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A quick breakdown on how HIV can be transmitted.

This topic aims to show ways in which HIV can and cannot be transmitted. It ties in with a recently published topic found here http://www.drtanandpartners.com/how-does-hiv-enter-the-body/.


This topic will be split into 3 parts; Definite ways of HIV transmission, theoretical ways of transmission, and no way of transmission.


Bear in mind that in order for HIV to be transmitted fluid from a positive person has to come into contact with the negative person. Semen and blood hold high loads of the virus but saliva and vaginal fluid hold very little.


According to Singapore Ministry of Health UPDATE ON THE HIV/AIDS SITUATION IN SINGAPORE 2014.

Definite ways of HIV transmission (risk will be listed as risk per 10000 – so 1/10000 means that for every 10000 people who engage in that activity, 1 person will become infected.

  • Blood transfusion – 9250/10000 (this is only with HIV infected blood which is very rare nowadays as every donor blood sample is screened before use).
  • Needle sharing in intravenous drug use – 63/10000.
  • Needlestick injury – 23/10000.
  • Receptive anal sexual intercourse – 138/10000.
  • Insertive anal sexual intercourse – 11/10000
  • Receptive penile-vaginal sexual intercourse – 8/10000
  • Insertive penile-vaginal sexual intercourse – 4/10000
  • Receptive and insertive oral sexual intercourse – low (too low for accurate numbers).



Estimated risk per exposure to HIV transmission: assume that the ‘source partner’ is always HIV-positive. For a partner of unknown status, the risk is affected by the prevalence of HIV in the relevant community – i.e., the chance that the partner does in fact have HIV. Unless otherwise stated, the sexual acts are always without a condom.


Theoretical ways of HIV transmission:

  • Blood contact onto an open wound – possible but an unlikely scenario as open wounds should be tended immediately in order to reduce the risk of other infections. The risk of a bacterial infection would be higher than an HIV infection.
  • Blood contact onto mouth or eyes – again possible but extremely unlikely unless you happen to be in a horror movie.
  • Dried blood – although HIV can survive in dried blood for several days, the environment has to be favourable and transfer this way is very very unlikely.


No risk of HIV transmission:

  • Breathing the same air as someone.
  • Touching a toilet seat or door knob.
  • Drinking from a water fountain.
  • Hugging, kissing or shaking hands (although kissing may transfer fluids the level of virus in saliva is so low as to make the risk negligible).
  • Sharing utensils.
  • Sharing gym equipment.
  • Skin to skin contact with an HIV positive person even if they happen to have fluid of unknown origin on them (particularly applies to commercial sex workers).
  • Biting or scratching that does not break the skin or draw blood.
  • Essentially, as mentioned above, fluid-fluid contact is necessary for transmission – if this hasn’t happened then there is no risk for HIV.


I hope this helps answer most questions that concern people over possible ways of HIV transmission – if new questions pop up I will try and add to this topic to help allay people’s fears.



Feel free to email your queries, feedback and suggestions on what other topics you want to see in the comments section below.

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  1. Hi dr,

    Recently i was visit CSW and without any sex involved and oral or handjob or fingering. but i just touched her breast. is that any risk for std and hiv? (i just check back my hand after the visit no wounds or cut on the finger that i touch the girl).

  2. Dear Dr Tan,

    I have a question which I didn’t find an answer to yet, regarding the possibility of infection in a recent (from my subjective perspective dangerous) encounter.

    I have had sex with a commercial sex worker in Malaysia (she was originally from Vietnam though), first unprotected oral sex (which wasn’t wise due to other possibilities for infection, but less so probably for HIV), followed by protected (condom) vaginal insertive sex.

    However… as it turned out afterwards she was on her period, and after taking off the condom I had a visible blood smear around my groin area; as a result she tried to ‘clean’ the blood, and distributed it even more across my penis (also across the top). I had a shower about one minute afterwards (plenty of water, no soap); I am also circumcised, had no apparent cuts to the groin area.

    So how do you judge the risk for this? I couldn’t find much information to which extent (fresh) blood smears lead to HIV infection. I should add that I have started PEP treatment 39 hours after the event, so I hope that things overall turn out well.

