I am an HIV negative man who is back in the game after a long time being single. You recently helped me with a concern I had and I had one more question come up based on something that happened today:

I fooled around with a guy today who was pre-cumming A LOT! at several points during our time together, I believe his pre-cum made its way into my ass from being on his finger. I witnessed him masturbate his penis and then finger me directly several times. 

This guy says he's negative, but lets say for the sake of argument he is recently positive and doesn't know it yet. Would this activity be a cause for concern for HIV? Very little time passed between when he was touching his pre-cum covered penis and when he inserted a finger from that same hand into my ass, so I'm a bit concerned. 

Thanks doctors!

I do not accept your "sake of argument" premise that your partner is recently HIV positive. Most people do not lie about HIV status when asked directly. But even if he had been recently infected, the risk of HIV transmission must be extremely low. If the infection risk is one chance in 200 with receptive anal sex including ejaculation in the rectum -- as we discussed two weeks ago -- the risk with the very much smaller viral exposure from pre-ejaculate fluid on fingers would have to be very much lower. I can't say the risk is zero, but I really wouldn't worry about it.

Having said that, based on both your threads, it seems clear you're close to playing with fire in regard to HIV. With your anus now a newly important feature of your sexuality, and with the apparent sexual partnership pattern that seems to be evolving since your long term relationship ended, you should consider yourself at significant risk for HIV. Even with careful limitation to partners who believe they do not have HIV (or are taking effective treatment), receptive anal sex is inherently risky. Condoms break, sometimes they are forgotten in the heat of the moment, etc. Unless you decide to forego any and all sexual contact with your anal area with other men, I would strongly encourage you to consider pre-exposure prophylaxis (PrEP) with anti-HIV drugs. A local HIV/AIDS or public health clinic would be an excellent resource for advice about it.

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

HHH, MD

Thank you for your response. In an effort to spare you the details/make the question more universal for people who might be browsing, I may have given you a false impression of what is going on with me. 

The guy from today's question is the same guy as from the last question. I met him in the wake of my newfound single status and he has been the only person I am comfortable enough having full-on intercourse with. He is HIV negative and on Prep and we have used condoms in addition to this.  I am still working on finding the right route for me with regard to PrEP. My insurance isn't the best, but I am absolutely planning on going on it. In the meantime, I only intend to have intercourse with this same guy. The OCD/'been cheated on before' part of me worries that him being negative and on PrEP is a bold faced lie, but the more rational side of me understands that most people, when asked directly, tell the truth about their status, as I have seen you bring up several times in other responses on here. 

I'm guessing you don't see the need more me to run out and start PEP based on this fingering experience. 

Thanks again for your help, and I will make sure to get on PrEP as soon as I can!

With or without PrEP, it shouldn't be necessary to come to us with questions about every new sexual exposure you have, especially with the same partner -- or for the most part, with new ones. From the two threads so far, plus general safe sex descriptions found all over the internet, undoubtedly you now understand the basic issues and can predict the replies we would have.

You're absolutely right about not needing to seek answers every time. The truth is: I have OCD and HIV is one of my main OCD focuses. OCD thrives on nit-picky questions that are hard to find professionally-given answers to online: i.e. "pre-cum on a finger that goes into an anus several seconds later from a person who might be lying for all I know!" It's all these disaster scenarios that my brain comes up with. I know that you have plenty of experience dealing with OCD-driven questions on this site.

I will make more of an effort to trust my rational understanding of safe sex and not get lost in all the what-ifs

Thanks again Doctor!

That concludes this thread. Best wishes and stay safe.