Anonymous
Hello.
I'm a young male who recently had a sexual encounter with a transgender. We had kissing and oral which evolved, receptive and insertive. Well he's kissing for some while and had oral sex either ways. She also licked my anus and fingered it normally and then later with lubricant. Later we also kissed each other after she licked my anus. Later I performed oral sex on her and she had some precum on. I didn't swallow it but spat after 2-3mins. I also had a bit of sore throat and some throat irritation that time. We didn't have anal intercourse. Just oral and fingering. I later learnt that she is an escort and I asked her about her status where she told me that she disease free and has regular check up.
But the thing is I'm freaked out about it and the possibility of hiv transmission or any other STDs
My question is.. As I mention above, is there any chance or hiv transmission or any other STDs?
Can having a sore throat and performing oral sex transmit any disease?
I also have gum bleeding when I brush my teeth but the oral sex was performed much after two hours. Still is there any chance?
Also, she fingered me in my anus, initially with bare fingers and later applying lubricant, is there any chance if she had a cut on her finger and the blood on it while fingering might have enter the thin linings of anus and infect?
Is there any possibility of transmission and when can I get it tested to know exactly about my status?
Thank you.
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Anonymous
Hi there,

Thanks for contacting AIDS Vancouver's Helpline. I can see you're feeling concerned about this situation and I hope my answers give you the answers you need.

Let me first tell you about the necessary factors for HIV transmission:

1. The exchange of body fluids with high levels of HIV, such as blood, semen, or anal/vaginal secretions,
2. A high-risk activity, such as unprotected anal or vaginal sex or the sharing of used needles,
3. Direct access for the virus to enter the bloodstream, such as through the vagina, anus, or urethra of the penis, and
4. No exposure to the air, since the oxygen in the air breaks down HIV thus preventing transmission.

In your case, let me explain why 1) receiving oral sex, 2) giving oral sex, and 3) fingering are not a high risk. These activities are actually "low to negligible risk" activities. "Negligible risk" means that, even though there is *technically* a risk since partners exchange body fluids during the activity, there has *never* been a reported case of HIV transmission from this activity. "Low" risk means that out of the millions of HIV cases in the world, only a few have ever occurred due to this activity, and usually it was due to outside factors that changed the activity's general risk.

1. Receiving oral sex: A negligible risk activity. Saliva actually contains enzymes that prevent the growth & transmission of HIV. Therefore, your partner's saliva protected you against any HIV transmission, which means that criterion #2 (a high-risk activity) was not met. Your risk for receiving unprotected oral sex was negligible.

2. Giving oral sex: A low risk activity. Again, your saliva acted as a protective barrier against HIV transmission when you were giving oral sex. Therefore, criterion #2 was not met with this activity. Having a sore throat also does not change anything about risk for HIV transmission. Overall, your risk was low.

3. Fingering: A negligible risk activity. Fingering does not involve the exchange of body fluids; it mostly one person's finger/skin against another person's body fluids. Therefore, #1 is not met, which means this is not a high-risk activity (#2). Even if your partner had a cut on her finger, the cut would not have been able to transmit HIV. Small surface cuts can't transmit HIV since the clotting that happens inside the cut prevents pathogens and viruses (like HIV) from entering/exiting the body. Therefore, your risk does not change even if your partner had a cut. Overall, your risk was negligible.

In sum, your HIV risk was low to negligible, and you most likely do not have to worry about HIV transmission in this case. For STI transmission risk, I encourage you to visit [this website](http://smartsexresource.com/about-stis/stis-101) and [this website](http://www.cdc.gov/std/) since AIDS Vancouver concentrates on figuring out HIV risk and not other STIs. However, we at AIDS Vancouver still encourage *all* sexually active people to get regularly tested for HIV and all other STIs for their own benefit. Therefore, even though this encounter did not necessarily need HIV testing, I still encourage you to get tested -- just like I encourage all other sexually active posters to get tested.

Lastly, I would like to say that the likelihood of HIV/STI transmission is *not* affected by the person you're with. Instead, HIV and STI transmission risk is determined by the *activity* you engaged in. You said your partner was a transgender "escort" (or commercial sex worker, as we at AIDS Vancouver prefer to say), but this does not mean that she was at higher risk for being HIV positive. HIV does not discriminate based on gender, occupation, age, sexuality, or any other factor. It is the activity, *not* the person that you need to be concerned about.

I hope I've answered your questions completely and you feel more reassured with these answers. Thanks for reaching out to us and posting; I'm glad you turned to us for information!

In good health,

Tiina

AIDS Vancouver volunteer
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