open enough needing surgery. So I don't know which information I should believe.

1. Could I know specific reasoning how you assessed my event is no risk including my suppositions one by one?

My biggest concern is that the wounds on my scrotum. I read your answer over and over again not to repeat which you already answered

but the part you mentioned "HIV is not spread through transfer of genital secretion or blood on the hands of one person to another"

The wounds on my scrotum was actually bleeding open cuts not that healthy skin working properly as barriers.

2. Is it true HIV is not infectious outside of the body even though there are open cuts and wounds when they contact such those body fluids directly?

Hope I become aware of the right scientific info and my misconception about "Open Cuts" transmission part is resolved thoroughly through this opportunity.

Edward W. Hook M.D.

50 months ago

Thanks for your follow-up questions. Indeed, we get many questions from concerned persons regarding the potential for cots and abrasions to be a source through which HIV can enter the body. That is a misperception. Open cuts, including fresh ones, the flow of blood is out of the body not in and HIV must be introduced deep into tissue in order to cause infection. Furthermore the body closes off cuts and operations to the outside world very quickly after they occur. The riskOf acquisition of HIV through open cuts and scrapes is in large part, theoretical.

Likewise, you have a misperception that HIV does not become non-infectious soon after coming into contact with the environment. While carefully conducted laboratory studies show that the virus can be cultivated following brief exposures to the environment, this does not reflect real world circumstances. The fact remains that it is not transmitted following virtually immediately following exposure to the air. This is the reason that practices such as mutual masturbation are no risk events, even when persons get each other’s general secretions on themselves.

Please be aware of what you find on the Internet. Much of what is found there is out of date, taken out of context, or occasionally just plain wrong. While I suppose that the sorts of contacts you are concerned about our have a theoretical risk for acquisition of HIV, the reality is that the chances of this are lower than your chances of being struck by lightning today.

I hope that these explanations are helpful. EWH

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50 months ago

Thank you doctor. I appreciate your corrections.

I interpreted your answers and summarized them by myself.

If there are any misunderstandings, please correct me again.

-HIV cannot be transmitted even if the transmittable body fluids directly contact open cuts, abrasions (in my case, the open bleeding eczematous sores) no matter how fresh, if it happens outside of body parts.

-HIV is deactivated and becomes non-infectious immediately after exposed to the environment in real world.

-Thus, the event I have got is no risk even considering the unsure scenarios I worry about (Even if he's in acute infection phase and if there actually were any body fluids on his butt area which my open eczematous sores being rubbed on)

-I don't need to worry anymore and I don't even need to get tested again for this event.

If I should count all the scenarios which might happen in real world, I don't think there is any sexual acts which is 100% safe even theoretically.

I know there's no such things which can reach 0 or 100% in science but still...

I learnt a lot and will try not to do anything even slightly sexually risky.

I'm able to let it go and move on now thanks to the reliable information you offer for me.

Hope that blessed happening will happen to you always.

Edward W. Hook M.D.

50 months ago

Thank you for your summaries. I agree with them although, as I mentioned above, I cannot be so absolute. In science we learn new things every day and thus while I can say with complete confidence that you are not at risk from the events you describe, others taking a more technical approach would say that transmission of HIV through an open cut remains theoretically possible. While I cannot debate that this is theoretically possible, I also would point out that it is also theoretically possible that you will be struck by lightning today. In my opinion, based on many decades of practice and research, such theoretical concerns should not change the way we move forward and live out lives. Thus I agree that there is no need for concern or for testing related to the events you describe.

I hope this makes sense. this will complete this thread. Take care and please don't worry. EWH

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