Thank you for reaching out to AIDS Vancouver. I hope the following information will help you understand the risk level of the activity you described.

I'll begin by cutting to the chase: Fingering someone (whether or not you lick your fingers afterward) is NEGLIGIBLE RISK. This means that there is a theoretical risk of transmission due to this activity, but that there has never been a confirmed case of anyone acquiring HIV this way.

Here's why:

To acquire HIV there must be an activity + an exchange of bodily fluids capable of transmitting HIV (blood, semen, pre-semen, rectal secretions, vaginal fluids or breast milk) + a way for HIV in those bodily fluids to get direct access to your bloodstream.

When you are fingering someone, there is no obvious way for HIV to get direct access to your bloodstream if your finger is free from any major cuts deep enough to require stitches or major infections.

Licking your finger doesn't increase the risk of acquiring HIV for a number of reasons. First, HIV quickly stops being transmissible after exposure to an open air environment. And once you remove you finger, the vaginal fluids on it are exposed to the air. Second,your saliva contains an enzyme that provides some added protection against HIV.

I hope this has answered your question and provided you with a bit more understanding about how HIV is transmitted. If you have further questions about the risk level of other activities, you are welcome to refer to our Risk Assessment Chart.

Yours in health,

Matt, Helpline Volunteer
AIDS Vancouver Online Helpline
helpline.aidsvancouver.org

Thank you for reaching out to AIDS Vancouver. It sounds like you're worried about the risk of exposure to blood and semen getting on a wound of some sort. I hope the following information will help you understand your situation a bit better.

The first thing I want to do before going into the risk assessment is just clear up the difference between HIV and AIDS, since it sounds like you're using them interchangeably. HIV is a virus. AIDS is a syndrome caused by the virus after many years, and diagnosed when two or more opportunistic infections are present in someone with HIV. Everyone with AIDS has HIV, but not everyone with HIV has AIDS.

Secondly, I want to be upfront that I don't fully understand the scenario you described in some key ways because you left out some critical details. That said, I'll do my best to indicate what I don't know and why that matters, which hopefully will allow you to understand your situation a bit better.

The basic thing to understand is that to acquire HIV there needs to be an activity + the exchange of bodily fluids capable of transmitting HIV (blood, semen, pre-semen, rectal secretions, vaginal fluids or breast milk) + a way for HIV in those bodily fluids to get direct access to your bloodstream.

It seems clear that you were exposed to bodily fluids capable of transmitting HIV. But the risk levels of what happened depend upon whether your wound is something that would provide direct access to your bloodstream.

If your wound was a superficial wound on dry skin such as the skin of your arm or leg, it would be unlikely to function as the kind of entry point necessary to acquire HIV and would pose a negligible risk (which means there is a theoretical risk but there are no confirmed cases of HIV transmission this way) .

On the other hand, if the wound was on a mucous membrane or if the wound was severe (a cut deep enough to require stitches or an infection that causes inflammation), that would pose a greater risk. I just can't tell you exactly how much that would increase the risk.

Additionally, the risk level is also affected by the quantity of fluid you were exposed to, the size (surface area) of your wound, and how long the fluid had been exposed to air prior to it coming in contact with your wound.

Notably, HIV is a a relatively weak virus that quickly stops being transmissible after exposure to the air. So even if the wound was severe, exposure to blood or semen that had been exposed to air for more than a handful of seconds before coming into contact with the wound would only carry (at most) a negligible risk.

I hope this helps you understand your situation a bit better. If you want to understand more about HIV and AIDS, and how transmission occurs, there is a lot of useful information on CATIE.ca.

Yours in health,

Matt, Helpline Volunteer
AIDS Vancouver Online Helpline
helpline.aidsvancouver.org

Hello and thanks for contacting AIDS Vancouver with your question.

It sounds like you have some concerns about the likelihood of acquiring HIV from your most recent sexual encounter.

From what you have told me, you engaged in various sexual activities such as protected vaginal intercourse and received protected oral sex with a commercial sex worker. First off, it is great that you used a condom during your sexual encounter, the condom itself is one of the best contraceptives available and significantly reduces the risk of one acquiring HIV and other sexually transmitted infections. With this taken into account, the sexual act of vaginal sex with a condom is distinguished as a Low Risk. This is primarily due to the exchange of body fluids and there have been a few reports of infection in this manner, but are usually under certain identifiable conditions.

