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bleeding hand and HIV positive semen.

Question: 

Hello Everyone,

I really need some professional help and your help is much appreciated.
My hands are really really dry with a lot of red scratches cuts from the cold weather(I also have a dermatological skin condition where my skin is so dry that it opens and bleeds in different places of my body). They bleed and stop bleeding a lot during the day, depending if I touch them or rub them.
Im a gay male not out yet and a bit scared of getting sexual with men. I went to a bath house today (gay sauna), I usually don’t touch anyone because of my hands condition, I just like to walk around and watch people. I watched a guy masterbate, as soon as he ejaculated, he ejaculated on his hand and I have no idea why he touched my hand directly. I freaked out because I might be bleeding, I put the towel directly on my hand to see if there was blood, and yes a patch of dry skin was bleeding, basically my towel had a lot of small dots of blood on it. I washed my hand directly and that patch of dry skin kept on bleeding for 20 minutes.

The issue is once he ejaculated he had semen on his hand, and touched my BLEEDING hand skin directly, so his semen touched my blood.

I spoke to the man and found out that he is HIV positive, I made sure of this information through someone else there and indeed he is HIV positive. He was helpful and told me to go to the hosipital directly.
My friend is a nurse at a hospital and she says I need to go to the emergency room and get my situation checked and she told me to insist on take treatment (PEP – post exposure that’s what she called it). She told me because the towel did not have just one drop of blood it had a lot more, which means that my skin was open and actively bleeding.

I am REALLY WORRIED scared I feel numb.. please tell me whats my risk from this situation. What shall I do at the moment ? am I infected ?
Thanks a lot for all your work and help here.

Answer: 

Thank you for reaching out to AIDS Vancouver

It seems you're looking for some advice about the risk of acquiring HIV from ejaculate. It also sounds as though this experience has been quite distressing, so I hope I can alleviate your fears and help you discover ways to have more fulfilling encounters in the future.

Firstly, I'd like to reassure you that this was a no risk encounter. HIV is not transmitted through contact with ejaculate in the way you describe, and so you do not need to worry about the possibility of having acquired HIV from this one experience.

Let's talk in more detail about how HIV is transmitted.
HIV is a fragile virus which becomes intransmissible once outside the body. Stray body fluids on superficial wounds is quite common (and a question we answer often), however there is simply no risk for acquiring HIV in this way. There are other blood-borne viruses which are much more robust and can be acquired through small cuts, however HIV is not one.

For successful HIV transmission to occur, it requires that body fluid (containing HIV) has a DIRECT route of entry into the bloodstream of another person. Our transmission equation shows this in some detail:

HIV TRANSMISSION EQUATION

BODY FLUID
+
ACTIVITY
+
DIRECT ACCESS TO BLOODSTREAM
• blood (including menstrual) • unprotected anal or vaginal intercourse • vagina
• semen • sharing needles • anus
• pre-cum • mother to child (in specific cases) • urethra in the penis
• rectal secretions • open cuts and sores (in theory)
• vaginal fluids • other mucosal membranes
• breast milk • points of needle injection

= RISK OF HIV TRANSMISSION

One of our most used resources is the Risk Assessment page, which shows the risks associated with some common activities. When you look at it, consider the three factors from the transmission equation, and that will help you assess risk in your own experiences in the future. Being comfortable with the activities you engage in is essential to having a fulfilling encounter, and we find that for many people, knowing the risks really helps them to decide what they do and do not wish to participate in. Proper use of condoms is also a great way to reduce risk by preventing exposure to body fluids, and you'll notice that activities move up and down the risk assessment depending on whether condoms are used or not.

I notice you mention that this man is living with HIV. It's great that you were able to have an open discussion with him, and I believe that many people frequenting bath-houses are quite open about their status. I would like you to know that people who know they are living with HIV are usually on medication which can reduce their viral loads to clinically undetectable levels, so while they will always be living with HIV, it becomes more like a chronic illness that is managed and monitored, and their risk of transmitting the virus to others is drastically reduced.
There is still a lot of stigma around living with HIV, but in reality, if a person stays on their medication, they can live as long and as healthy a life, as someone who is negative.
So while it's still important to protect yourself from HIV and other STIs, if you do happen to fall for someone who is living with HIV, there are ways in which you can have a fulfilling relationship and maintain your negative status - we call this a sero-discordant relationship, and it's more common than you might expect.

Because our forums are anonymous, I have no idea where you're posting from, however if you happen to live in the BC area, please take a look at our Health Promotion service; I'm sure our team would be very pleased to hear from you.

It's great that you have such supportive friends who you were able to turn to after this experience, and it's always good to know that people are aware of access to PEP. PEP (Post-Exposure Prophylaxis) is a course of medication taken within 72 hours of a high risk encounter to reduce the likelihood of HIV establishing in your body. In BC, it is only offered for high risk exposures, such as a condom failure, a sexual assault, or an occupational exposure, however, we at AIDS Vancouver recommend that individuals seek out the advice of a medical professional to assess suitability for PEP on a personal, case-by-case basis. As mentioned, your encounter in the bath-house is no risk. We would say that PEP is not warranted here, and I expect that it would not have been prescribed had you asked for it. It also has some side effects, and because of the way the drugs work, HIV testing must be delayed for an additional four weeks after PEP, which can be emotionally challenging after an exposure.

One of our favourite websites is the Health Initiative for Men; it has lots of advice on safe sex, STIs and HIV, and they have some really great conversation starters for coming out and living out.
As you're already aware of the local bath-house, I'm sure you'll also find information there about local AIDS Service Organisations and LGBTQ networks, both of which could introduce you to a supportive community, if that's something you're interested in.

Returning then to your original question, there was no risk of acquiring HIV from this experience. As AIDS Vancouver recommends testing for all people who are sexually active, perhaps you might want to consider where you might go for testing? Becoming familiar with services in your area before you need them is always a great idea.

Additionally, I wonder if you're having your skin condition addressed? Why not have a chat with your doctor and see if there's some treatment available? That way, you've one less stress to deal with when you're out and about.

I hope this helps and enables you to relax a little.

Very best wishes. Look after yourself.

Wendy (Volunteer)

helpline.aidsvancouver.org