QUESTION
I was fisting a trick in a sex club and afterwards noticed that although my hand was clean, I had a little scab on it. The cut must have been well on its way to healing since I hadn't noticed it. If I had noticed it, I wouldn't have fisted him. I am HIV negative.

I had a poz partner for three years and fisted him without wearing a glove on a regular basis. Since I've passed the 72 hours in which I could have done PEP (post exposure prophylaxis), is there anything in particular you would advise me to do besides getting tested in three months? As you can imagine, I am starting to get nervous now.

ANSWER
Fisting is not considered a risky behavior for transmission of HIV, so even if you went to see a PEP counselor within 72 hours, he or she would not have recommended starting the regimen. For more information on PEP, click here.

Washing up before and after ass play like fisting or rimming with soap and warm water is a good idea to prevent the transmission of enteric infections like hepatitis A, shigella, giardia and amoebiasis. These could potentially be transmitted from any fecal matter left on your hand if you touch it to your mouth accidentally before washing up.

The CDC recommends all sexually active gay men to be vaccinated for hepatitis A (and hepatitis B). Preventing these infections is much easier than treating them.

To your health,
Dr. K