[Question #111] Really worried - lap dance

38 months ago
Dear Dr,

I went to a strip club again last night in Miami which has a high amount of people living with hiv. Also this woman was African American and that group has a higher his rate In the city. I did not drink much as I was driving, and received a lap dance in the champagne room. My pants were unzipped and she played with my penis over the underwear and directly. I also deep fingered her and she fingered herself and her vagina was somewhat wet and after that my penis was hand stroked to climax and ejaculation.  I would totally not be worried about this as I have learned about how hiv is transmitted and I know 1000% there was no penetration. My only concern is that I was undergoing treatment for genital warts while they were not completely gone, the skin was still red and a little sore from treatment - a solution my dermatologist prescribed.. I read that having an std increases the odds of HIV transmission. I am almost sure that this is a no risk situation for HIV but need some reassurance or facts from the experts. Thank you kindly. 

I forgot to mention. After we finished I told her I was worried about catching something and she said we didn't even do anything and that she checks herself. but assuming she was positive - is there any risk to me? 

Would her masturbating me with her vaginal fluids on her and my  hand be an HIV risk to me with genital warts? What about any other STD's? Do I need any HIV testing? Thanks a lot for your to,e. 
38 months ago
Just wanted to add I had a hangnail on my finger that had a little bit of dry blood on it from an injury earlier in my trip possibly that day I am not certain. I know fingering even with cuts is no risk but I just want some reassurance. Thank you so much. I am so worried and feel guilty I already feel all of the symptoms and it has been less the 48hrs just to give you an idea of the kind of person you are talkin to :( 
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago

Welcome to the Forum.  This was a no risk exposure.  Even in areas where the infection is common, most commercial sex workers and other members of higher risk groups do not have HIV.  Even if your partner did happen to be infected, there is still no risk to you from the activities you describe.

There is a lot of understandable concern that comes up when people hear that HIV transmission can be facilitated when persons have open sores which might act as "doorways" for acquisition of infection,  Let me try to clarify things.  There is much research that shows that when people have infectious sores such as those caused by syphilis or herpes, they are statistically more susceptible to HIV than people who do not have these infections/sores are.   In turn, many people mistakenly (but understandably) assume than any abrasion, cut, or healing sore  might act in the same way as sores caused by infections.  This is not the case.  When the infections I mentioned cause sores, the infectious process results in larger numbers of target cells for HIV infection to be present in lesions and this is much of the reason that these infections enhance risk for infection- more targets for infection.  The sores which result from chaffing, recent cuts, rashes, treated warts, etc. do not meaningfully increase risk for infection. The same is true for your healing hang nail.  Further, in your own case, the risk is even lower (if you can be lower than close to zero risk to start with) because the HIV virus (as well as other STIs) is not transmitted by the transfer of genital secretions from person to person on the hands.  Mutual masturbation regularly results in transfer of genital secretions from person to person yet there are no instances in which HIV has been transmitted from person to person in this way.  You are not going to be the first.

The exposure you describe was no risk for HIV or for other STIs. there is no reason for concern and no reason for testing of any sort.  I hope this comment is helpful.  EWH

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38 months ago
Dr Hook,

Thank you so much for your quick reply. You have lowered my anxiety level considerably. Just want to ask you one follow up question and then I can hopefully put this behind me. 

You mentioned healing Genital warts, however my warts are certainly not gone and still have several weeks of treatment with the solution my dermatologist prescribed. I'm not sure I would call them open wounds but worst case scenario is there any risk and any need for testing? 

Secondly, I am almost positive that no frottage occurred, as I was exceptionally careful and I am 10000% sure there was no penetration. Would frottage with genital warts, in the worst case scenario, change your risk assessment? You are absolutely positive I am not at risk? 

Thank you so very much for the service you provide in educating people about how to stay safe. Have a fantastic weekend.
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Sorry if I was not clear on this.  The presence of partially treated genital warts does not increase your risk for HIV or other STI from the exposure that you have described.  Frottage would not change your risk in this setting either.  Take care.  EWH
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38 months ago
Thank you Dr. I really appreciate your help. Just to confirm everything I described is a no risk situation with no need for testing correct? Wow HIV sure is a hard virus to catch. I am amazed at the worldwide epidemiology. Really appreciate what you do here. Just out of curiosity, in the past I read your forum on Medhelp. Why did you and Dr HH switch over to here. It was very difficult to find! All the best wishes to you for your help. 
38 months ago
Sorry and last thing. Still no risk even though the treatment irritated the warts? They are being treated with podofilox solution. Here in the UK it is called Condyline. 
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago

MedHelp changed owners and the current owners chose not to continue the Expert forums

Your question about HIV risk is repetitive.  I have already told you that the fact that your warts are irritated by podophyllin treatment still does not put you at risk for HIV from the exposure you describe.  EWH

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38 months ago
Thank you Dr. Hook. I'm not sure why I can't accept the fact that this was a no risk situation. It's just my guilt and this is the wrong forum for that. The Podofilox treatment actually causes breaks in the skin. I am so sorry to ask one last time but that would make no difference as well right? Thank you for all you do. 
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago

MedHelp changed owners and the current owners chose not to continue the Expert forums

