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Can One Contract HIV From Non-penetrative Sexual Activity With A CSW?

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Posted on Fri, 13 Oct 2017
Question:
I had an encounter with a sex worker. There was no penetration. Just unprotected handjobs. But throughout the session, she kept kissing my body (stomach, chest, neck and nipples) She also licked my nipples for like 10 seconds. Also she sat on my leg shin area while she was in her underwear. (shin area for like 7 seconds) There was no broken skin upon insoection of the area.

Do i have anything to worry about from my exposure? (If there was non intact skin)Is hiv test warranted? If so, which gen? and what is the window period?
doctor
Answered by Dr. S. Murugan (38 minutes later)
Brief Answer:
Your HIV risk is negligible as per CDC XXXXXXX USA

Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
Hand job is the safest sex activity. Kissing over body, licking the nipples and sitting over shin with under wear was on, have negligible risk.
If your activities were restricted to what you had described, then a HIV test is not necessary for you.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (3 minutes later)
for these past few days i have been to thousands(figureatively) of websites and they all said that vaginal fluids are a means of transmission, so why is it tjatbin my case its not considered a risk? and that i dont have to test for hiv?

Just a few details to paint a clearer picture

1) she was in her underwear

2)she sat on my shin area, upon inspection there is no broken skin.

3) Im afraid of the little wounds like healing cut/abrassion/nicks

4) And after she sat i didnt immediately wash it off. I however had a full shower afterwards (soap and all)

So can you please tell me more to ease my anxiety? And you said that it was negligible risk? Can you elaborate further?

Thanks
Zaida
doctor
Answered by Dr. S. Murugan (17 minutes later)
Brief Answer:
Your HIV risk still remains negligible only.

Detailed Answer:
Hi,
Welcome back.
Of course Vaginal fluid of a HIV positive individual is infectious during sexual intercourse as there is possibility of minute abrasions during sexual contact.
Contact with infected Vaginal fluid over intact skin has negligible risk even if we consider that your shin was having some invisible and/or healing abrasions. Moreover she was on underwear. Vaginal fluid in normal women would not come out of her external genitalia. It could not wet her inner wear and contacted your skin. In that case also HIV can not survive not for few seconds over cloth. No such incidence of HIV transmission was reported so far.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (8 hours later)
Please tell me more about HIV from a non sexual transmission method.

Ive read from a forum dedicated to HIV that wounds that are considered a risk would be one that are really major (knife wounds, major lacerations)

And that the vaginal fluids that contain hiv are not the one from the bartholin glands, but rather the fluids from the cervix. Can you follow up with me on this matter? Im still abit anxious if you dont mind.
doctor
Answered by Dr. S. Murugan (31 minutes later)
Brief Answer:
Blood transfusion,sharing needles,mother to child are nonsexual modes of t

Detailed Answer:
Hi,
Welcome back.
HIV can be transmitted through non sexual route through transfusion of an infected fresh blood and blood products and through infected sharp instruments especially among the health care workers while surgery, handling blood and internal body fluids and during some invasive procedures. That too, the nonsexual route of transmission including mother to child transmission amounts to less than 15% of the total HIV positive population.
The risk with a casual contact with an abrasion, healing wound is negligible (https://www.cdc.gov/hiv/risk/estimates/riskbehaviors.html).
We can not separate bartholin's secretions, cervical transudate and cervical secretion during any sexual play. It will be infectious if the individual has HIV and not on treatment during sexual activity concerned with vaginal penetration. If the individual on ART treatment and if her viral load is well under control then also she would cease to be infectious.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (3 minutes later)
So doctor either way my situation has put me in risk? And i still require testing? And what is negligible risk? Is it the same as low risk? Im still very anxious about this whole affair
doctor
Answered by Dr. S. Murugan (13 minutes later)
Brief Answer:
Negligible risk for HIV is far less than 'low risk'

Detailed Answer:
Hi,
Welcome back.
I personally feel that you don't need any test for HIV as per act described by you. Negligible risk is not low risk. It means that you can ignore the same, very much lesser than low risk.
You can have a HIV test 12 weeks after this incident to rule out HIV infection just for the sake of your disturbed mind. After seeing the HIV nonreactive result you can relax and get rid of your mental tension. Otherwise in future any small ailments like fever or head ache would likely be attributed to HIV.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (5 minutes later)
I just wanted to point out that before my reply, you said that "We cannot separate secretions......during any sexual play" But i didnt have sex. Im just wanting to find out the risk that my actions have caused.

Primarily, the risk of vaginal fluids getting on to non intact skin. Plus ive read that it takes more then abrassion, nicks, cuts to be really a risk (major laceration)

Also, if i decide to test, can i go for the 4th gen testing at 4 weeks

I apologize from the bottom of my heart for troubling you with so much questions.

