[Question #97] Worried about HIV by fingering a prostitute with a possibly bleeding cuticle
110 months ago
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Edward W. Hook M.D.
110 months ago
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110 months ago
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I wish I had written to you earlier. My plan was to wait until 3 months and then get tested. However, I just couldn't handle the fear, got the tests done that I described to you and decided that I get your opinion. I cannot describe to you how much at peace I have been in the last few days after hearing from you. I think I am done with this now and feel ready to move on.
However, if I may, I would really appreciate your response and be grateful to you from the bottom of my heart if you would answer a few more questions:
1] Before I went into the motel room to meet the lady, I noticed peeling skin/hangnail on my ring finger. As mentioned, while I was fingering her vagina using the same finger, I felt stinging sensation around the hangnail which later made me suspect whether the peeling skin peeled further as a result of friction while fingering her and made me bleed during the act. Assuming this happened, would I be at risk for HIV infection.
2] Given I was so afraid of the possibility, I actually went to an urgent care facility within 48 hours of the incident. I explained to the doctor that I indulged into mutual masturbation with a prostitute, however, did not elaborate on these details on possibly bleeding hangnail etc. He did not find it necessary to put me on PEP. I later realized that I left out the important details during my consultation with the doctor, mostly because of anxiety and probably subconsciously thinking that the doctor would inquire about any details he may deem necessary/important. I later started to wonder whether he would have put me on PEP if I had described the situation to him in detail. If you were the doctor and knew all these details, would you put me on PEP?
3] Was HIV testing recommended/necessary in my case in the first place.
Again, I feel very grateful that I can write to you and get your advice. This is a wonderful service and I thank you for your time and compassion in answering our questions.
Edward W. Hook M.D.
110 months ago
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Straight to your questions:
1. In experimental animals abrasions (and this, by extension peeling skin) does increase the efficiency (likelihood) of HPV transmission. How important this is for humans however is not quantified and if there is any risk at all, that risk is tiny. I would not be worried.
2. There are countless instances in which persons with abrasions, sores, or scrapes on their fingers have masturbated HIV infected persons and gotten HIV infected genital secretions directly on the cuts. Despite that, there are no instances in which HIV has been transmitted from person to person through masturbation. I certainly would not give PEP to someone whose only exposure was the sort of masturbation you have described.
3. I really do not think you needed testing related to the exposure you described. It is now done however and I hope the results add further reassurance to your concerns. Glad I could help. EWH