[Question #9636] Hiv risk in this situtation

30 months ago

Hello Doctor, I purchased a question and I appreciate if you can help me with it
I met a women online and we decided to have sex. her status was unknown. she gave me oral sex first and after that we started having unprotected vaginal sex.
During intercourse ,sex was hurting her and during the whole duration of sex, she had active bleeding due to trauma.
The blood volume was alot and my penis was fully covered with blood. I was shocked

Also I noticed that during the oral sex, her teeth made couple long deep cuts on tip of penis ,sides and shaft. the cuts were definitely fresh because I started intercourse immediately after oral sex .
if she had HIV :
1- that huge amount of blood definitely can touch and enter urethra. is it guaranteed to get HIV in this case?

2-I heard open cut is a perfect way for hiv infected blood to enter body during sex. I got anxious due to amount of blood touching the cuts during sex. I want to know how risky it is based on scientific evidences.

meantime, Im planning to get tested using 4th generation 45 days after my exposure but considering the volume of blood and other conditions I explained ,will I catch HIV %100? If I tested negative ,should I trust the results?

Edward W. Hook M.D.

30 months ago

Welcome to the Forum and thanks for your questions. I happended to be on the Forum when your question arrived so you are getting a reply far more quickly than normal. I'll be glad to comment. This was a low risk exposure. Most women do not have HIV, even women who have had many casual partners and most single exposures do not lead to infection (there has NEVER been a case of HIV proven to be acquired from receipt of oral sex, even when sores/bites are present on the recipient) and the risk from any single unprotected vaginal sexual exposure to an HIV infected, untreated partner is substantially less than 1 infection, on average, per 1000 exposures (i.e. 99.9% of exposures do not result in infection). The presence of traumatic genital lesions does not change this. Nor does the blood - interestingly, the amounts of HIV in blood is about the same as the amount in genital secretions.

1- that huge amount of blood definitely can touch and enter urethra. is it guaranteed to get HIV in this case?

See above- this is no riskier than unprotected sex without the presence of blood. The amount of blood makes no difference

This is incorrect and an oversimplification. The presence of infectious sores, like syphilis or herpes, (but not cuts) on the genitals, if exposed to an untreated, HIV infected partner, are associated with a modest increase in risk of HIV acquisition but this is not the case for cuts or scratches, even fresh cuts of scratches. The difference is that with infected sores, host defense cells, which are the target cells for infection, are on the surface of the sore- this is not the case with cuts and sores.

Testing at 45 days is certainly reasonable. In the meantime, your risk for other, far more common STIs like gonorrhea or chlamydia is much higher than your risk for HIV. \A urine tests for gonorrhea and chlamydia any time more than 3-5 days after exposure will provide accurate results.

I hope this information is helpful. I would not be worried. EWH

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30 months ago

Hello doctor

First of all, I appreciate your time and immediate response and thank you for you calming answer

I just have a question to close this

The reason I asked about the bleeding is because as soon as I googled this issue, the result showed that they did a study in cape town and they found out bleeding during sex accelerated the transition of HIV due to higher viral load and that made me so anxious

Also, I dont know if my fresh cuts were bleeding or not because my partner was bleeding too .

in worst case scenario, if my cuts were bleeding ,do doctors still consider it as low risk when the cuts contacts the hiv infected blood?

Edward W. Hook M.D.

30 months ago

I would still consider fresh cuts to be low risk. Remember that to cause infection HIV must be introduced deep into tissue. With a fresh cut, your blood would flow out, not in. EWH---