[Question #1270] Risk assessment

47 months ago
Hello doctors,

I'm grateful for the service you provide to us anxious minds.

Yesterday I contacted a masseuse from an advertisement website, during the session I was lying on my back and she was on top of me, both of us were naked and she started rubbing her vagina against my erect penis vigorously until completion, I'm not sure as to if a brief penetration could have happened during the rubbing but I'm sure the tip of my penis was involved in it (meaning she was sliding from the base to the tip and back), my memory of the encounter is now clouded with anxiety I can't think straight regarding the facts. The whole session must have lasted 15 minutes.

My questions :
1) Do you consider this to be a risk for HIV ?
2) Right after the encounter I panicked and rubbed my penis with hand sanitizer and I felt burning in the shaft, does that mean that I have cuts and that they would contribute the the infection ?
3) I'm not sure if the tip of my penis actually went in or not as I couldn't keep eye contact with it, let say for the worst that it went in but just the opening, what does my risk become ? is it the same as unprotected vaginal intercourse?
4) She used baby lotion on my penis before the frottage, would the baby lotion kill the virus on contact and thus decreasing the risk ?
5) During 10 seconds of the frottage we were in a position where she was rubbing her lower abdomen on my penis and it hurt because of her shaving the hair was sharp but I didn't bleed, can that be the cause of the burning sensation felt with hand sanitizer and would it increase risk ?
6) can any other viral std like Hep B be transmitted like that?

I'm really anxious about this, I can't find sleep and the not knowing part is the most difficult, I  now have to wait at least 2 weeks before taking RNA test and at least 4 weeks for HIV DUO, I don't know how I can last all this time in the current state of mind, is there anything else I can do?

Thank you doctors. 
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

Welcome to the Forum.  You are asking questions which can only be answered with a knowledge of whether or not penetration occurred.  My guess is that it did not and that this was a no risk exposure and that had penetration occurred, you would have known.  Answers to your specific questions below:

1) Do you consider this to be a risk for HIV ?

Even if penetration did occur, which I doubt, this was still a statistically low risk event.  Few masseuses and commercial sex workers have HIV (or other STIs) and even when they do, a single unprotected exposure rarely ( once in every 1000-2000 episodes) leads to infection.  If there was no penetration, there was no risk at all.  I would not worry if I were you.


 2) Right after the encounter I panicked and rubbed my penis with hand sanitizer and I felt burning in the shaft, does that mean that I have cuts and that they would contribute the the infection ?

No, the burning is due to the alcohol in the hand sanitizer and the delicate nature of the skin of the penis. 


 3) I'm not sure if the tip of my penis actually went in or not as I couldn't keep eye contact with it, let say for the worst that it went in but just the opening, what does my risk become ? is it the same as unprotected vaginal intercourse?

See above.


 4) She used baby lotion on my penis before the frottage, would the baby lotion kill the virus on contact and thus decreasing the risk ?

There are no data on the effect of baby location on the infectivity of HIV or other STIs.


 5) During 10 seconds of the frottage we were in a position where she was rubbing her lower abdomen on my penis and it hurt because of her shaving the hair was sharp but I didn't bleed, can that be the cause of the burning sensation felt with hand sanitizer and would it increase risk ?

The shaving may have contributed to the sensation you experienced.  See above.

If I were you, I would not be worried about this event.  If you are (and it seems that you are) you could return to see the massurese and ask her about her HIV (and other STI) status and when she was last tested.  Most people tell the truth.

I hope my comments are helpful.  Please don't worry.  EWH


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47 months ago
Thank you for your reply, I'd like to use my follow up question to learn more.
If my urethra was rubbing against the opening of the vagina, then vaginal fluid getting out would be pushed into the urethra, and its contact with outside environment would be insignificant. isn't it usually the condition necessary for infection to occur ? 
She was really wet as I recall.

Thank you Dr Hook, your first reply has brought some ease to my mind, I just want to make sure we are talking about the same thing.
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

You are working to make distinctions that really serve no practical purpose.  Either there was penetration or not.  Getting vaginal fluid on your penis is not a risk factor - period.  This not a nuance or qualified answer.  If your urethra (what you really mean is your penis- your urethra goes where the tip of your penis goes!) went into her vaginal, there was penetration.  if not, there was no risk!

How wet the masseuse was is really irrelevant and, I would point out, that what you consider to be "her" lubrication may well have been the lotion she used as lubricant.

EWH

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47 months ago
Thank you for your answer.
So to summarize what you said and close the thread (correct me if I'm wrong):

- If penetration occurred I will certainly know it as the difference is clear
- If penetration occurred then risk becomes 1/1000-2000 regardless of the conditions
- If penetration didn't occur then regardless of the conditions of the frottage and all the situations I'm imagining I have no risks

To finish I have 2 questions for the future :
1) If I take an RNA test 2 weeks post exposure can I be confident that it's results are conclusive ?
2) Testing is for my fears only, and in a situation like this I don't need testing and can resume my monogamous sexual life ?

Thanks again doctor, you've been of a great help.

Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

You are correct, this is the 3rd and final response to this thread. the thread will be closed later today.

1.  Your summary is correct.

In answer to your further questions:

1.  An RNA test at 2 weeks is very strong evidence that you did not acquire HIV from the exposure you described.

2.  Correct, I see no MEDICAL reason for testing at all.

I wish you the best.  EWH


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