On the other hand, the sexual act of receiving oral sex is distinguished as a Negligible Risk as while the act itself does involve the exchange of body fluids, there has never been a confirmed report of one acquiring HIV in this manner. Furthermore, for there to be a risk of HIV transmission there needs to be a body fluid, a sexual activity such as unprotected anal or vaginal intercourse and a direct access for the virus to enter the bloodstream. Saliva contains enzymes that actually damage the HIV virus to the point where it is no longer transmissible, which supports the overall risk assessment of receiving oral sex.

If you are still concerned about your current HIV status, it might be helpful for you to partake in routine HIV testing as it is a great way to stay up to date on your current HIV status. With this taken into account, when pursuing HIV testing, official HIV testing guidelines still recommend re-testing at 12 weeks post-exposure for completely conclusive results. These testing guidelines are in regard to all HIV testing.

Below I have attached an HIV Transmission Equation chart, which goes into further detail on the necessary factors that are required for there to be a risk of HIV transmission.

For more information on HIV you can visit What is HIV?.

Regards,

Chris, Volunteer

AIDS Vancouver Online Helpline
helpline.aidsvancouver.org
Private & Confidential

Hi there and thank you for reaching out to AIDS Vancouver with your questions! We're happy to help.

To start off, here is a risk assessment of the activities that you described:

1) Giving oral sex is considered to be a low risk. While there have been a few reports of infection attributed to this scenario, they have only been under certain identifiable conditions (i.e. the condom breaking).

2) Assuming the anal sex was also with a condom, this is also a low risk activity. If there was no condom involved, this would be considered a high risk activity.

I also wanted to briefly address your symptoms. There are no specific symptoms of HIV. In fact, certain individuals may never develop symptoms, and for those who do, most symptoms will go away after a few days, or at most, a couple of weeks. This is why the only way to diagnose HIV is to get tested. Because HIV symptoms mirror so many other viral infections or can be explained by other things, we do not go by symptoms here at AIDS Vancouver, as you already know.

You also mentioned taking the Rapid Test in the upcoming few days. Here is some information regarding the Rapid Test:

I hope I was able to answer your question, and feel free to contact us with any further concerns.

Regards,

Sierra, Helpline Volunteer

AIDS Vancouver Helpline/Online
helpline.aidsvancouver.org
Private & Confidential

Hi there and thank you for reaching out to AIDS Vancouver with your questions! We're happy to help.

Receiving oral sex is considered to be a negligible risk. This means that while it is theoretically possible to acquire HIV in this scenario, there has never been a confirmed report.

If you have any further questions about your risk level, please consult the AIDS Vancouver Risk Assessment Chart.

I hope I was able to answer your question, and feel free to contact us with any further concerns.

Regards,

Sierra, Helpline Volunteer

AIDS Vancouver Helpline/Online
helpline.aidsvancouver.org
Private & Confidential

Hi there and thank you for reaching out to AIDS Vancouver with your questions. We're happy to help!

First of all, here at AIDS Vancouver, we are trained volunteers and not medical professionals. Hence, we are not doctors.

In terms of your risk level, fingering is considered to be a negligible risk, meaning that while it is theoretically possible to acquire HIV in this scenario, there has never been a confirmed report.

Lastly, in order for a cut to pose as a risk for HIV transmission, the cut needs to be gushing blood and require immediate and professional medical attention. Small, superficial cuts like the one you have described do not pose as a risk for HIV transmission, as they do not provide direct access for the virus to enter the bloodstream.

I hope I have answered your question, and feel free to contact us with any further concerns.

Regards,

Sierra, Helpline Volunteer

AIDS Vancouver Helpline/Online
helpline.aidsvancouver.org
Private & Confidential

Hello and thanks for contacting AIDS Vancouver with your question.

It sounds like you have some concerns about the likelihood of acquiring HIV from the described scenario.

From what you have told me, you recently had a sexual encounter with a commercial sex worker, which consisted of kissing, receiving a hand-job and giving one as well. It is important to note that when it comes to the risk of HIV transmission it is based off the actions rather than the individual. Furthermore, for there to be a risk of HIV transmission there needs to be a body fluid, an activity such as unprotected anal or vaginal intercourse and a direct access for the virus to enter the bloodstream. When it comes both kissing and receiving a hand-job are both distinguished as No Risk activities as none of these practices have ever demonstrated to lead to HIV infection. On the other hand, the act of fingering your partner would be distinguished as a Negligible Risk as while there is an exchange of body fluids, there has never been a confirmed report of one acquiring HIV in this manner.