Your question about HIV risk is repetitive.  I have already told you that the fact that your warts are irritated by podophyllin treatment still does not put you at risk for HIV from the exposure you describe.  EWH

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38 months ago
Doctor I'm sorry to bother you again. I just need reassurance one last time. I am so worried. You are 100% confident that from everything I described to you there is no chance I could have contracted HIV or any other STD's? I feel so guilty I have a fiancé and am to be married. I don't want a mistake like this ruin my life. I feel so guilty. It is literally impossible that I contracted HIV or anything else correct? 
38 months ago
It's only been 2 days I already have throat and muscle pain and I know it's not ARS but I can't get this out of my head. Sorry :( 
38 months ago
And very last thing sorry the nail still had a little dry blood under the nail bed I am very anxious and bite my nails constantly even if it had happened quite shortly before the incident it would still be no risk? Sorry and I promise this is the last question. Really appreciate your patience. 
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
I understand.  Guilt and anxiety related to it can have a powerful impact on our perceptions of signs and symptoms, leading us to detect sensations that would otherwise be overlooked and then mistakenly attribute them to diseases that are really not present.  No change in my assessment or advice.  EWH
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38 months ago
Doctor thank you so much for replying. I understand this was a no risk situation with no need for testing. It is just guilt that is manifesting itself in symptoms. In your experience is it better to just come clean with your partner? Also I just want to confirm you saw my post about the nail and blood before your last reply.  Thank you again. All the best. 
38 months ago
My doctor offered me the HIV Rna test it is nearly 500 dollars here in the UK. He said it would ease my mind. What is the window period for this test? I understand you are certain that I don't need it. I am just so scared. It seems logical that if a genital wart comes in contact with vaginal fluid HIV can spread I just feel like I will be the first. I have had HIV phobia for a long time. 
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
If you have $500 to waste, I suggest you just light it on fire- that way you don't have the inconvenience of having to go to the doctor or having your blood drawn.  Better yet, use it to see a mental health professional to help you address your guilt and resulting anxiety.  I say this out of compassion, nothing more.  No test would provide a totally reliable result two days after an exposure.  EWH 
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38 months ago
Doctor Hook,

Thank you for your honesty. I feel terribly guilty about what I have done. After logically thinking about it - HIV is not my issue. It is the underlying guilt of my actions. If a true expert in his field such as yourself can assure me that there was no HIV risk, I need to accept it and move on. This is clearly an activity I should not be engaging in as I can not handle the emotional repercussions of my actions. Thank you for your patience and your blunt advice. I know it is meant kindly. I completely understand I need no testing and had no risk. I need to deal with the psychological and guilt issues. Thank you once again and all the best. 
38 months ago
Doctor I am freaking out. I have been feeling sick for the past day. Headaches, throat pain, back pain and congestion. Is there anything I could have caught? I forgot to mention there was some kissing with tongue. This is not a risk for sur right? Sorry I am just very scared and my fiancé is growing very suspicious at my behaviour and the fact that I do not want to have sex with her. Am I safe to do so?
38 months ago
I very frequently have sores in my mouth like canker sores and burns etc...please let me know Dr Hook. Sorry for being so annoying. 
38 months ago
Doctor even if my warts were opened up because of the treatment? They had bled earlier from this treatment I am not sure if they were open or not. It would have made no difference regardless right? Please reply to my last few questions and then you can close the thread. I feel like I have gotten more than my money's worth and I apologize in advanced for this craziness. 
38 months ago
Doctor maybe this will help. Has anyone every gotten HIV in the matter I describe? If not I think I could calm down. 
38 months ago
I would happily pay again to get your opinion Dr Hook. I am sorry for bothering you. 
38 months ago
Doctor H - I have calmed down and accepted the fact that due to the genital warts I could not have caught HIV. I am sill really concerned about the fingering as the finger had blood on it. I came home and washed it off and it was not actively bleeding from what I remember but it is still scarred and red to this day. It certainly wasn't a very old wound. Are you certain I could not have caught HIV like that? I bite my nails very often subconsciously due to my anxiety. I think some reassurance on that front would help me out this behind me completely. There is a lot of mixed information online about fingering. 
38 months ago
Doctor I am just freaking out because I have gone through this 4 week wait to be tested before and it has always been negative. Are you 1000% sure I don't need any testing for this event I described. Please reply one last time to all of my questions. I am so sorry for taking so much of your time. 
38 months ago
Doctor all I would like is some reassurance on the fingering. I am concerned as like I mentioned there was some blood around the finger it was where I had bitten off/peeled the nail off. Would this have any impact on my risk assessment? Thank you so much and really looking forward to your reply. 
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago

This will be my final response.  We are supposed to close these interactions following two additional responses and we are far beyond this.  These will be my final comments.

No risk from masturbation (fingering) even if you had an open sore on your finger and in the unlikely event that your partner had HIV or any other STI.  Same for kissing including open mouth kissing ("tongue").

My sense is that your guilt has led to a state of hyper vigilance which, in turn is leading you to consider normal sensations which you would otherwise overlook as "symptoms".   Further, your fiancé knows you well enough to detect your guilt.  If she is a forgiving, level-headed person, my suggestion would be to acknowledge your mistake, to explain to her that there is no risk for STI (including HIV) from your error in judgment, and that it has taught you the error in your ways.

This thread will now be closed.  EWH

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