    Thank you for your input in this matter,

    • Hi,
      While the risk for STD/HIV transmission is present and definitely increased if she was on her period, the fact that you used a condom throughout the majority of the act reduces that risk considerably. Plus now that you are on PEP, I would judge your risk to develop HIV to be extremely low. In any case, you will have to repeat the HIV combo test after completing your course of PEP and again at 3 months post-exposure.

      • Dear Jonathan,

        Thank you for your reply – this was reassuring.

        I have just calculated my approximate risk – I am aware that this is not a definite answer, and I will get tested as recommended, however his helps me worry a bit less at the current stage.

        As far as I am aware this should somewhere around the following:

        Baseline likelihood penetrative vaginal intercourse: 1:1,000
        HIV Incidence in CSW from Vietnam: 1:30

        Modifying factors:
        If HIV in active phase (shortly after infection): x7
        Condom use (assuming 80% effectiveness, likely higher): x0.2
        Circumcised: x0.4
        Menstruation: x4
        PEP (assuming 80% effectiveness): x0.2

        So an upper estimate would be around 1:2,500 (assuming infection and active phase), and a lower estimate around 1:500,000

        This is of course more a mathematical exercise at this stage, however I have found this reassuring to at least sleep a bit better right now and think it might also help others (to realize that, on the whole, HIV is not as readily transmitted as one might think in the active fear of having been infected).

        That being said, everyone needs to reduce his risk him- or herself, so use condoms, etc., just to make this part clear as well.


  3. Hello doc.
    My engglish is not good. Hope you understand. I get massage and hand job with massure worker. Can i get hiv this activiti. On 90 and 131 days i do hiv test cmia (ag/ab) all result negative. Is conclusive? Or i need do re-test agian at 6 month?

    • Hi,
      There is essentially no risk of contracting HIV through a massage and hand job. Your HIV tests are conclusive and you do not need to re-test again at 6 months.

  4. Hi doctor,

    Recently I had my blood drawn at a clinic. At the end, the doctor who drew my blood took one glove off and opened a plaster, and put it on my needle site. I’m worried what if she handled hiv+ blood and then touched the inside of the plaster, will I get hiv from this way?


  5. Hi Dr

    I have went for eyebrow embroidery recently. After the procedure was almost complete, the beautician applied a calming cream (texture feel like Vaseline) onto my brows. However After she is done with 1 side, she used the same side of the cotton bud dipped into the cream to apply onto my other brow. This cream is shared by all customers that she served, will hiv be transmitted this way? Is this consider an open wound since there are cuts/bleeding involved.


    • I agree with you that this is not a very hygienic practice. However in this case, there is no risk of HIV transmission . The environment has to be favourable and transfer this way is very unlikely. You can click here to read more on HIV and how it can be transmitted.

  6. Can someone got hiv within two minutes if condom got broken,Especially if the female is not wet and the male not ejaculating on the female?

    • There are risk of exposure to HIV and STD with a broken condom . You can read further here
      There is no data to quantify any increase or decreased risk based on duration and ejaculation .

      I recommend you getting tested for STD and HIV as you had unprotected sex.
      please visit us for a formal consultation . click here for the location.

  7. I was fingered vaginally very deep penetration with lube and no gloves or protection. The next morning the sheet is covered in stains of blood. Can fingering to the point of stained blood sheets cause transmission. We could not figure out where the blood came from as I was not bleeding nor him. Penile penetration did not occur.

    • Fingering is unlikely to cause transmission of HIV. Please see you doctor to ensure you haven’t suffered trauma to the vagina especially if you still have bleeding.

  8. Hi Dr,

    I was expose to the CSW 4 weeks ago and waiting my combo test result however, i was worried and would like to see your comment at here.
    Dr i was masturbate myself with condom and i wear the condom myself and take out the condom after i masturbate myself (i take out the condom by myself also). i just ask the girl naked but i never ask for sex or oral sex as well. for what i recall is she dint touch me also. may i know am i at the risk ?

    • Really? You really think you can catch HIV because a CSW was sitting naked next to you and never touched you? You really think that is possible? You are either trolling or need some serious psychiatric help.

