Fingering and fisting

Fingering the rectum or female genitals carries a negligible risk of HIV transmission unless there is an open cut, sore or other wound on the finger. There is also some risk that fingernails could damage the rectum or vagina and make it more susceptible to infection through subsequent sexual activities such as intercourse. 

Similarly, fisting (the insertion of most or all of the hand into the rectum or vagina) in itself presents only a minimal risk of transmission, as long as there are no open cuts, abrasions or the like on the hand. However, fisting presents a much higher risk of rectal or vaginal tissue damage. Damaged tissue is much more vulnerable to infection through subsequent sexual activities. There have been reported cases of rectal trauma, sometimes severe, during fisting – particularly when recreational drugs are also being used.¹

There is one reported case of HIV infection as a consequence of fisting. A man who had not engaged in anal or oral intercourse for several years seroconverted eighteen months after beginning a sexual relationship with a man who was already symptomatic. Their sexual practice consisted only of dry kissing, mutual masturbation and fisting. The subject of this report had frequent ulcers on his hand, and it was common for him to fist his partner without covering the cuts.²

Fisting has been identified as a possible risk factor for hepatitis C acquisition among HIV-positive gay men (for both the insertive and receptive partner).³

Risks from fisting and fingering can be reduced by wearing latex gloves.