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Mouth-to-Anus contact during Recal Bleeding: HIV Risk?

May 7, 2004

I'm an HIV- gay man. I recently had sexual contact with a man who told me it was his "first" time with another man (but given it was anonymous in nature, who really knows?! He could have meant I was the first one that evening! Anyway, when I was rimming him I suddenly noticed there were what appeared to be abrasions around his anus, and some blood was present, then some blood oozed from his anus. I think the abrasions (they didnt look like sores) may have been the result of him having shaved the hair off around his anus (so much else of his body had five oclock shadow!) But I dont really know what exactly was going on down there, or what caused the bleeding .. also, he had just been vigorously rubbing & maybe fingering himself at the same time as I was giving him oral sex .. so I think maybe he irritated these already irritated abrasions, which started to bleed. I pointed out that he was bleeding (needless to say, I was freaking!), and he said, "oh, that's normal for me!" ..God, what does that mean!? He may have had hemorrhoids, or some other internal condition causing him to bleed. But when I asked if he used toys, etc., he said no. (they always say no to everything!) Anyway, I suggested he see a doctor immediately, as I pointed out I didnt really think bleeding from the anus was normal for anybody. Anyway, I don't know how much of his blood got into my mouth, as I'd rimmed him for several minutes prior, before noticing the abrasions/irritations, and the oozing blood. Some of it MUST have gotten into my mouth. I hadn't brushed or flossed my teeth that day (which my Dentist wouldn't appreciate), but which might be a good thing here? I also went immediately to the bathroom and gargled repeatedly with a hydrogen peroxide/water mix. Then I gargled with rum (wow, panic is comical in hindsight!) I don't have any sores in my mouth that I'm aware of, but sometimes my gums do bleed a little when I brush or floss. Anyway .. sorry for this LONG posting and you may have answered this question numerous times before .. but I'm totally freaking out, and have kind of plummeted into a panic/depressive state over this incident. What, if any are my chances of contacting HIV, should this person have been infected? The other (probably crazy) question is this, could the dried blood he left on a towel be tested for HIV, or does all trace of the virus die in the open air .. not to mention any unethical/illegal aspects of trying to have the dried blood of another person tested for HIV (Im not normally this crazy, believe me!) And one LAST question, what is the process I should embark upon now, in terms of HIV testing (how long should I wait to get a test if I want to be sure this incident didnt infect me, and future, periodic testings, etc.)? And, hey, thanks .. I really appreciate your indulgence/assistance here. David from Toronto.

Response from Dr. Frascino


The encouraging news is that there are no documented cases of HIV transmission from rimming or getting rimmed. Other STDs, however, can quite easily be transmitted this way, e.g. hepatitis, intestinal parasites, etc. The real question here is that blood may or may not have come in contact with your mouth or tongue. Other pieces of the equation include the facts that we do not know if your partner is HIV-positive or not, and that you did not have any cuts or abrasions in your mouth. Taking all this into consideration, I'd say your risk of HIV transmission from this adventure is very low; however, it is not nonexistent. What should you do? You may need STD screening, particularly if you develop symptoms (diarrhea, fever, jaundice, etc.). You'll also need HIV testing three months or more following this episode.

Analyzing the dried blood or spunk on a cum towel will not help you in this situation. I kind of wonder why this has not been discarded or at least run through the washer with an extra dose of chlorine bleach by now.

David, "plummeting into a panic/depressive state" is not helpful. Facing your dilemma, getting the appropriate tests done, and doing a "load of whites" ASAP are!

Good luck, David. All the odds are in your favor.

Dr. Bob


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