  9. Dear doctor,

    I visited a massage parlour last week and received a massage and a hand job. After the massage, and while I was showering, I experienced some pain on my foot and discovered a 2mm nick on my second toe. I am not sure if it bled or if the wound was caused by a sharp, but it did look like something scraped against it as there was a tiny bit of skin over it. I pressed the wound at home and some plasma exuded but no blood came out. What are my risks of contracting hiv in this instance? Could it be a deliberate act by the masseur?

    Also, can I do the 4th gen test 15 days after exposure, followed by a confirmation three month later?

    Thanks so much for your opinion.

    • You are seriously paranoid. I do not think you are at any risk of HIV. Sure you can do the 4th Gen test at 15 days for peace of mind then repeat it at 28 days.

  10. Hi Dr Tan,

    I went for a massage in Indonesia which was accompanied by a handjob.

    I am afraid that I may have contacted HIV as I may have HSV and the massage lady did massage my rectum area.

    I am having a sore throat and fever currently. Please kindly advise.

    Many thanks.

  11. It says ‘skin to skin’ contact is ‘no risk’. This include handjob?

  12. Hi Doc

    A few weeks ago, I went to a massage spa and receive a hand job from the massage lady. While cleaning up my penis, she lightly bit my penis head with my foreskin pulled down, my penis is covered with a towel during this incident so there is no direct contact. After a while (around 10-15 mins), when I go to shower, I checked my penis and there is no bite marks/wounds or break of skin. I am worried since.

    Is there any risk of HIV transmission?
    Is it necessary to go for a HIV Test?

    Thank you for your time and hope to hear from you soon.

    • Personally I do not see any cause for concern. I do not think there is any risk of HIV transmission here. I cannot to tell you to test or not as that constitutes giving medical advice.

  13. Hi dr tan, recently i visit the CSW. what i had exposed is i masturbate myself with condom and i just my right hand masturbate and my left hand touch the csw. (without any cut on my finger after i check back) after i finish all the things i use my right hand to take out the condom and wash my penis. am i in the risk?

  14. Dear doctor,

    3 weeks before, i had protected(condom) sex with call girl. after i noticed that i have a tiny tear on follicle. it was tiny but small amount of blood was there.condom was not covered on the small tear . after that i got runny nose, mild cough, mild cold and cold.

    am i at high risk?
    can i get 4th generation test at 4th week?
    is it conclusive at 4 week after exposure?

    • Sex with a sex worker puts you at high risk of STD and HIV. Condom usage reduces the risk.
      Yes, you can.
      In my opinion, yes.

      • sir, I tested combi test(HIV-1 & 2 P24 antigen). the signal to cut off is 0.2(non reactive).

        Is this conclusive?
        should i retest?
        can latex gloves prevent STD, HIV from vaginal fingering?

  15. Dear Dr.

    I received a handjob at the end of a massage from the hotel masseusse. If her hand was bleeding could the blood get into my urethra and give me an STD?

    She was fully clothed in masseuse uniform so no vaginal fluid but perhaps her hand was bleeding and I didn’t notice. Would the hand dry in the 40 minutes of massage-giving? Would there have to be a lot of blood?

    • There are infections such as Herpes and Syphilis that can be spread via skin to skin contact. So even if she did not have any blood on her hands, you are still at risk. If she did have blood on her hands, you have to think about blood borne infections like hepatitis. If she had genital fluids on her hands, you have to think about other infections like Chlamydia or Gonorrhea.

  16. Hello Dr

    im a breastfeeding mom, earlier today was I was massaging someone and noticed a healing yet still open sore that I massaged for a good minute.what r my chances of transmission. a worried first time mom

    • If you are worried about getting HIV from touching a sore, you really need not worry. The risk is negligible. However, if that was a sore caused by Syphilis, then your risk is significant. I have in fact seen patients get infected with Syphilis from giving massages. Please speak to your doctor.

  17. I read that you have mentioned blood contact through HIV . I am afraid of going to having my head massaged at babar shop . Any risk ? How would I know I have cuts from his hands if he is HIV positive

    Question 1) any risk if he scratches me or has cuts his in his hands that can go into my head

    Question 2) my head needs to be gushing with blood or his hands would need medical attention like stitches ? To put me at risk

    Question 3) should I ever be afraid of having head massages ever ?? Or I should stop these massages

    Some clarification would really help dr tan !

