Anonymous
So I'm a bit worried about a possible exposure. I was with a sex worker in Amsterdam and we had protected oral and vaginal sex. However while she was preforming oral sex I touched her vagina and anus for a bit, I did not finger her just touched. After that we had protected vaginal sex. When we were finished I removed condom from my penis ( uncircumcised ) and with the same hand that I used to touch her genitals I lifted my foreskin a bit up as it was bothering me. Is it possible I had some rectal or vaginal fluid on my fingers and than passed those fluids to the gland of my penis, urethra the inner epithelium of my foreskin ? I should point out that there was some time between touching her genitals and toching my penis. During that time I touched her skin and bed sheets as well. I know this is low risk or maybe it isn't rist at all, but it keeps bothering me so if you can calrify that for me I would be very very happy. Thanks for the support, keep up the good work
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Anonymous
Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the possibility of HIV transmission after protected vaginal sex. Here at the AIDS Vancouver Online Helpline, we focus on the individual act being reported, and do not assume that groups of people, such as commercial sex workers are more highly associated with HIV risk. From the information given, this scenario is determined to be Low Risk (Evidence of transmission occurs through these activities when certain conditions are met).

The scenario mentioned above does not meet the three components of the [HIV Transmission Equation](https://www.aidswindsor.org/healthy-me/hiv-transmission/). It does not meet this criteria because there was no direct access to the bloodstream unless a condom was broken or not put on properly. HIV incidence is reduced by 80% with the use of condoms during all acts of penetrative vaginal sex [1]. Condoms do not reduce the transmission of HIV to zero. However, consistent condom usage is one of the primary methods to protect against HIV transmission.

As to your question regarding non-insertive masturbation, as there was exposure to oxygen and no direct access to bloodstream in a closed environment there is No Risk of transmission through the non-insertive masturbation. In this event, the HIV transmission equation is not met, because there is no *direct access to the bloodstream*. Because in the scenario above, you had touched the vagina with your fingers which you described had bodily fluid; there was a definitive exposure to oxygen in the process.

When HIV positive bodily fluid is exposed to the environment or environmental surfaces, there is a rapid reduction in concentration, and HIV in the fluid is rendered effectively inactive [2].

Recommendation: Refer to a health care provider for HIV testing, due to the Low Risk exposure described above, and not specifically the second situation of non-insertive masturbation.

Regards,
AIDS Vancouver Helpline/Online, Carson

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