[Question #11636] Concerns After Inappropriate Massage: HIV and STD Risk

13 months ago

I (male) had a massage in the Middle East where the therapist made sexual advances, including touching my inner rear area. Despite insisting I remove my underwear, I kept the disposable ones provided, though he adjusted them, leaving me uncovered at times. No intercourse occurred. Ten days later, I had dull pain under my left ribcage for a day, followed by jaw pain near my right ear the next day. Concerned about swollen lymph nodes (a symptom of HIV), I panicked and had stomach cramps, diarrhea, loss of appetite and sex drive, occasional night sweats. I tested negative for HIV with a rapid test on day 14 and an HIV Ag & Ab blood test on day 16. My doctor assured me no sexual activity meant no STD risk, I worry about infection from the therapist's fluids. I have a small protruding lump below my left earlobe. HIV concerns me and affects my daily life. Any risk of STDs from this incident?

H. Hunter Handsfield, MD

13 months ago

Welcome to the forum. Thanks for your confidence in our services.

Your doctor is exactly right: no sex means no risk. There was no possibility of catching HIV or any other STI from the events described. In addition, your symptoms are not typical for a new HIV infection. You did not need testing for HIV and I would have advised against it. That said, your negative test results are reassuring, although not conclusive. The AgAb test detect around 80% of new infection by 16 days.

For the reasons already stated, you don't need any more HIV tests. But if you feel you need a conclusive blood test, have another AgAb test 6 weeks after the event. In the meantime, if you have a regular sex partner, you can safely continue your usual contacts with that person. And of course see your doctor again if your symptoms continue or you remain concerned -- but you can. be 100% certain HIV is not the cause.

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

HHH, MD

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12 months ago

Thank you, Doctor, for your response.

After considering your advice, I felt reassured and decided against pursuing further tests. The symptoms I previously described have subsided, and I feel like I am returning to my normal self. However, I now can't help but entertain the "what if" scenario. Specifically, I find myself worrying about the possibility that the massage therapist might have been engaging in inappropriate behavior, such as pleasuring himself, and that his bodily fluids could have been inadvertently transferred to me while I was unaware. Though there was no sex act involved whatsoever.

I realize that this line of thinking is irrational and is likely fueled by my heightened sensitivity to my own bodily functions. I find myself constantly checking for any lumps or lymph nodes around my neck, interpreting normal sensations as symptoms of something potentially serious.

Is there a risk of infection if his bodily fluids were present on my hands and I subsequently washed my genital area with those same hands? Thats because during the massage, I felt his pants brushing against my hand and after the massage ended, I took a shower before washing my hands.

H. Hunter Handsfield, MD

12 months ago

I don't know what advice you expect or hope I might have. All we can do is provide science-based facts and understandings; we are not psychologists and make no effort to deal with the emotional or psychological issues involved in STI risk. I agree your thinking, if not irrational, obviously shows an obsession with risks that don't exist. Nobody ever gets STDs by the events you are worried about. Whether or not his hands had semen or other body fluids, or your hands did, did not put you at risk.---

12 months ago

Dear Doctor,

Thank you for reply, I apologize if my last reply was anxiety driven. I am now seeking advice based on symptoms that I now dealing with that might be related to what I have been through. Now almost 4 weeks after my encounter at the massage place, I have a sudden sore throat, the stomach cramps came in as well, the doctor attributed this due to a viral/ bacterial infection and prescribed a course of antibiotic for it to clear. When I took the antibiotics for 2 days I developed severe case of diarrhea also one lymph node on the side of my neck was swollen. I have no fever and no rash just general fatigue.

In a panic, I went to the ER, where the doctors dismissed the possibility of an STD and advised against testing. They explained that this is a normal side effect of the antibiotics. I requested a CBC blood test instead which they agree to do and everything came back normal except for the white blood cells count which was on the lower side of the normal range

12 months ago

Based on the symptoms that I think very close to HIV symptoms, I do have few questions:

1- Was there a chance that I was infected based on transfer of bodily secretions without penetration?

- I am concerned about the potential for infection through non-penetrative contact.

2- Could there be an infection if I had a cut on my back that I was not aware of?

3- Could I be intentionally infected with a needle without me knowing during the massage? I did not feel any sharp objects or notice any scratches, but I am concerned about the possibility of exposure to infection through such means.

I would like to request an STD test for reassurance, but the doctors I’m seeing now are denying any further testing and advising against it. The onset of the new symptoms has been draining me mentally. I thought I had closure to this situation based on your previous advice and I sort of did and moved on with my life. Thank you for your assistance and guidance in addressing these concerns

H. Hunter Handsfield, MD

12 months ago

I agree exactly with the ER doctor(s): your symptoms did not suggest HIV or any other STD. And I also would not have agree to your request for STD testing in absence of risk. There was no good reason for the CBC (and I'm a bit surprised they went along with that request!) but I'm glad to hear about the normal result.

"1- Was there a chance that I was infected [with HIV] based on transfer of bodily secretions without penetration?" Nope.

"2- Could there be an infection if I had a cut on my back that I was not aware of?" No chance. Exposure of cuts rarely if ever transmits HIV, despite alarmist information easily found online.

"3- Could I be intentionally infected with a needle without me knowing during the massage?" Irrelevant. You know this didn't happen.

I have no other advice. However, having started down the path of HIV testing (i.e. already tested at ~2 weeks), for reassurance I would advise you to have a final (conclusive) AgAb test 6 weeks after the massage. In the meantime, do your best not to worry; your symptoms make no difference. Perhaps it also will help you to know that in the 20 years of this and our previous forum at MedHelp.org, with thousands of questions from persons worried about HIV, nobody has yet turned out to be infected. You will not be the first. If and when if finally happens, surely it will be from a genuine exposure (think unprotected anal sex between two men) and without atypical symptoms that don't fit with HIV.

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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