[Question #10120] Massage Parlor Encouter. HIV/STI Fear
25 months ago
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Hi Drs
I am a male in Canada. At the beginning of the month, I was at a massage parlour and saw a CSW there. She unexpectedly performed oral on me for a very short amount of time (about 5 seconds). There were also times when my penis came dangerously close to the outside of her vagina and probably touched on occasion. There was no penetration. In reading similar situations that other users have asked you have mentioned that these are essentially no risk events in terms of HIV. But still, I do not feel completely at ease. Other literature online suggests that there can be some risk if there are ulcers or bleeding gums present in the mouth. I am also a bit concerned of bodily fluids entering through the urethra. One study I looked at suggested that up to 7% of new HIV cases can be attributed to oral and that HIV spread may be more prevalent than initially thought. I can provide links if you like. In terms of other STIs, I have had no symptoms since this encounter. Am I worrying needlessly? Do you recommend testing? And can I continue regular sexual activity?
25 months ago
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Also in general, does a brief encounter such as the ones I had, lower the risk of contracting and sti?
25 months ago
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Sorry, one more point of clarification, the oral was unprotected.
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Edward W. Hook M.D.
25 months ago
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Welcome to the Forum. Thanks for your questions. I'll be glad to comment. HIV is transmitted only through unprotected penetrative sexual encounters with untreated HIV infected persons. Even with unprotected exposures the risk for infection is low and varies with the site of exposure. Following unprotected vaginal sex, fewer than 1 infection occurs per 1000 exposures. For receipt of oral sex, the risk is lower, conservatively estimated at less than 1 infection for every 10,000 exposures and probably lower as there are NO proven cases in which HIV was acquired from receipt of oral sex from an infected person. I do not know what online sources you have been accessing but they are wrong, as much of what is found on the internet is. Remember, there are no editors on the internet and much of what is found there regarding HIV is wrong because it is either out of date, taken out of context, or just plain wrong.
Regarding other STIs, your risk is low, both because most commercial sex workers do not have STIs and because you have no symptoms now, a month out from your exposure. If you would feel better by proving that you were not infected, a 4th generation test for HIV would detect more than 99% of recent infections and a urine test for other, more common STIs such as gonorrhea and chlamydia would be conclusive at this time.
Regarding the duration of your exposure, while it makes common sense that shorter duration exposures would be less likely to result in transmission of infection, there are no studies on this issue.
Bottom line, in my opinion, you have absolutely nothing to worry about in terms of either STI or HIV. Personally, I would not even bother to test although that is certainly a personal decision. Take care. EWH
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25 months ago
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Hi Dr Hook,
Thanks for the response. I order to provide some closure, I got a hold of some rapid hiv tests (insti). I am reading that the window period is 3 months but most positive results will be caught within 4-6 weeks (somewhere between 80-95%?). As I have tested negative, can I be somewhat reassured?
25 months ago
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Today would be day 33
. Also happy 4th from north of the border
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Edward W. Hook M.D.
25 months ago
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There are several types of rapid tests; some test only for HIV antibodies while others test for both antibodies and the HIV p24 antigen. If your rapid test was a test for HIV antibodies, most experts would suggest that testing after 6-8 weeks (not 3 months) will be conclusive. If the rapid test is a 4th generation, combination HIV antigen/antibody test, results would be 99% conclusive at 4 weeks and entirely conclusive at 6 weeks. EWH---
25 months ago
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I did the insti blood test, which is a 3rd Gen test. I had to try a couple times because I did not get a large enough blood sample. I eventually got a negative result. At almost 5 weeks, would you call this an encouraging but not conclusive result? Are my findings of 90ish percent would develop antibodies at this time correct? I know my fears are not necessarily rational, but I am still somewhat anxious.
25 months ago
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Also, would I be able to trust this negative result despite having to try a couple times?
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Edward W. Hook M.D.
25 months ago
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This result is encouraging but not yet conclusive. At this time you would have detected more than 90% of recent infections.
I hope the information I have provided has been helpful. We provide up to three responses to each client's questions. This therefore will be the final response. There should not be a medical or scientific need for further questions related to this virtually no risk encounter. I wish you the best. Please don't worry. EWH
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