Below I have attached a copy of an HIV Transmission Equation chart, which goes into further detail on the necessary factors that are required for there to be a risk of HIV transmission.

For more information on HIV you can visit What is HIV?.

Regards,

Chris, Volunteer

AIDS Vancouver Online Helpline
helpline.aidsvancouver.org
Private & Confidential

Hello,

Thank you for contacting the AIDS Vancouver Helpline as your source for HIV/AIDS related information. I would be happy to answer your questions and provide you with some information.

To ease your worries, I would like to say that your situation is considered negligible risk at the most. I will explain why by showing your HIV transmission equation. For HIV transmission to occur, you must have all 3 of the factors listed in the table.

Receiving oral sex is a negligible risk because it has one of the factors listed above (exchange of body fluids). Negligible means that while there is a risk for HIV due to the exchange of body fluids, there has never been any confirmed reports of HIV transmission occurring in this manner. On the other hand, giving a hand job is considered a no risk as it has none of the factors present. Even if you got his semen on your hand, you are still considered no risk from the hand job because HIV is a very weak virus that is broken down the moment it is exposed to the air.

Based on this experience, you are a negligible risk and you do not need to be tested. If you are worried about this situation, you can get HIV testing. Prior to testing, please know that based on the guidelines AIDS Vancouver follows, all HIV tests are considered conclusive at 3 months or 12 weeks after the last high risk exposure.

In the future, please know that many people living with many are on medications called Anti-retroviral medications. These medications help control their HIV levels to a point where many of the are considered Undetectable. When someone is Undetectable, their HIV levels are so low that the risk for transmitting HIV is also very low. For more information regarding this subject matter, please refer to the links provided.

I would also like to say that it is not who you engage in sexual activities with but rather how you engage in these sexual activities that determine your level of risk for HIV transmission. AIDS Vancouver promotes safe sex through the use of condoms and regular HIV and STI testing for all sexually active people.

I hope I have answered your questions. Please feel free to contact us if you have any more questions.

Best Wishes,

Mary

AIDS Vancouver Online Helpline
helpline.aidsvancouver.org
Private & Confidential

Hi there, and thanks a lot for contacting the AIDS Vancouver Helpline with your HIV/AIDS related health information. You seem concerned about the possibility of HIV transmitting through some activities. We're happy to answer your questions for you.

You seem concerned about a couple activities. One is that you received oral sex, and the other that you think you may have penetrated your partner. First off, receiving oral sex is considered a negligible risk activity, meaning that it is theoretically possible for HIV to transmit through activities such as these, but it has never actually been shown to occur. As to the risks associated with the possible penetration, only you really know if penetration occurred. We think if penetration did in fact occur, you'd most likely know. However if penetration did somehow occur this would be classified as a high risk activity. We'd suggest putting on a condom even before this point in the future.

If you'd like more information on protection, check out one of our favourite resources at SmartSex.

Thanks for contacting the AIDS Vancouver Helpline with your questions. We hope our answer has eased some of your concerns.

Trevor

AIDS Vancouver Online Helpline
Private & Confidential

Hello,

Thank you for contacting the AIDS Vancouver Helpline as your source for HIV/AIDS information. You sound very stressed about this situation and have many "what if" questions. To help you, I will try to answer your question as simply as possible and by providing you with facts.

Before I answer your questions, I would like to show you the HIV Transmission Equation. To get HIV, you must have all 3 of these factors present.

First, receiving a hand job is considered a no risk situation. It is no risk because it has none of the factors listed above (you did not engage in any insertive activity, there is no exchange of body fluids and there was no direct access for the other person's fluids to enter your body).

Second, receiving oral sex is considered a negligible risk. Negligible means that while there is a potential for transmission due to the exchange of body fluids, there has never been any confirmed reports of infection occurring in this manner. Since receiving oral sex has one of the factors listed above (exchange of body fluids), it is considered a negligible risk. On the other hand, giving oral sex is considered a low risk activity as it has two of the factors listed above (exchange of body fluids and direct access for the virus to enter the blood stream). Since it was your female partner giving you oral sex, she is actually at a higher risk of contracting HIV from you (if you had it) than you are from her!

