[Question #1248] Oral Sex Encounter

60 months ago
I am a male and exactly 3 weeks ago a had a regular massage with a chinese male and during the massage he decided to force himself onto my penis and started sucking briefly until i stopped him. Then after the massage i masterbated by myself and finished it off. I do not know his hiv/std status, nor could i figure out whether he has gum disease, cuts or sores. He was rather sweaty though!

My penis possibly due to regular masterbation usually has minor cuts and very sensitive skin as when i showered later that night my penis did get a bit irritated from the water possibly due to some small cut down there which got me terrified even more.

One week after the above incident occured i noticed some burning when urination so waited till fourteen days past and then took gonorrhea and chlamdia and tract infection testing and results all came back negative and doc says its dehydration.


Ever since the above incident i have had sore throat, dry mouth, itching in the neck area with some redness.

 On a second incident three days ago i noticed a very small single bump perhaps two centimeters wide which was painful originally only when pulling my hair and now the pain seems ok but same size bump is still there and its location directly on top of right ear which appeared after i got a head and neck massage by another masseuse. 


My questions are as follows


Do you think the above incident requires hiv testing and i was a hiv risk

Do you think i require any further testing from the ones mentioned above

Can hiv be transmitted through having a normal head massage with the massuese possibly having a cut on her hand and me having a cut in my head even though i didnt witness any blood or cuts on her hand or should i move on and stop doubting

Thanks doctor in advance as i am very worried and concerned individual





H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
60 months ago
Welcome to the forum. Thanks for your question.

Oral sex is safe sex in regard to HIV. There has never been a proved case of oral to penis HIV transmission (despite some claims of it, mostly by people who really don't know when and where they were infected). In addition, one analysis by CDC estimated a risk of 1 in 20,000 if the oral partner is infected. That's equivalent to receiving BJs by infected partners once daily for 55 years before transmission might be considered likely. Hypothetically, having cuts or nicks on the penis might increase this risk. But with no proved cases at all, it's obvious the risk remains extremely low, probably still zero for practicall purposes. Also, going to your closing question, HIV cannot be transmitted by massage or the sorts of contact you describe.

As for your symptoms, they are not at all alarming in regard to HIV, which is not a likely cause of any of the symptoms you mention. The skin bumps sound like folliculitis or pimples, which would not be caused by HIV. I'm sure your massages were coincidental, i.e. not the source of any of your symptoms.

The gonorrhea and chlamydia tests are highly accurate, so you can trust those negative results.

From a strictly medical standpoint, you don't need any further testing. However, most people who become worried about HIV continue to lose sleep over it until and unless they have definitive testing. So for reassurance, you probably should be tested. Wait until 28 days after the last exposure you are concerned about, then have a 4th generation blood test (also called "duo", "combo", or antigen-antibody test). At that time, or any time later, the negative result will be conclusive.

The bottom line:  you really not be worried about any of this. Get tested for HIV if you will find the result reassuring. Otherwise, move on without further concern.

I hope this has been helpful. Let me know if anything isn't clear.

HHH, MD

---
60 months ago
Thank you for your in depth and specifc reply - very much appreciate the way this forum responds to everyone specific case. 

My follow up questions would be:

1) anxiety and putting losing sleep to the side , if you were in my position would you go for hiv testing or shall i just move on ? I was super positive when i was reading this forum prior to my question as it looked like from similar cases i didnt need hiv testing but from what i understood is from your response i might of been exposed even though its low risk? Sorry slightly confused.- im a kinda black and white guy if you get me - excuse my ignorance.

2) i forgot to mention that i have some molluscum do you think this increased the risk?


Thank you so much doctor for your time and responses.



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
60 months ago
1) For sure I would not be HIV tested if somehow I were in your situation. You may have a "black and white" approach to things, but with any sexual contact, there is no such thing as an absolute yes/no HIV risk. As I said, there have been no proved oral to penile HIV transmissions, but that doesn't prove it can't happen. But the odds are extremely low, as I said above. And as I said, you are free to be tested despite the virtually zero risk exposure. At least that outcome (duo test at 28+ days) WILL be "black or white", i.e. conclusive one way or the other.

2) There are no data on this, but I doubt molluscum contagiosum increases the risk of HIV if exposed. If it does, it's probably by a trivial amount.

Thanks for the thanks. I'm glad to have helped.

---
60 months ago
Thanks doctor for again a well informative reply.

Just some final follow up questions:

1) getting bit nervous now- do you think in your experience the hiv test should come out negative based on the above single  exposure?

2) some say wait 3 months but i believe you have suggested 28days- i cannot go through this 3months thinking about this as it will kill my inside morale and put me moody and down :(

I am in 2 minds- one that says it was zero risk and as you say there has been no case of oral-penile and the other says go get tested because it looks like you are indirectly saying i was under some risk or is that me just overthinking and not understanding you??


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
60 months ago
1) False negative tests do not occur as long as testing is done sufficiently long after exposure.

2) Three months is old news, based on the earliest (first and second generation) HIV antibody tests. 1 months is sufficient with the 4th generation tests.

You are overthinking it. Re-read my comments above, accept the reasoned, science based reassurance I have given, and don't split hairs. If nobody in the world has ever been known to acquire HIV from this sort of exposure, do you really think you'll be the first?

That completes the two follow-ups and replies included with each question, and so ends this thread. Please don't be tempted to post another about the same exposure and testing. The replies wouldn't change!

Best wishes and stay safe.

---