Anonymous
Hi, I am hoping that you can ease my fear. The incidents were as follows. I engaged in mutual masturbation with a male who I did not know. He ejaculated on my penis at the same time I was masturbating, so essentially I was using his semen as lube immediately. I understand non-insertive masturbation is not a risk, but even under this scenario? I also received oral sex from him, but I did not ejaculate. I know you say that this is a negligible risk, meaning no one has ever been confirmed has having been infected this way. So am I correct that I wouldn't need to test for receiving oral sex. The last incident was one where I also thought I was being safe, but now I am not sure. I was a sex arcade and was touching a man I didn't know. I sort of lick the side of his penis (but not the tip of his penis )for a few seconds, I did not insert his penis into my mouth (ie his head etc.) There was no semen or pre cum that I could tell. Would you consider this as non insertive oral sex? I would think that if there was any fluids on the shaft of his penis then they would have been rendered inactive from the air etc.? I am very scared that I have put myself at risk. I know you say oral sex is low risk, but given that no fluids were involved (definitely not semen and no precum from what I could tell) and I did not insert his penis in my mouth. I also didn't have any stds or sores etc in my mouth. would this still be a low risk? Are the only cases involving people with STD's in their mouth? Also I read there were only a few confirmed cases (ie 3) Is this the only basis for the low risk assessment. It seems like 3 cases out of 30 years of this epidemic would mean it is extremely extremely rare. I know you get a lot of these questions, but I am very scared and anxious that I cannot function. The more specifics you can give me as to my risk, the better. Thank you very much for your time.
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Anonymous
Hi there,

Thank you for choosing AIDS Vancouver for your source of HIV/AIDS related information. It's great to see that you are taking initiative when it comes to your health and well being!

Mutual masturbation poses no risk for HIV acquirement, even under the circumstances you have described. Keep in mind that HIV dies upon exposure to oxygen, and it needs to enter the urethra directly in order to gain access to the bloodstream. As you have indicated, receiving oral sex poses a negligible risk for HIV transmission. The third scenario you described does not pose a risk for HIV transmission; as you indicated, even if any fluids were present they would have died upon exposure to the air. Remember, there needs to be a direct exchange of bodily fluids for HIV acquirement to occur - which did not occur in this scenario. Based on everything you have described, you are not at risk for HIV. You do not require HIV testing for these particular incidences.

I have attached a link to a chart that I think will help clear up any confusion regarding HIV transmission: http://www.aidsvancouver.org/get-informed/faq/what-hiv-transmission-equation. In order to be at risk for HIV, you have to be exposed to one of the fluids mentioned, during one of the activities listed while having access to the bloodstream during that activity. Performing oral sex does pose a low risk for HIV transmission; however, these reported cases were under identifiable conditions such as the person performing the act having other sexually transmitted infections (STIs) and/or poor oral health. Saliva is able to break down and kill the virus, making transmission of HIV through the mouth very difficult. Furthermore, even if the fluid containing HIV is swallowed, the gastric juices in the stomach will kill the virus. Having sores and cuts does increase the likelihood of transmission, since these are points of entry into the bloodstream (however, even under these circumstances, the act of performing oral sex is still considered a low risk activity).

If you are worried or unsure of your HIV status, the only way to know is through testing. According to international guidelines, all HIV testing is considered conclusive 12 weeks (or 84 days) post exposure, provided there are no other exposures during that window period. At AIDS Vancouver we advocate for all sexually active individuals to test for all sexually transmitted infections (STIs), including HIV, as part of their health routine. This can be in the form of testing every 3 months, bi-annually, annually or whatever suits their lifestyle.

I hope I have addressed all of your concerns, and if you have any other questions please feel free to contact us again!

All the best,

Greg
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