With regards to your concern regards cuts, please know that when we talk about cuts posing as an access point for HIV to enter the body, we are talking about deep, large and actively bleeding cuts. This is because our body has many layers of skin and mechanisms designed to protect outside particles, like HIV, from entering our body. The cuts you describe in the situation do not seem to fit the description and therefore, pose as no risk.

Last, please take note of the fact that HIV is transmitted from person to person and direct access to the blood stream is needed for HIV to be transmitted. This means that the virus needs to go directly from the other person and then into your body through an access point. The reason for this is because HIV is very weak and when it exits the body, it is broken down and can no longer cause infection. Therefore, there is no way the virus could have gone from your female partner's vagina, to your friend's penis, back to the female partner's hand and then to you. Likewise, there is no way the HIV can go from the sponge and then yourself.

Based on this risk assessment, you do not need to be tested for HIV. However, if you are very worried about it, it may be helpful to get tested just get the peace of mind you are searching for. AIDS Vancouver recommends that all sexually active people be tested on a regular basis for all STI's and HIV. We also recommend safe sex practices such as the use of condoms during sexual activity.

I hope I have answered your questions. Please feel free to contact us if you have any more questions or refer to the link provided for more information.

Best wishes,

Mary

Helpline Volunteer

Hi there and thanks for reaching out to the AIDS Vancouver Helpline. My name is Colin and I'm happy to answer your question.

I understand you are concerned about the possibility of acquiring HIV after fingering an HIV positive woman's vagina. I hope the information I can provide can put your mind at ease.

Right away I can tell you that any kind of fingering or "digital stimulation" is considered a negligible risk activity meaning that while it is theoretically possible to make a case for transmission via this route, it is never known to have actually happened before. For there to be a successful transmission of HIV there must first be HIV present. Next there must be an exchange of bodily fluids with direct access to the bloodstream. Additionally, and important in your exposure, when exposed to the air for even a few seconds, HIV is immediately rendered non-transmissible meaning it can no longer be passed on from person to person.

Even though your question is about the fingering, I should mention that protected vaginal intercourse (which is what I assume you did after you put on the condom) is considered a low risk activity. This means that while rare, transmission has been known to occur via this method and because of this we would recommend testing for this exposure and regular testing for all sexually active people.

Depending on where you are, most commonly-administered tests will give you a good indicator of your status about a month after your exposure and any test you take at or after 3 months (12 weeks; 84 days) post-exposure will be considered conclusive.

I hope the information I've been able to provide has been helpful to you. Feel free to post again if you'd like any more information or clarification.

All the best,

Colin

AIDS Vancouver Helpline

Hello,

Thank you for contacting the AIDS Vancouver Helpline as your source for HIV/AIDS related information. I would be happy to answer your questions regarding HIV. However, please know that we are an HIV/AIDS specific helpline and therefore, have limited knowledge regarding Hep C. For information on Hep C, please refer to the website link provided.

First, I am glad to hear that you have taken the initiative for your health and well being by getting yourself tested. HIV testing is the only way to know if you have HIV. Good job! With that said, all HIV tests are considered conclusive at 12 weeks or 3 months after the last high risk exposure. Since your HIV test was at 3 months after the exposure and if you have not had any other sexual encounters between that time, your tests are conclusive and you are HIV negative.

With regards to testing for HIV at 6 months, know that you do not need testing at 6 months unless you meet any of these 4 criteria:

1. if you are currently receiving antiviral treatment for Hep C
2. if you are currently receiving treatment for cancer
3. if you have received Post Exposure Prophylaxis (PEP) medication
4. if you have an underlying immunodeficiency

If you do not meet any of these, then your test at 3 months is considered conclusive and you do not need any more testing.

To help you further your HIV information, know that receiving unprotected or protected fellatio is considered a negligible risk. This means that while there is a risk due to the exchange of body fluids, there have never been any confirmed reports of infection occurring in this manner. On the other hand, protected anal sex, no matter how long or short the intercourse was, is considered a low risk. In this case, the use of a condom went a long way towards protecting you as it provides a barrier, preventing direct access for fluids to enter your blood stream. If you hadn't used a condom, your risk would be high for contracting HIV, Hep C and other STI's. Good job on using the condom! For the future, if you would like to know your HIV risk, you may refer to our HIV risk assessment chart.