Regards
Zaida
doctor
Answered by Dr. S. Murugan (2 hours later)
Brief Answer:
Go ahead with another test 28 days after the incident

Detailed Answer:
Hi,
Welcome back
I can say that your HIV risk is negligible ligible with the activities that you have mentioned.
You can go for another HIV 4th generation test 4 weeks after that incident and very well ruled out HIV 1 infection beyond any doubt.
Nothing to worry.
Dr S Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (6 minutes later)
Hiv 1? there is a HIV 2? What is the difference? Now im really scared.

But after reading through my postings, its still a negligible risk right?
doctor
Answered by Dr. S. Murugan (2 hours later)
Brief Answer:
Your HIV risk still remains negligible only.

Detailed Answer:
Hi,
Welcome back.
AIDS can be caused by two different types of virus HIV 1 and 2. HIV 1 is prevalent worldwide to the extent of more than 99% except in certain XXXXXXX countries. HIV 1 is more virulent.
After gone through every point posted by you, I strongly feel that your risk is almost 'nil' or negligible. Nothing to worry at all.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (51 minutes later)
Doctor, i also have a history of cold sores. contracted it last year after kissing a girl. Will this affect your judgement regarding risk?

I apologize for the many questions. Just trying to keep my anxiety low.

Thanks XXXXXXX
doctor
Answered by Dr. S. Murugan (18 minutes later)
Brief Answer:
Cold sore history does not alter your risk for HIV.

Detailed Answer:
Hi,
Welcome once again.

Cold sore is a such a common menace. Even children can get affected. Nearly 40% population in any community at one time got affected by Cold sore or HSV Type 1 infection. So the past history of cold sore in no way concerned with your HIV risk with that incident. Cold sore persisting for more than a month can be a manifestation in HIV.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (6 hours later)
Hello again doctor, need more advice from you.

Most websites talk about wounds/cuts/nicks and bruises being a risk for hiv transmission.

As you know, she sat in her underwear and on my shin.

If so why is it still negligible risk?

Does the trauma to the skin have to be deeper then just a scrape/bruise/nick/cut? (lacerations/knife wound)etc

If so, why is there no updated information updated on websites. Sorry for messaging you again. Im just a very paranoid person waiting for the 28th day mark
doctor
Answered by Dr. S. Murugan (3 hours later)
Brief Answer:
Transmission of HIV in this route are quite unlikely.

Detailed Answer:
Hi,
Welcome back.
I am practicing HIV medicine for the past 29 years. I am handling so many patients during these time (more than 2000), and I was a consultant for a care center for HIV people (funded By NACO) and also for a HIV orphan home for few years. During these periods, myself and my subordinates were handling various situation including clean bleeding wounds and removing certain skin conditions in this children with needles, sometimes with gloved hands ,many a time with even bare hands. Everyone of us would have some sort of minute abrasions in our fingers at one time or another. Similarly there are lot of people offering care to HIV affected individuals world over. Family members of HIV positive individuals are caring and providing all assistance in every walks of their life and would have met with such situations. Nobody gets the disease in such a way except with deep prick with a treatment naive individuals blood. That also we can count with our fingers worldwide among health care providers.
Sexual situations are different from that of casual contacts with blood or vaginal fluid. Fingering carries a negligible risk only as CDC, XXXXXXX
More over vaginal fluid causing wetness over the inner wear and contact with the body and transmitting HIV is unheard. I knew people played with their penis on women with inner wears and free fro HIV infection even after years. During these type of contact HIV would not survive to cause an infection. So forget about this incident and carry on your routine. Don't search in internet.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (8 hours later)
Thank you for thr replies doctor. Right now it is just fear of the unknown and paranoia that is fuelling my actions. I will defitnely go test at the 28th day mark with the 4th gen test, and expect a negative result.
doctor
Answered by Dr. S. Murugan (42 minutes later)
Brief Answer:
You will get a non-reactive report

Detailed Answer:
Hi,
Welcome back.
I assure you that you will get a non-reactive report only.
If you have still much trouble, you can consult a psychiatrist also.
Dr S Murugan
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
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Dr. S. Murugan

HIV AIDS Specialist

Practicing since :1974

Answered : 2992 Questions

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Can One Contract HIV From Non-penetrative Sexual Activity With A CSW?

Brief Answer: Your HIV risk is negligible as per CDC XXXXXXX USA Detailed Answer: Hi, Welcome to HCM. Thanks for posting your query. Hand job is the safest sex activity. Kissing over body, licking the nipples and sitting over shin with under wear was on, have negligible risk. If your activities were restricted to what you had described, then a HIV test is not necessary for you. Dr S.Murugan