Yesterday I engaged in a threesome (3 men). I was more watching then active.  The host was topping the other guy with condom. The top used first his finger to facilitate his 'entry'. The bottom ejaculated on his stomach. I was standing up and bottom lying on the bed.  Then the bottom left home and I put on condom. The host gave me bj. He briefly fingered my anus maybe 5 seconds or so. I  don't think he fingered me deep. I can't recall if he had semen on his fingers (I don't think that was likely)from the bottom or his fingers were 'dirty' from fingering bottom. Anyway I asked him to wash his hands but I realize now that I might be too late. I  was in the heat of the moment. I am worried that semen or rectal fluid from the bottom got in my anus. What is chance of getting hiv from this event?

Kind regards 

Your several questions indicate you are overly worried about minor details of potential HIV exposure. For any males having sex with other men, the way to avoid HIV is to 1) ask about and know your partners' HIV status (avoiding most sex with those who don't know or evasive, or who are infected and not on effective treatment); 2) use condoms consistently for anal sex, both giving and receiving; and 3) use PEP or PrEP (more about which below). That's pretty much it. Other sexual practices -- fingering, getting infected fluids (e.g. semen) on the skin or even on the anus or in the mouth -- carry no additional risk beyond what you already experience with condom protected sex. Hand washing isn't a bad idea, but probably makes little difference in risk. Looked at another way, you are greater risk of HIV from anal sex, even when condom protected, than from the other minor details you have asked about in this and previous threads. Condoms sometimes fail, either with recognized breakage or for other unknown reasons.

The basic fact is that you will always be at some risk of HIV from the sexual lifestyle you have described. You cannot reduce the risk to zero, and therefore you should be tested for HIV from time to time, probably once every several months or once a year, depending on the frequency of these events.

Which brings me back to pre- and post-exposure prophylaxis (PrEP and PEP). Given the apparent frequency with which you have sex with other men, PrEP definitely is the way to go. It can either be continuous, especially if such events are more than several times a year; or "on demand". PrEP on demand involves taking 3 doses of anti-HIV drug, once in the several hours before contact, and then two more doses over the next day or two. It's highly effective and doesn't require continuous treatment . However, continuous PrEP probably is best if you have such sexual experiences quite frequently, e.g. more than once a month.

But to repeat my main message, the main concern here is not trivial things like fingering or superficial contact with partners' semen. It is your general sexual lifestyle. I'm not suggesting you change that lifestyle, but that you go about it with maximum safety. In any case, let's make this your last question about the minor sorts of exposure events you have been asking about. OK?

HHH, MD

Normally I always ask about hiv status  and  I take prep for receiving anal intercourse. This time I didn't ask because the top used condom and that somehow reassured me at that moment. Also I didn't have anal intercourse because I was too late to take prep. The top performed blowjob on me while I had a condom on. I just had fingering, not remembering if he had secretions on his finger.

I don't understand quite the sentence you wrote: Other sexual practices -- fingering, getting infected fluids (e.g. semen) on the skin or even on the anus or in the mouth -- carries no additional risk beyond what you already experience with condom protected sex. 

Yes -- you do not need to worry about fingering. That was the main point in my reply. The amount of semen or other body fluids that can be carried on the fingers is too little to carry any meaningful risk of HIV transmission. You should not take PEP on account of this event.

Also, you should not have HIV testing every time you have a new sexual experience, especially if it happens a few times a year. Instead, put yourself on a schedule of testing every so often -- every 6 months probably would be about right. Ignore individual events unless especially high risk -- for example, if no PrEP and a condom breaks during anal sex. Otherwise each individual event is always too low risk for testing to make sense.

Normally my hiv test was planned this week.  Thank you for reassuring me again that I couldn't catch hiv from this event. Should I get tested or wait? Last intercourse was May 15th. 

Although Dutch information site stated that there's a risk with getting fingered with semen or rectal fluid. I believe your information because you helped me before.

Thank you 

That concludes this thread. As implied above, you need to not overthink all this. If you do your best to have safe sex and all your anal exposures are condom protected, you really shouldn't need to ask about other exposure risks. Having had several questions along these lines, I'm sure you could accurately predict our replies!

I do hope this discussion has been helpful. Best wishes and stay safe.