Questions:

1. Am I at risk given my cuts or bumps?

2. Should I get an HIV test?

3. Can the use of lotion reduce viral transmission risk?

After reading the consultation, it seems unclear.

* Shaving wound on my pubis and near my anus.

* Blisters and peeling on my penis.

I fear that the massage therapist may have had cuts on his hands and may have touched my wounds, causing the skin on my penis to peel.

Scanning your two questions and Dr. Hook's replies a year ago, and from this question, it seems you have a greatly inflated view of the likelihood of HIV transmission. The bottom line is that sexual transmission rarely occurs (maybe never) in absence of direct penile penetration into a partner's vagina, rectum or (rarely) mouth. Infection requires exposure to far more HIV virus than could occur with the events you describe here. (When an HIV infected male ejaculates inside the vagina -- with semen containing billions of HIV particles -- the women's chance of becoming infected is only one chance in a thousand.) There was no risk to you from these events, even if your massage partner had untreated HIV. And no, superficial nicks and cuts, like from shaving, are not known to increase the risk. I would advise against HIV testing.

My greater concern is that you might have genital herpes -- by far the most common cause of otherwise unexplained penile "blisters" or "scabbed bumps". Have you ever been diagnosed with herpes? Has this sort of problem happened previously? Especially at time when you haven't recently shaved the area? Genital herpes due to HSV type 2 increases the risk of HIV if exposed -- but that doesn't include the kind of exposure you had with your massage partner and so it doesn't change my advice. But do let me know if you'd like to further discuss these symptoms and the possibility of herpes.

In the meantime, I hope this information is helpful.

HHH, MD

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Dear Doctor,

Thank you very much for your reply.

My main concern was about HIV because of the shaving cuts and the peeling of the skin on my penis, combined with the massage worker’s bare hands. — thank you for reassuring me, I will put this worry behind me —

As for herpes, I have never had symptoms like the typical herpes blisters (which burst, become painful, and ulcerated). In my case, it is more like mild peeling of the skin without pain. The spots are about the size of a sesame seed, and when I scratch them they flake off, without pain or pus. I should also note that I had noticed this before this encounter, several months ago. It tends to appear for a period and then disappear.

Could you kindly guide me on what this condition might be and whether I should seek further evaluation?

⸻

I apologize, Doctor, as the term “blisters” may be understood differently from one person to another.

In any case, Doctor, we conclude the following:

1. HIV is unlikely in my case, which involved masturbation by the massage worker and rubbing of my anus while I had shaving cuts and peeling on my penis.

2. Herpes is also unlikely because I have not experienced its typical symptoms before, and I almost have none now. Only if the peeling increases, I will consult a dermatologist.

Is this correct, and can I move forward?

1. Your first statement is correct.

2. Your second is not. Herpes is highly variable; "typical" symptoms and skin lesions probably occur about 60% of the time. Up to 40% are less typical. I'm not saying you have herpes, which usually doesn't cause "peeling". But I agree it makes sense to see a doctor if the symptoms continue or recur again. Otherwise, you can "move forward" without worry.