I hope I have answered your HIV related questions. Please feel free to contact us if you have any more questions or refer to the links provided for more information.

Best wishes,

Mary

Helpline Volunteer

Hi there and thanks for reaching out to the AIDS Vancouver Helpline. My name is Colin and I am happy to answer your questions today.

I understand you are concerned about the possibility of acquiring HIV after noticing a small cut on your finger after fingering your partner. I hope the information I can provide will be helpful for you.

Right away I can tell you that this was a negligible risk exposure. This means that while it is theoretically possible for HIV to transmit via this method, it is never known to have actually happened in the real world. For there to be a successful transmission of HIV, there must first be HIV present. Next there must be an exchange of bodily fluids with direct access to the bloodstream. Also, an important detail in your exposure is that when we are discussing cuts or injuries as the potential entry point for infection, the wound must be very severe. Our rule of thumb is that if the injury isn't actively bleeding heavily and requiring medical attention and/or stitches, then it is not significant enough to allow direct access for HIV. Given that it sounds like these conditions weren't met during your exposure, you can consider your risk to be very very low.

That said, here at AIDS Vancouver, we recommend HIV and STI testing for all sexually active people. If you are in Canada or the USA, I would encourage you to check out ASO411 or the CDC's Get Tested website respectively to find the best services and facilities for you.

I hope the information I've been able to provide has given you some peace of mind. Please feel free to post again if you'd like any more information or clarification.

All the best

Colin

AIDS Vancouver Helpline

Hi there, and thanks for contacting the AIDS Vancouver Helpline for your HIV/AIDS related health information. It seems you're concerned about the possibility of HIV transmitting during an encounter. We're happy to answer your question for you.

These situations have different risk levels associated with them. Her giving you oral sex carries with it a negligible risk of her transmitting HIV to you. You giving her unprotected oral sex is considered a low risk activity, and having protected sex is also considered to be a low risk activity. Low risk means that while it is possible for HIV to transmit, specific conditions are required. When giving oral sex, this might be that you had had major dental work, or when having penetrative sex, that the condom breaks. You state that prior to your encounter, you bit your lip to the point it was bleeding. This does not increase your risk to any significant extent, as it is not considered a wound that would increase your risk. Wounds that increase your risk are much larger, like the type you might have after getting major dental work done.

That said, have you ever gone for an HIV test? We always recommend routine HIV testing for all sexually active individuals. So if you haven't had a test, we'd encourage you to go.

Thanks a lot for contacting the AIDS Vancouver Helpline with your question. We hope this eases your stress a bit.

Trevor

AIDS Vancouver Online Helpline
helpline.aidsvancouver.org

Hi there and thank you for reaching out to AIDS Vancouver with your questions! We're happy to help.

1. Receiving oral sex is actually considered to be a negligible risk activity, meaning that while it is theoretically possible to acquire HIV in this scenario, there has never been a confirmed report.

2. Protected sex is indeed considered a low risk activity, meaning that there have been a few reports of infection attributed to these activities (usually under certain identifiable conditions).

3. Giving oral sex is ALSO considered to be a low risk activity. The bite on your lip has no impact on the risk of HIV transmission. In order for a cut or sore to provide direct access to the bloodstream, the cut needs to be gushing blood and require immediate and professional medical attention. Since your cut does not match this description, it does not provide direct access to the bloodstream.

Here is some information regarding the two tests that you took:

If you want a conclusive answer regarding your HIV status, you would have to re-test 3 months after your most recent exposure.

I hope I have answered your questions, and feel free to contact us with any further concerns.

Regards,

Sierra, Helpline Volunteer

AIDS Vancouver Online Helpline
helpline.aidsvancouver.org
Private & Confidential

Hello, and thank you for contacting the AIDS Vancouver Helpline. I will be more than glad to address your concerns.

The risk of acquiring HIV from receiving oral sex is negligible. This means that although in theory we can make a case for it, there has never been a documented case. Therefore, you do not need to extend the PEP treatment.

