Expert: Terry B - 4/14/2008

Question
Hey!! Question: Yesterday ( 4-13-08) I had sex with a woman i didn't know and I had a
small dry 2 to 3 day old cut on my thumb, and i believe a few fluids might have gotten on
it.. It was not bleeding or nothing like that.. What are the chances of me getting HIV from
that?/

Question.. I also was having sex with her and i felt a few small holes come about on the
side of the condom and I immediately changed the condom and resumed to just getting
oral sex... there wasn't any holes are splits at the TIP of The Condom, But i'm not sure if
any fluids got threw the small holes on the side of the condom and made its way to the tip
of my penis.. Could I still be at risk of HIV?? When i was finished 10 to 15 minutes later i
went and washed my cut and my penis with some water that i had in the car just to clean
immediately.. then when i made it home about another 10 minutes later, I washed both my
cut and penis with some HAND SANATIZER, Then i washed with some Soap and Water!!  I
did all of this washing no later than 40 minutes to an hour after having sex with her.. Whats
the risk of me getting HIV through the small 2 to 3 day old cut and the small holes on the
side of the condom!!

Answer
Dear Doral:

Peace.  Let me begin by saying that HIV isn't easily transmitted; exposure to blood, semen, or vaginal secretions from an infected person is a risk, not a guarantee of infection.  

The degree of risk varies - a lesion (sore), or open cut provides the virus in these fluids good access to the cells HIV needs to reproduce; it doesn't matter if at the tip of the penis or the scrotum, though undiagnosed or untreated infections might cause lesions at the urethra (opening at the tip of the penis) that would be less noticeable.  Holes in a condom that are visible to the naked eye would be large enough for HIV-containing fluids to contact your skin, but the amount and area across which that contact occurred would be much less than if a condom had not been worn.

Washing reduces the amount of the potentially infectious fluids, and lessens the duration of the exposure, but a caution - especially in the case of receptive sex - is in order as such practices as douching after intercourse actually increase risk by spreading the fluids around - increasing the area across which the fluids are distributed.

I can't give you "chances" except to point out the factors that increase the risk from an exposure.

1) Q: Was the person infected, and what was the amount of virus in their fluids (primarily blood, semen, vaginal secretions)?  A: Unknown
2) Q: To how much of their fluid (amount) were you exposed?  A: By your description, very little.
3) Q: How much area was exposed?  A: Very little.
4) Q: How often did the exposures occur?  A: Once
5) Q: What was the duration of the exposure?  A: Significant - 40 min
6) Q: What was your general health, skin and mucous membrane integrity at the site of the exposure?  A: Varied.  Don't know your Sexually Transmitted Infection status, cut on your hand was probably healed to sufficient degree as to provide at least moderate protection against infection.
7) Q: What other factors are important in assessment?  A: None noted.

Risk occurs along a continuum.  I would place what you describe on the lower (less risk) end, but recommend that you consider visiting a test site and learning your status, as well as discussing how to reduce your risk in the future.

The best to you and yours,

Terry