Am I at Risk of HIV After Intimate Contact Without Intercourse?

Is it possible to get infected with HIV in this way?

A month or two ago, I engaged in intimate activities with someone, but we did not have anal intercourse.
We did engage in mutual masturbation, even holding each other's genitals together.
The other person also rubbed their penis against the area around my anus and near my tailbone with considerable force.
Afterwards, I felt some pain above my anus and near my tailbone, which felt like a tear.
Two days later, I experienced painful urination and noticed pus, which led to the diagnosis of gonorrhea.
I received an injection for treatment, and although the gonorrhea is now cured, I am starting to worry about the risk of HIV infection.
I have also experienced some diarrhea, which is making me increasingly anxious.
I'm really scared.

Klaus, 30~39 year old female. Ask Date: 2018/10/01

Dr. Li Xinyi reply Urology

Treatment for gonorrhea should also include simultaneous testing for HIV and syphilis.
It is recommended to return to the urology clinic for follow-up examinations.

Reply Date: 2018/10/01

More Info

When it comes to assessing the risk of HIV transmission after intimate contact without intercourse, it's essential to understand the modes of transmission and the specific circumstances of your encounter. HIV is primarily transmitted through certain body fluids such as blood, semen, vaginal fluids, rectal fluids, and breast milk. The most common routes of transmission include unprotected sexual intercourse (anal or vaginal), sharing needles, and from mother to child during childbirth or breastfeeding.

In your case, you mentioned engaging in intimate behaviors such as mutual masturbation and genital rubbing without penetrative intercourse. While the risk of HIV transmission through these activities is significantly lower than through unprotected anal or vaginal intercourse, it is not entirely absent. The key factors that influence the risk include:
1. Presence of Cuts or Open Sores: If you had any cuts or abrasions in the genital or anal area, this could increase the risk of HIV entering your bloodstream. You mentioned feeling pain and a possible crack near your anus and tailbone, which could be a concern.

2. Infected Partner: The HIV status of your partner is crucial. If your partner is HIV-positive and not on effective treatment, the risk of transmission increases. Conversely, if your partner is HIV-negative, the risk is negligible.

3. Other STIs: You mentioned having been diagnosed with gonorrhea, which can increase susceptibility to HIV. The presence of other sexually transmitted infections (STIs) can compromise the integrity of mucosal barriers, making it easier for HIV to enter the body.

4. Body Fluids: While mutual masturbation and rubbing do not typically involve the exchange of bodily fluids that carry HIV, if there was any contact with infected fluids (e.g., if your partner had cuts or sores), there could be a risk.

Regarding your symptoms of pain during urination and diarrhea, these could be related to your gonorrhea infection or other factors. However, they are not specific indicators of HIV infection. The acute symptoms of HIV, known as acute retroviral syndrome, typically occur 2-4 weeks after exposure and can include fever, sore throat, fatigue, and swollen lymph nodes, among others.

Given your concerns, it is advisable to get tested for HIV. The window period for HIV testing can vary depending on the type of test used. The fourth-generation HIV tests (which detect both antibodies and the p24 antigen) can typically provide accurate results within 2-6 weeks after exposure. If you test negative at this point but remain concerned, it is recommended to retest at three months for conclusive results.

In summary, while the risk of HIV transmission from the activities you described is lower than from penetrative sex, it is not zero, especially considering the presence of potential cuts and the STI you contracted. It is crucial to have open conversations with sexual partners about their health status and to practice safer sex methods, including the use of condoms, to reduce the risk of STIs and HIV. If you have ongoing concerns or symptoms, consulting a healthcare provider for further evaluation and testing is the best course of action.

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