Contracted bacterial STI, do I have to worry about HIV, too?

[iank]

Hi,

two and a half days ago I had an anonymous sex date with another man that we had arranged through an app. It was the first sexual encounter for me since my last, comprehensive STI test (all results negative), which I take at least once a year despite being not very active sexually.

We performed the following actions (without condom):

- Mutual handjobs (he used lubricant on my penis because I’m circumcised; I didn’t use lubricant on his penis as he was not circumcised)
- Him rubbing his erected penis between my buttocks

There was no penetration, neither oral nor anal. I didn’t touch his sperm, because he eventually finished it for himself with his own hand.

Through the described actions I came into touch with his pre-cum, of which there was a noticeable amount quite some time before his ejaculation, at my hands and my outside anus area. In between touching my penis he repeatedly touched his own penis, hence my penis likely came into contact with his pre-cum through his hands.

About an hour after the encounter I noticed a small cut at the inside of my index finger - possibly a paper cut. This cut did not bleed but gave me a burning sensation. Furthermore my anus area is very sensitive and bleeds easily which is why I don't have passive anal sex at all anymore. So I was then worried that contact with his pre-cum (even rubbing it in) of the cut on my finger or my anus area might have posed an HIV risk. Initially, I tried not to think too much of it though.

Two days later, my HIV worries have returned though, as a small rash appeared on my glans and I’m experiencing a burning sensation when urinating. I immediately visited a GP who suspected gonorrhea or chlamydia and prescriped an antibiotic which I now have to take for three days. I asked him about the HIV risk and a possible PEP (as I was still within 48 hours of the encounter when visiting the doctor), but he denied the PEP with the argument that an HIV infection was “very unlikely” based on the described actions, even in case of the worst case scenario that my partner was HIV positive and highly infective.

In any case, the bacterial STI I most likely contracted from this encounter has renewed my anxiety that I might have contracted HIV as well. I think my partner is quite active sexually as he claimed he takes an HIV test every 3 months.

So these are my questions:

1. Would you say there was an HIV risk for me here?
2. If so, how high might it have been in the worst case scenario that my partner only recently contracted HIV himself?
3. Was the doctor right in denying me PEP?
4. Does fact of a bacterial STI infection influence the HIV risk assessment in any way?

Thank you very much for your time.

[Wade]

Hi, From what you have posted you did not have risk for HIV , and your doctor was
correct to not advise PEP. The virus is very fragile and does not survive once exposed to air and outside the body , so the rubbing even with small cuts made no difference.

As we always say,  get checked for other STIs because the are much easier to contract, and no this did not increase your risk for HIV.
From what you said you can expect another negative HIV result during your regular screening.

Best, Wade

To avoid infection,
You need to be using condoms for all anal and vaginal intercourse until you are in a trusting monogamous relationship and both have been tested for all STIs and HIV.
Everyone who is sexually active should have an annual exam and test for all STIs and HIV ,and always after unprotected intercourse. Always using condoms will give you peace of mind your tests will return with a negative result.

[iank]

I always wonder about this statement "does not survive once exposed to air". Does it mean just mere seconds or longer?

In any case, thank you very much for your assessment, which I hope will turn out to be true. I will not just rely on my regular screening though, but schedule a specific STI exam just for this incident in about 6 weeks from now and remain abstinent from any kind of sexual activity till then. I hope your assessment will help me to stay relatively worry-free.

[Wade]

You can test if you like, and can expect a negative result.

Wade

[iank]

About 24 h ago I had another encounter with the following actions that occurred in the heat of the moment that might have been risky because I was having both two inflamed mouth ulcers from about two days ago (so maybe somewhat healed already but not quite) and a gum self-bite from earlier in the day.

- Me giving a blowjob without condom but also without cum (pre-cum possible though)
- Deep kissing

The following further actions I now consider not risky myself, but correct me if I'm wrong:

- Mutual anal fingering (very briefly without condom, but mostly with condom)
- Me receiving a blowjob without condom
- Body lips
- Mutual masturbation despite possible slight cuts on the hand (I have some scratchy skin because of cold weather here)

How would you assess my risk? Do mouth ulcers increase the risk for infection when giving a blow job? Should I get some PEP medication?

[Andy Velez]

The only 100% safe sex is with your own hand.  But many years in the epidemic have  proven that only unprotected vaginal and anal intercourse are confirmed risks for HIV.

As you've already been advised other STIs are much easier to transmit.  If you are sexually active you ought to at least annually have a full STI panel done and every 6 months is even better.

But no, I don't see HIV as a risk in your latest incident.