No penetration — What are my chances of getting HIV?

Dear Quite Curious,

It’s difficult to predict the risk of transmission in this situation. Other factors could be at play which would affect the transmission risk (more on that later). Generally speaking, it appears your risk of HIV transmission is very low. Without penetration, it is still possible to contract HIV from a woman's vaginal fluids, but only if there is some contact with an open wound on your penis or contact with the urethra or rectal membranes.

The best way to verify your HIV status (and subdue your stress) is through an HIV antibody test. You may want to scope out whether any health care providers in your area offer free or reduced price services. Although the chances of HIV transmission is low in this situation, there are other sexually transmitted infections that can be transmitted through skin-to-skin contact — no penetration or contact with open wounds, your penis, the urethra, or rectal membranes required. Practicing safer sex can help protect you from these STI’s in addition to HIV.  

Routes of HIV transmission ,and the Related Q&As, provides general information about how HIV is transmitted. HIV transmission depends on many factors, and different sexual acts generate different risks. HIV is more likely to be transmitted during contact with the mucous membranes, including the vagina, anus, rectal membranes, and urethra. As such, there is a higher risk of HIV transmission during vaginal and anal sex, and lesser risk of contracting HIV from oral sex. Mutual masturbation can be practiced without latex barriers as long as one is certain there are no open sores or injuries on ones hands. There are other factors which affect the transmission risk of HIV. These include:

• HIV status of each partner: You can only contract HIV from a person who is HIV positive.
• The duration and roughness of the sex: Longer and rougher sex can irritate the mucous membranes, increasing the likelihood viral transmission.
• How many times you have sex with a person: The greater the number of times you have sex with an HIV positive person, the higher the risk of transmission.
• An HIV positive person’s viral load: Recent research suggests that an HIV positive person who adheres to his or her antiretroviral medication regimen has a lower risk of transmitting the virus to a partner.

It is important to be aware of other sexually transmitted infections (STIs) that can be transmitted through skin-to-skin contact. These include herpes, and Human Papilloma Virus (also known as HPV, the virus that causes genital warts). Herpes and HPV do not require penetration to be transmitted. These two viruses can spread without any symptoms present, as well. You can reduce your risk of contracting these STIs by abstaining from sex with a partner exhibiting symptoms, limiting your number of sexual partners, and of course, adhering to the ‘ole adage, “wrap it before you tap it!” Always use a condom. However, be aware that these viruses can be spread through skin-to-skin contact in areas not covered by a condom. Speaking with your partner about STIs can help you assess your risk and might just make you feel more comfortable. 

One thing here is for certain — not knowing your partner’s HIV and STI status can contribute to the stress of this situation. If you are unsure about your partner’s HIV status, it is best to ask. Moreover, it is always recommended to use condoms, which are proven to be a highly effective (and cheap) method of HIV prevention. All in all, partner communication, getting tested, and practicing safer sex are the keys to a more healthy and fun sexual experience!