  18. Is it possible to contract HIV from a HIV Postive girl if the girl while giving a handjob touched the penis urethral opening. Also is it possible to get MSRA UTI from the above episode if the girl had MRSA? Please reply sir

    • As far as my opinion goes, you cannot get HIV from a handjob. Neither can you get a UTI.

      • Dr, I am concerned with a possible blood splash into my eyes fr an HIV(+) patient we were doing an open suction to. I felt fluid went to my forehead but I did not remember if it went to my eyes. At that time, we did not know his status yet. I failed to report it and his hiv status was only made known to me after 2 days post-exposure. Please help I am really worried if I’d get infected. Wil be waiting for your response. Thanks

        • There is a risk of infection if HIV +ve blood splashes onto mucous membranes like the conjunctiva of the eye. That is why surgeons wear face masks when operating on HIV +ve patients. You should report this incident to the hospital. I am sure they will have protocols on how to deal with it.

  19. I gave oral sex to a male. I know this is low risk, but I tend to bite my inner cheeks when I am nervous. Does this increase the chances of being infected by HIV from the oral sex?

    • I assume you are also male. That puts your risk of HIV (if your partner is HIV +ve) at an estimated 0.04%. The injuries in your inner cheek may increase risk but I am unaware of any published medical data that proves or disproves this or quantifies it.

  20. Dear doctor, my friend went to a massage parlour and took a body to body massage and finally ended with a handjob as he said.I need to mention the two reasons for which he says he is extremely terrified.He had a kind of cut which occurred one day ahead of the encounter which was a deep one.The second whether he is at a risk by a hand job given to him as there might be some HIV fluid on the masseurs hand and while giving might have touched the uncovered tip of penis or might have caused cuts due to friction.Body oil was also used but only for massage and not for handjob is what he said.

  21. I do a handjob(mastubration) by myself before few yrs…. At somedays i do 5-6times handjob per day.but i feel so sad coz in my pennis thr should be some pimples occur i swear it is the symptoms of hiv or i want to know it would be happened by the continuous handjob(it should not risk for hiv are not i want to know) in somedays at that time of handjob i feel tired and i slept without washing my pennis but thr should no fluid-fluid contact,the pimple arise in my pennis more over 5-6yrs but i never feel sick….By an continuous handjob my body weight will increased and my thies are elongate so i stoped that .i was scared about that pimple and one day i apply a face removing pimple cream on my pennis even detol too thats my fear while the hiv virus will attck us. I ask my frnd the hiv will appear by the way of pimple in an pennis near that open cut……someone said yes someone said no..still i wont consult the doctor,for this reason i can’t do anyhing like blood donation,organ donation,(even i can’t sleep well) etc…..by the way of fear i am waiting for ur rply plz send ur opinion doctor as soon as

  22. I do a handjob(mastubration) by myself before few yrs…. At somedays i do 5-6times handjob per day.but i feel so sad coz in my pennis thr should be some pimples occur i swear it is the symptoms of hiv or i want to know it would be happened by the continuous handjob(it should not risk for hiv are not i want to know) in somedays at that time of handjob i feel tired and i slept without washing my pennis but thr should no fluid-fluid contact,the pimple arise in my pennis more over 5-6yrs but i never feel sick….By an continuous handjob my body weight will increased and my thies are elongate so i stoped that .i was scared about that pimple and one day i apply a face removing pimple cream on my pennis even detol too thats my fear while the hiv virus will attck us. I ask my frnd the hiv will appear by the way of pimple in an pennis near that open cut……someone said yes someone said no..still i wont consult the doctor,for this reason i can’t do anyhing like blood donation,organ donation etc…..by the way of fear i am waiting for ur rply plz send ur opinion doctor as soon as

  23. Dear Dr. Tan

    Good morning

    I had mutual masturbation with a girl and I was touching her Virginia from outside , she was kind wet and after few minutes about 3 minutes , I touch with same finger my Open penis , could I catch Hiv that way


  24. Hi Dr I went to massage center in china I had blowjob for 2sec and hand job and i fingering the vagina for few minutes. And the sex worker had dry wound in leg she touch the wound and she give hand job to me and she touch my penis. By this way hiv will transfer.
    Please reply as soon as possible because I am very sad.

  25. Hi, I did mutual masturbation with a guy. Not sure is there present of precum on his finger. He attempted to finger me by sticking his finger. Hence will i be any form of risk?

