[Question #11467] Handjob risk and Condom / Latex glove / PrEP

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14 months ago
Hello Doctors,
I go to massage parlour from time to time to relax and sometimes ended up with happy ending (handjob only and the masseuse was fully clothed, no oral nor penetrative sex).
My question is:
1) Is there any STD, including HIV, I can catch from this kind of encounter?
2) Do you recommend additional layer of protection for the handjob? For instance, I wear condom, or the masseuse to wear latex glove, or taking PrEP?
3) I have read some information regarding hand-genital STD transmission from Dr. Handsfield on healthtap website stating that "hand to genital STD transmission could happen in theory, but it does not happen with any measurable frequency", and also Dr. Hook on medhelp website stated "Despite the theroretical risk, this does not occur with any meaningful frequency".
I'm quite confused from this statement. Does this mean you have seen this kind of transmission case once in a while during your years in this field or it has never happened at all?

I really like the massage and the happy ending, so I don't want to avoid it, but I just want to be sure what I'm getting myself into. Hope you can clarify them for me.

Thank you in advance.
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H. Hunter Handsfield, MD
14 months ago
Welcome to the forum. Thank you for your question and your confidence in our services.

Responding only to the title you chose for your question, before reading anything else:  hand-genital contact rarely if ever transmits any STD. Probably you are not at risk for anything. Now to your specific questions:

1) No. STDs and HIV are not transmitted in this way, even if a partner uses genital fluids for lubrication. Not enough STD viruses and bacteria can be carried over, and contact with intact skin (on the penis or anywhere else) is risk free.

2) For those reasons, few if any experts advise condoms or other barriers for hand-genital contact. Of course you are free to do that if you would worry less after such an event, but it really isn't necessary.

3) I agree exactly with my and Dr. Hook's statements on those other health information websites. They are consistent with my replies now. I am unaware of any actual known cases of HIV or STDs being transmitted by hand-genital contact, even if it is theoretically possible.

So all is well. You really need not be worried about such events. My only advice is that many men in such situations end up tempted and accepting offers of more advanced exposures, like vaginal or oral sex. It probably would be wise to have condoms with you in case this happens and the massage worker doesn't have condoms available (although probably most of them do.)

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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14 months ago
Thank you for the detailed respond Dr. HHH,

I have some follow up question regarding the answer number 1) and 3)

1) So basically if the penis shaft has no cut and skin is intact, then it wouldn't allow any bacteria or virus to enter correct? Thought the shaft also consider as mucuous membrane which is also the receptor of all the virus.

3) I'm sorry but still quite not clear, so the transmission does occur right even it is rare, as you said one chance in many millions. May I ask, is there any of your patient claim they got STD from handjob, and if so, which STD is it?

I just want to know if it is 'no risk' or 'extremely low risk', so I can decide whether I will continue to do this.

Also wanted to say thank you for the information you have provided on this page in different circumstances. It helps educated us a lot just by reading your past answers.

Thank you in advance.

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H. Hunter Handsfield, MD
14 months ago
1) Mucous membranes only line internal cavities; skin anywhere is not mucous membrane.

3) Sorry, such a distinction is not possible and unnecessary. I am unaware of any proved cases, but biologically it is conceivable. This isn't worth obsessing or worrying about! There is real risk you will be hit by a meteorite, but I would not advise you to take precautions against it.
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14 months ago
Noted Dr. HHH

One last question,  I used to get tested routinely as all sexually active people should do, but I just don't do penetrative sex casually anymore. So, would you still recommend yearly routine STD/HIV testing if along the year, the activities I do are only handjobs.

Thank you
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H. Hunter Handsfield, MD
14 months ago
Entirely your choice. From an objective risk analysis, no need. But you're in a good habit and I see no need to change; and the tone and style of your questions suggests you might benefit from knowing you have tested negative. If so, continue to test every year or two, or maybe after something like every 10-15 such exposures (?). But please limit to urine for gonorrhea/chlamydia and blood tests for syphilis and HIV. All other tests are for infections so unlikely it makes no sense, and/or the tests themselves are not sufficiently accurate to justify them -- high risk for misleading results. No tests for HSV or viral hepatitis, and for sure not urine for ureaplasma, mycoplasmas, etc.

That concludes this thread. Best wishes and stay safe.
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