Hey there, I’m not entirely certain whether or not I’ve had an HIV exposure today and was wondering if my situation warrants PEP. I visited a Thai massage parlor where the massages they offer are done completely nude with body to body gliding. Long story short the masseuse’s vaginal labia slid a few time on my penis and glans (I’m uncircumcised but glans was exposed during this). I was wondering if the possibility of her vaginal secretions coming into contact with my urethra/mucosa or microtears invisible to the eye would be a cause for HIV concern and given the fact that I don’t know her status if I should rush for PEP. There was no penetration of any kind, and I could not see any blood, just a manual “finish” at the end. Any help is appreciated, thanks.

However, what I can say is that nobody has ever been known to get HIV sexually without penile penetration. "Body gliding" and even direct genital-genital contact without penetration carries little or no risk. The presence or absence of "micro tears" make no difference; and I have never heard of such a thing that would be "invisible to the eye". If not visible, it would not be possible to catch HIV by such contact. And hand-genital contact ("manual finish") also is risk free. This event doesn't even warrant HIV testing.

You'll have to use this information to help with your own decision whether to see a provider who might consider prescribing PEP. But if somehow I were in your situation, I would not feel a need to see anyone or to seek PEP.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

I appreciate you taking the time to respond. My question was merely to find out whether there had been an actual exposure today from the situation I mentioned and if said situation warranted testing and/or starting a course of PEP. I am relieved to read it does not in your reply. There’s one last thing I am uncertain of in your reply when you state “little to no risk”; would you be so kind as to clarify the “little”? I look forward to letting go and obsessing over this occurrence that has riddled my day with anxiety today. Thank you kindly. 

Does that help?

body massage on me completely nude. She slid over my body with hers and her genitalia slid over my penis shaft and glans. Now what I forgot to ask is the following: I am prone to irritations on the glans and foreskin (uncircumcised), could this make me more susceptible to HIV transmission in my scenario? Secondly, I have some acne on my back and chest that are tiny yet it came to mind that if they broke/popped while she was massaging and a tiny amount of blood came out inadvertently and while sliding over my entire body with her genitalia, could these have been an entry point big enough for HIV? I have spoken with the local sexual health authority and my primary who have both said that PEP was not warranted because of the risk being small. I do appreciate any clarity and reassurance you could give me though. Thanks again 

Now I have read beyond the first sentence. Guess what? Skin irritation or rash, acne, and similar things do not significantly increase the risk. HIV has never been known to be transmitted by skin-to-skin contact; and if you think about it, there must have been billions of massages (including full nude body rubbing) in the presence of such skin problems -- and still no known HIV transmissions.

It's nice to know you have been in touch with your "local sexual health authority" and your primary care provider and that both agree with my evaluation and advice.

That completes the two follow-up exchanges included with each question and so ends this thread. Do your best to stop overthinking this simple and straightforward issue. And trust me on this:  nothing will come to mind that has any possibility of change our opinions and advice., and repeated questions on the same topic are discouraged -- so please don't start a new thread about this exposure. Thanks for your understanding.