  26. Dear Doctor,

    I had a low risk exposure. Hand job with oil. But that’s not my concern as you’ve answered this previously. What’s worrying is the wet towel the masseuse used to clean my privates. I’m not sure if it was contaminated, possibly causing the HIV virus to make its way from the wet towel through my urethra and causing me to be infected.

    Thank you for your time.

  27. Dear Doctor, I have a few concern,

    first i went to a blood test and the nurse in charge just took blood from one person and the proceed and ask me to take a blood test too without changing her glove ? he did touch my hand before he injected me and took my blood, if the person before me had HIV will i be infected ?

    Secondly, i went to a saloon last week and the barber cut my brother’s hair first then he cut mine but his shaver accidently cut my ear and cause a bit small cut, am i at risk of HIV ?

    Thirdly, I went to a doctor and i scratch on my hand last night and i got a bit blood but it dried and the doctor touch that part of the wound with his bare hands and i dunno has he come in contact with blood before that, am i at risk ? thank you

  28. Senthil

    I wrnt to massage parlour. Myself and girl was naked. We rubbed our body each other. During that time we rubbed our genitals each other. So rubbing vagina and penis will it cause hiv.
    I didnt have any sex with the girl.

    • It is very unlikely that non-penetrative genital contact can transmit HIV. However, the only way to be sure if you are free of HIV and other STDs is to get tested.

  29. is it possible for hiv transmission??

  30. doc.. i have hiv symptoms..like oral thrush na hindi mawalawala..rashes sa both.arms.ko..recurring cough..and constant peeling of my skin in the amrs….before i experience this hiv symptoms i remember i touched fluid in the doorknob then wipe my urethra……i suspected someone put his semen in.the doorknob….

  31. Dr, i am Ray, recently my expose with a cal gal from party. No sex or hj invol. i dint naked myself. Bt i was hugging by call gal and she was naked. The concern part is my finger might hav visible small cut and might touching the vaginal outside the hairy and got the line part May i know the risk?

    • Dr FYI i dint insert my finger into her vaginal bt i just slightly around 5 sec touching the hairy part or the center line of the vaginal part is that consider inside vaginal? Is tht any risk from my expose?

    • Dr FYI, i dint insert my finger to her vaginal i just slightly touching the outside of the vaginal or the center line of vaginal then i go to wash my hand immediatly. I was notuce that i got a visible cut without bleeding and wound on the same fingers. So am i in risk?

      • You cannot get HIV this way.

        • dr tan, if there is not any fingering (mean my finger dint insert into the vaginal) is there is no risk right?

          • Finger to genital contact does not carry any risk of HIV infection.

  32. Hi. 40 year old heterosexual male.

    My last sexual partner was in June 2015. We had unprotected vaginal intercourse.

    I had taken a HIV test in November 2015. The HIV test was negative.

    I had taken another HIV test in July 2016 just to confirm the results and that HIV test was negative, as well.

    I had no sexual partners since June 2015 and no risky behavior regarding drug use or anything of that nature.

    My question is, a few days ago, I had used the bathroom at work. I closed the door and then when I pulled out my penis to urinate, the hand I had used to close the door touched the tip/urethra of my penis.

    Is there any risk of HIV transmission? I did not feel anything wet that I recall on the doorknob. Even if there was a fluid on the door knob, is there any risk in this scenario?

    • You cannot catch HIV this way. That honestly is a rather unhealthy level of paranoia. Hope you can overcome this unnecessary worry soon.

  33. Worriedman

    Dear Dr I had a kissing exposure 1 week after my dental surgery from a massause. She just smooch a bit for a second or two. No pain or bleeding during this exposure. After this we had closed lip kiss.no other activities. No french or deep kissing. What is my risk?
    Thanks & Regards

    • No risk. Do not worry unnecessarily.

      • Worriedman

        Dear Dr, after 33 days from my kissing exposure I took Hiv combo test p24+antibody (CMIA).The test came non reactive.
        1.Is this test conclusive?


        • In my view it is. Please verify this with the doctor who did it for you.

          • Worriedman

            Dear Dr, this test was done in lab.As per customer care it’s duo test. But I am confused on window period?

            Please help.

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