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question regarding a response you made on nov.20,2006
Mar 12, 2011

Dear Dr. Bob, A person wrote you and called himself desperate and terrified after an encounter with a thai trans sex worker.He said this worker had inserted her finger into his anus and felt the worker's fingernail cut the inside of his anus. He was concerned that the worker could have had cum or precum on her finger and could have rubbed this into the client's scratch in the anus which was caused by the fingernail. I thought this would be an external situation as any sex fluids on the finger that were inserted into the anus were externally on the finger and had been introduced to air before it was introduced into the anus at which time the scratch within the anus occurred.You did say that the risk was remote but you did tell him that it was a good idea for him to go on and take an hiv test due to this circumstance.I was a little surprised by you encouraging him to test because of this.I have read in many places that you can't get hiv from a fingernail scratch. One reason I got concerned over your response was because I was at a store recently and when the clerk returned my change to me she scratched with her fingernails an approx day old cut on my thumb which was not very deep but which had been intermittently ozzing a little clear like blood especially when pressed.There was a little blood ,not dripping, present on the cut when I got back to the parking lot.I don't know if it was hers or mine.I was just concerned of getting a scratch on a cut on my thumb which was not a fresh cut but would still occasionally ooz a little clear like blood especially when pressed. If the clerk was hiv positive and had blood on her fingernails and then scratched an older cut on my thumb which occassionally bleeds when pressed could I get hiv? Any real risk here? Thanks Doc, Please give me some good news.

Response from Dr. Frascino

Hello,

The reason to consider testing in the Nov 20, 2006 question was the possibility of getting fresh infected pre-cum inserted into the anus and/or a fresh cut. As I mentioned, this HIV risk is "remote." See below.

The HIV-transmission risk for your situation is nonexistent, as I'm presuming the store clerk wasn't masturbating while returning your change.

Dr. Bob

donation from desparate and terrified! Nov 20, 2006

I'm grateful for your service. i realize you have so many letters to answer, but i hope you can finally answer mine as i'm in a state of terror.

I had an encounter with a thai trans-sex worker. After she was masturbating for a while she slid a finger in my backside. it was the same finger that would have been rubbing near the top of 'her' penis. her fingernail seemed to cause a slight cut or scratch inside me, as theres no mistaking that feeling. i am worried that if their was pre cum or cum on her finger it could have got rubbed in the cut/scratch. i wont bore you with any symptoms as i have learned here they could be from anything. i will get tested at 3 months. but please estimate my risk! any info on why i should or should not worry so desparately needed.

Response from Dr. Frascino

Hello,

I see no cause for being "desperate and terrified." The HIV-transmission risk you describe would be remote, at best. I agree with your decision to be tested at the three-month mark, but your actual degree of HIV risk is extremely low, OK?

Thank you for your donation! A formal acknowledgement and thank-you letter will be sent to you via snail mail very soon. Also, I'm sending my best good-luck/good-health karma that your definitive three-month test is negative, as I strongly suspect it will be. (By the way, my good-luck karma hasn't failed yet!)

Dr. Bob



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