Sincerely,

Ali

AIDS Vancouver Helpline/Online

helpline.aidsvancouver.org

Private & Confidential

Hi there and thank you for reaching out to AIDS Vancouver with your questions. We're happy to help!

Fingering is considered to be a negligible risk activity, meaning that while it is theoretically possible to acquire HIV in this scenario, there has never been a confirmed report. The AIDS Vancouver Risk Assessment Chart has great information regarding the risk level associated with different activities, in case you had any further questions: Risk Assessment Chart.

Furthermore, saliva actually contains an enzyme that inhibits the transmission of HIV!

I hope I have answered your questions, and feel free to contact us with any further concerns.

Regards,

Sierra, Helpline Volunteer

AIDS Vancouver Online Helpline
helpline.aidsvancouver.org
Private & Confidential

Hi there, and thanks a lot for contacting the AIDS Vancouver Helpline for your HIV/AIDS related health information. It seems you're concerned about the possibility of HIV transmitting during an encounter. We're happy to answer your question for you.

Here is a summary of the situations you're questioning:

• receiving unprotected oral sex
• protected vaginal sex
• fingering

Receiving unprotected oral sex is considered a negligible risk activity, meaning that while transmissions are theoretically possible, none have been observed to occur through activities such as these. Protected vaginal sex is considered a low risk activity, meaning that transmission is possible only under certain circumstances (like the condom breaking, for example). Fingering is considered a no risk activity (even if she fingered herself and then fingered your anus). HIV does not transmit this way. To see the risk levels associated with various activities, we'd encourage you to check out our risk assessment page.

Thanks a lot for contacting the AIDS Vancouver Helpline with your question. We hope it has been answered fully.

Trevor

AIDS Vancouver Helpline/Online
helpline.aidsvancouver.org

Hello,

Thank you for contacting the AIDS Vancouver Helpline as your source for HIV/AIDS related information. I would be happy to answer your questions!

You are correct when you say that receiving oral sex is considered a negligible risk. On the other hand, giving oral sex is considered a low risk activity, meaning the masseuse who provided you with oral sex has a higher chance of getting HIV and other STI's from you, rather than you getting anything from her. I will explain this further by showing you our HIV transmission equation. To get HIV, you must have all 3 factors present.

As you can see from the table, receiving oral sex is considered a negligible risk because it has only one of that factors present, the exchange of body fluids. Negligible means that while there is a risk due to the exchange of body fluids, there have never been any confirmed reports of infection occurring in this manner. Conversely, giving oral sex is considered low risk because it has 2 of the factors present, the exchange of body fluids and access to the blood stream via the mouth. However, please know that the mouth has saliva present which, thankfully, has enzymes that help to breakdown HIV and make it very difficult to transmit. If she did have cuts in her mouth that are deep, large or due to recent major dental work, then her risk would be increased but your risk still remains negligible. From this explanation, I hope you can see why the masseuse has a greater chance of getting something in comparison to your risk.

Based on this, you do not need to get tested immediately. AIDS Vancouver does recommend that all sexually active people be tested on a regular basis for all STI's, including HIV. Since we are an HIV specific helpline, I cannot provide you with more information regarding STI's. If you are concerned about or have further questions regarding STI's, please refer to the Smart Sex Resource website.

I hope I have answered your questions. Please feel free to contact us if you have any more questions or refer to the links provided.

Best wishes,

Mary

AIDS Vancouver Online Helpline
helpline.aidsvancouver.org
Private & Confidential

Hi there and thank you for reaching out to AIDS Vancouver with your questions! We're happy to help. It sounds like you're concerned about the risk of HIV transmission from receiving oral sex and open-mouthed kissing.

1) Receiving oral sex is considered to be a negligible risk activity, meaning that while it is theoretically possible to acquire HIV in this scenario, there has never been a confirmed report.

2) Kissing (with no blood present) is considered to be a no risk activity. Here is a copy of the AIDS Vancouver transmission equation, which outlines how HIV is transmitted:

As you can see, all three factors (body fluid, activity, and direct access to the bloodstream) need to be present in order for there to be a risk of transmission. If you have any further questions about risk level, I encourage you to read through our Risk Assessment Chart.

I hope I have answered your question, and feel free to contact us with any further concerns.

Regards,

Sierra, Helpline Volunteer

AIDS Vancouver Online Helpline
helpline.aidsvancouver.org
Private & Confidential